Digital Health: The Next 10 Years
There’s no doubt that technology has become part of the healthcare landscape, especially over the past 15 years. Today, no one would question the presence of a computer in a healthcare setting, or the importance of consistent and accurate electronic medical records (EMRs). In fact, patients are more likely to question why digital technology isn’t playing a greater role.
by Philippe Houssiau
We have also seen the rise of a new kind of leader who combines clinical understanding with an appreciation of IT’s value. For instance, in the United Kingdom, a new leadership role has emerged: that of the chief clinical information officer (CCIO). Many National Health Service (NHS) trusts now have someone on their senior team whose focus goes beyond implementing technology to encompassing transformation, innovation and, above all, clinical outcomes.
Just the beginning
The real impact of technology, however, has just begun. The NHS Five Year Forward View says “most countries’ health care systems have been slow to recognise and capitalise on the opportunities presented by the information revolution.” All of us involved must consider how to shift from technology adoption to technology-led, outcome-driven transformation.
We all know that healthcare spending is increasing at an unsustainable rate. The healthcare funding crisis will be solved only by shifting focus from late disease to early health. Keeping people in the preclinical stages of disease significantly reduces demand on the healthcare system; more importantly, it delivers better life chances.
Dr. Robert Wah, CSC’s chief medical officer and a former president of the American Medical Association, says, “The evolution of healthcare is that we have gotten pretty good at ‘acute healthcare,’ like broken bones and infections. We are now moving to conquer ‘chronic’ healthcare challenges (which really cost society).” The parallel for healthcare technology is that we are now pretty good at “point” solutions such as patient administration systems and laboratory information systems, but we should move to conquer systemic transformation, where the real benefits in care outcomes and per-capita costs will come.
Embracing the information revolution
Healthcare organizations have already made substantial investments, and the rate of spending is increasing. Research from Digital Health Intelligence in the United Kingdom suggests annual growth of about 6%, and there are some striking examples: George Eliot Hospital NHS Trust has built on its investment in a new EMR to support its clinical goals for dealing with diabetes patients; Ipswich Hospital NHS Trust transitioned to CSC’s Lorenzo integrated EMR; and CSC and NHS Trafford Clinical Commissioning Group co-created a new approach to coordinated care.
These initiatives have some common features. For one thing, each initiative has a clear vision for transformation and a relentless approach to improving outcomes by reducing variation. George Eliot focused on the consistent delivery of a proven approach to diabetes patients. Ipswich focused on recording information once and using it across the entire care pathway. Trafford is ensuring care coordination by sharing information across a health economy and providing a comprehensive directory of services.
In addition, the organizations recognize that transformation is achieved by change management, not technology. In each case, the leaders took a pragmatic approach to technology, making choices based on desired outcomes. This outcome-driven approach is key. Over the years, IT suppliers have often focused on products and underestimated the need for rigorous change management. Today, however, we are increasingly engaging with customers as a change partner that happens to bring some innovative technology to the relationship.
Perfecting the art of knowing
If the next 10 years are going to be about outcome-driven, technology-led transformation, then healthcare leaders need clear insights into what’s happening in both their organizations and the populations they serve. That’s the role of analytics.
The amount of information physicians need to track is now beyond human interpretation. But today’s technology is able to analyze this information to provide health insights for both individuals and wider populations.
To illustrate the potential of analytics, CSC has recently applied “machine learning” to data relating to thelength of hospital stays (see related story, page 37). The analysis identified leading indicators (the patient’s age, core healthcare providers and secondary diagnosis) for predicting the length of stay. We then built a regression model using these indicators to identify patients who might experience problems in recovery and provide insight into future costs.
Cognitive approaches to data such as this will profoundly affect healthcare, helping physicians know where to focus attention.
As healthcare begins to shift its focus from episodic, late-disease management, to a long-term health partnership with patients, new models of care will need new models of technology. This technology will enable communication and collaboration; provide insights into individual well-being and population health; and manage repeatable, end-to-end care pathways.
For healthcare, technology has never been more important.
Three Imperatives for Chief Clinical Information Officers (CCIOs)
Maximizing the clinical and financial benefits of eHealth investments
- Are your investments driving service transformation and reducing variation?
- Consider clinical electronic medical records (EMR) projects, smart scheduling and transformational consulting.
Population Health Enablement:
Enabling new care models that deliver better outcomes for populations
- Do your processes maximize the value of people, resources and assets?
- Consider partnership, interoperability and analytics.
Agile IT as a Service:
Increasing flexibility and security in business and IT models
- Is your technology enabling — or inhibiting — the transformations you need to make?
- Consider as-a-service platforms, outsourcing non-mission-critical services and cybersecurity.
SCOTT DRYBURGH is CSC’s industry lead for media.