eHealth – transformational or just hype?
The world of eHealth (aka healthcare technology, healthcare IT, digital healthcare, E-health, telehealth and encompassing mHealth) is a rapidly evolving landscape of interwoven technologies, systems, data, informatics, applications, communication services and devices. Analysing current, emerging and future eHealth trends is akin to a sport with many strategic observers; Gartner, McKinsey and Accenture to name a few, calling the race for healthcare’s digital future.
What’s making news?
A scan of recent eHealth news sources reveal that the following topics are among those making headlines (in no particular order):
- Mobility/mHealth – BYOD, mobile devices, telehealth, point of care technologies, proliferation of mHealth apps including specialist and integrated apps for example; My Film Bag (patient films online), ApreSkin (skin lesion tracking), Breathe Easy (asthma management) to name but a few
- EMRs/EHRs – PCEHR, shared clinical records, clinical portals/viewers and other EMR related implementations in acute care (driven by HIMSS EMR Adoption Model - EMRAM) and in other health jurisdictions (Defence, Justice, Aged care)
- Data – access and ownership, security, big data, analytics, business intelligence, cloud storage, standardised terminologies and classifications
- Interoperability – open architecture, HL7/CDA/FHIR integration standards, shared identifiers and identity management
- Patients online – Patient portals, wellness/fitness apps, wearable sensors (personal monitoring devices), online appointments & scheduling, SMS reminders, social media, access to health information
eHealth trends tend to change rapidly with ‘next big thing’ predictions (otherwise known as the ‘hype cycle’), ensuring each prediction barely lasts out a year or fades to a slow burn. However, it is also evident that while some technologies such as robotics and 3D printing are in their infancy in healthcare, other technology driven innovations like electronic health records are reaching maturity in their design and adoption, and it’s about time!
What’s driving eHealth?
Gazing into the eHealth crystal ball, commentators uniformly agree that health information technologies and their adoption will be driven not only by the ongoing need for safe and effective healthcare, but also by the need for increasingly efficient healthcare delivery and that the transformational power of information technology has yet to be fully realised. But, predictive sources do not necessarily agree on the drivers and impacts of current and emerging technology trends. Accenture argues that the top three technology trends that have implications for healthcare are:
- The size and scale of digital technology - for example big data
- The shift towards personalisation and greater customisation for the individual
- The use of social networks which will be applied in healthcare in a variety of ways including gamification, telehealth and healthcare-specific social networks
Meanwhile WIPRO technologies argues that organisations choosing eHealth solutions to ensure better clinical outcomes and enhance the patient experience are actually driven by:
- Using technology effectively to save time
- Ease financial pressures by cost savings or containing spiralling healthcare costs
- Speeding revenue cycle management through electronic payment technology
- Providing online healthcare services for members, employers, providers and brokers
- Reducing administrative errors
- Decreasing the incidence of medical errors
- Improving customer experience
In Australia, technology development and adoption is also heavily influenced by legislative changes, public policy, quality and safety initiatives and funding priorities.
The traditional view that technology itself is not a driver of change, is being challenged. Clinicians are leading the push to use BYO mobile devices and cloud technologies in the care of patients, often well ahead of the healthcare organisation policy makers, health information and ICT departments. New technologies are also being deployed on hospital wards to improve the management of patient care and the flow of patients through the system. The implementation of these technologies often necessitate challenging and ultimately transforming traditional ways of working. However, in harnessing the transformational power of technology it must always be remembered that technology should never be adopted for technology’s sake, rather that any eHealth initiative must deliver measurable benefits related to efficiency and/or the delivery of safe and effective care.
Big data is being touted variously as a ‘mega trend that will change the world’, or a ‘revolution that will cure diseases’, and that organisations will need to move to cloud storage to ‘harness the hyperscale’ of exponential data growth. According to Accenture, other ‘digital trends fuelling disruption in healthcare’ that organisations will need to consider and plan for include:
- Enabling location-independent care
- New data sources for population management
- Ensuring the data supply chain
- Software as a core competency
Many healthcare organisations in Australia are not yet ready to participate in the ‘post-EHR world’, with the immediate future being still focused on planning the journey towards full digitisation and realising their near-term ICT and eHealth strategies. For some this is more about implementing and integrating existing technologies and systems such as clinical systems at the point of care; and for others it is about broader digitisation goals, for example - enterprise content management, patient flow and patient portals. McKinsey research offers some myth-busting insights for healthcare organisations wishing to begin their patient-enablement journey:
Myth 1: People don’t want to use digital services for healthcare
Myth 2: Only young people want to use digital services
Myth 3: Mobile health is the game changer
Myth 4: Patients want innovative features and apps
Myth 5: A comprehensive platform of service offerings is a prerequisite for creating value
IT adoption in health is both increasing and maturing on many fronts including the EMR adoption rate and use of mobile technologies. We can expect to see a multitude of discrete innovative technology based solutions being deployed across all health sectors. These will tend to be driven by the key challenges facing the broader health system including caring for an aging population, management of chronic disease, the need for hospitals to be increasingly efficient, population health management, personalised care planning and delivery and more health services delivered in the home and community.
However, it is becoming apparent that a subsequent wave of IT powered enablement will be required to build a fully integrated technology enabled healthcare system. Integration is still the fundamental challenge, from both technology and service design and delivery perspectives.
So, I hear some of you say, what has changed?!
Author - Valerie Thiessen, Consultant, MKM Health:
Valerie has more than 20 years’ experience in health care IT in Victoria and is the co-author of the book Project Management in Health and Community Services. She has worked extensively in strategic planning, project management and implementation of IT systems across the public and private sector.
 Bresnick Kendler, P., WIPRO Technologies, Trends in eHealth