Digital health – budget considerations

Ten digital hospital trends budget holders should consider:

1. Digital innovations have the potential to hugely improve patient safety. Healthcare has been slow to adopt digital models, but professionals, managers and patients alike are now recognising the benefits of digitalisation. Immediate access to records prevents problems of interactions between medicines, and means patients are much less likely to be given the wrong medication or treatment. Use of barcodes for patients, medications and equipment means errors are much less likely to occur.
2. Moves to digital records place control with the patient, not the provider. This may be hard for some providers to accept, but it is likely to improve outcomes. Evidence suggests that patients who are more involved in their care recover more quickly than those who are not. This is also supported by a move towards patient-centred care championed in, for example, Queensland, Australia.
3. Increasingly, digital is a ‘whole hospital’ approach, with a view to transforming patient care. A model hospital being built in Queensland is designed to demonstrate the ‘future’ of digital. It suggests that harnessing technology has the potential to transform the model of care. It will improve efficiency, safety and clinical outcomes, by ensuring that professionals have all the information they need at all times. Kaiser Permanente, in the US, also supports this ‘whole hospital’ approach.
4. Lack of evidence for a healthcare app or solution does not necessarily mean that it doesn’t work. A recent article on a new start-up, Evidation, points out that because healthcare is a relatively new market for technology, it has not really had time to build up evidence of efficacy, and clinical trials may be too expensive for small start-ups. New models of trialling technology may be necessary. While evidence of efficacy will continue to be important, budget-holders may need to consider being part of pilots.
5. Adoption of digital technology in healthcare is very different from a consumer-driven model. In healthcare, there are more players, including hospitals, payers (whether insurance or government), and pharmaceuticals. The process therefore tends to be slower and more complex, not least because of the risks to patients. Budget holders should be aware that it may be harder to find examples of previous use, or evidence of effectiveness, but they should still be sure that they are confident of the technology before full-scale adoption. Small-scale pilot studies on a site-by-site basis may be necessary.
6. The use of analytics is the essential link in transforming data into insights on an individual and population basis. Analytics are increasingly being used in healthcare to pull together data from multiple sources and generate insights. A recent piece suggests that analytics could have potential to make electronic records more useful, improve work flows, and also make digital tools more useful. They can also help with analysis of population information, supporting health promotion campaigns.
7. Analytics could also reduce costs for providers. This is a claim often made about much digital technology, but the key issue with analytics is that it makes costs much more transparent. This therefore makes it easier to focus and take action on the biggest elements, or the ones that cost the most, always the most effective cost-reduction strategy.
8. Electronic patient records will soon be the norm, not the exception. More and more countries are now introducing electronic patient records. Those who are involved early in the development of electronic records management are likely to be the ones whose views are sought when national systems are developed. Coming late to the idea could be very expensive.
9. The use of technology is now ubiquitous. The number of health apps nearly trebled between 2008 and 2012, and the number of connected devices is expected to increase eight-fold between 2012 and 2017, according to data from Kaiser Permanente. Patients and professionals alike expect to be able to draw on their devices in healthcare as in the rest of their lives, and will find ways of doing so.
10. Not developing ways to use technology could therefore be riskier in the longer term. Since patients and professionals expect to be able to use their devices, they need to be able to do so safely and securely. If providers do not enable this use, patient confidentiality is likely to be compromised, and providers could find themselves in a lot of trouble, even being sued. The vast amounts of data being produced will go somewhere, and that somewhere needs to be secure.