Roadblocks on the Digital Transformation of Healthcare, by Ignacio Ayerdi

Setting the scene: Healthcare feels challenged by a perfect storm of societal changes and converging technologies

Roadblocks on the Digital Transformation of Healthcare, by Ignacio Ayerdi
Most healthcare systems around the world are struggling to deal with ageing populations and chronic diseases, more expensive treatments, rising patient expectations and budgetary constraints. Simultaneously, technology is going through some exciting changes that have led to a significant increase in the number of innovative healthcare solutions that generate, collect and analyze data. Connected Health and AI promise to make the lives of patients a lot easier.

Therefore should not be a surprise that policy makers, clinicians, patients and medical industry endorsed the adoption of a digital transformation to improve outcomes at lower costs. 

The adoption of IT in healthcare systems, in general, followed the same pattern as other industries. Initially, automate standardized and repetitive tasks such as accounting and payroll, years later the second wave arrived that helped the integration of different parts of core processes, in the case of healthcare helped to bring the electronic medical record (EMR). The first and second wave focused more in processes and less on patients and clinicians needs, even though the EMR may serve as an efficient administrative business and billing tool, and even as a powerful research warehouse for clinical data, most EMRs serve their front-line users quite poorly.

Many industries have already moved to the third wave of IT adoption: Full digitization of their entire enterprise, including digital products, processes, as well as advanced analytics that enabled entirely new operating models.

What will this third wave of IT adoption look like for healthcare? Advanced healthcare organizations are amid a radical digital transformation funding a broad range of assets- from consumer-facing apps, wearable and high-tech monitoring devices, advanced technology for healthcare workflows, to electronic healthcare records and machine-learning-backed data- for disease prevention, better patient experience and clinical excellence.

However, the journey seems to be difficult and costly.

What refrain healthcare organizations to implement successfully this transformation

This is a selection of reasons:

Interoperability. Healthcare information is fragmented and not structured because is a “silo type” organization, furthermore healthcare inherently has a local/regional character therefore it is too hard to share medical information between hospitals, doctors and healthcare organizations.

Privacy. Digital technologies- wearables, medical devices- are increasing exponentially the amount of patient data, which has led to confidentiality concerns about maintaining patient´s private information.

Regulation. Healthcare, obviously, is a much-regulated service The EU has launched recently the GDPR, which means that any organization handling the data of an EU citizen must be ready for a new era of healthcare compliance to safeguard patient information.

Resistant to change. Healthcare professionals are very eager in adopting vertical innovations (those that affect an specific activity e.g. penicillin, TAC, surgical robot,..) but are slow in adopting horizontal innovations (affect many activities e.g. wheel, electricity, internet,..)
There are strong economic incentives to keep things the same. The creators of market-leading medical records software have no reason to open the door to deeper-pocketed tech giants. For providers, keeping information trapped within a hospital or health system makes it harder for unsatisfied patients to shop around and potentially leave.

Security. The value of patient data is increasing as well, and with it, the increase of cybercrime. Security researchers have demonstrated that some implanted medical devices like pacemakers and insulin pumps can be hacked, the weaknesses could lead to injury or death.

Lack of evidence of efficacy. Difficulty to differentiate efficacious digital products from commercial opportunism. The relatively low barriers of market entry have encourage innovative small and medium size companies, often new to the Health market, to bring new products.

Uncertainty to reduce cost. The implementation of IT in other sectors (banking, travel, and others) have led to significant cost reduction, transferring costly activities- personal intensive- to the customer, whereas in healthcare is hardly doable without a major education program of the population.

Dehumanization. Concerns that artificial intelligence applications might jeopardize critical social interactions between colleagues and with the patient, affecting the lived experiences of both groups. However, concerns about physician “unemployment” and “de-skilling” are overblown.

Getting started

As with many complex transformations, at least these five elements should be taking into account:
  • Understanding what patients and healthcare personal really want. (Recent surveys from the Economist Intelligent Unit, McKinsey and Philips, revealing surprising and actionable insights about what patients and healthcare personal really want).
  • Analyze the best way to give it to them considering the investment required and the value created.
  • Add new services continually to keep patient and healthcare personal attention and build value.
  • Skilling up a workforce to use this technology to best effect. 
  • Build appropriate governance, control mechanisms and a clear framework to provide the required level of evidence to realize the potential of digital medicine.  
There is no doubt digital technologies have transformed successfully many sectors, however the health sector, in spite of the fact of huge investments in these technologies, has remained comparatively unchanged. Even considering the specificities of healthcare systems we can´t afford to miss the opportunity to transform the healthcare organizations incorporating technologies such as AI, robotics, and the IoT that will complement traditional care in the coming decades. To speed-up the process is urgent and imperative that the healthcare stakeholders work toward standardization and building a uniform platform for sharing clinical data.

Ignacio Ayerdi

Former President of Philips Ibérica; he directed the Medical Technology Division of Philips, in Iberia, for 17 years. Board Member of IMAS (Institute for the Improvement of Sanitary Assitance), president of the Advising Board of Signo Foundation and Member of the Advising Board of the Health Division of Tecnalia and the Polytechnic University of Mondragón and Carlos III Bioengineer degree. Engineer of Telecommunications. Member of Fide´s Academic Council.