A digital prescription for making healthcare better

There is a growing shift in healthcare thinking from treatment and cure to prevention and wellbeing. Digitalisation is key to unlocking this more holistic systems approach and with it, the delivery of better health services and patient outcomes, write Abhi Shekar and Kerry Scott.

Having a video consultation with your doctor is one of the contemporary trends in modern healthcare that has become standard practice during the pandemic.

In the years ahead we will see more routine healthcare management conducted outside the four walls of a hospital.

Technology will also make it commonplace for people with conditions which previously required hospitalisation to be remotely monitored and treated in the comfort of their own homes.

The delivery of healthcare will change – it must. When the direct impacts of COVID-19 recede, healthcare systems will still need to be strengthened in response to ongoing challenges: the complex needs of growing, ageing populations, financial pressures, chronic staff shortages, and higher patient expectations.

The ultimate goal is to move away from the current reactive ‘one size fits all’ model towards more preventative and personalised healthcare. This is the pathway to radical improvement of patient outcomes and quality of care.

A key enabler of this transformation will be digitalisation. This means far more than just automating processes, cutting paperwork and increasing efficiency. It is about using tools, technologies and data to rethink and reinvent the way we plan, design and deliver health infrastructure and services.

Digital healthcare will be attractive to many groups but there will always be a need for face-to-face appointments for those less likely to benefit from virtual consultations.

Addressing the causes of poor health

A hospital should no longer be considered as a stand-alone facility at the centre of the healthcare service, but rather as one part of a city’s wider health ecosystem. Systems thinking is critical to co-ordinate society-wide efforts to improve the wellbeing and resilience of communities by addressing the causes of poor health, not just the consequences.

Healthcare planning needs to be linked to housing, employment and other socioeconomic determinants of health. If healthcare provision is co-ordinated with other sectors – transport, business, industry, education and leisure – holistic, society-wide policies and interventions can be developed that widen access to health services and recreation, improve air quality and green spaces, and promote healthier, more active lifestyles.

What will help make this possible is smarter, integrated infrastructure, enabled by 5G networks which allow data to be exchanged, subject to consent, between actors in different sectors – between health improvement agencies, local government and schools, for example, so they can collaborate and develop joint responses, which are evidence-based, to address growing health challenges such as obesity and diabetes.

Improving the patient journey

Historically, hospitals were essentially designed to be a one-stop shop meeting every healthcare need. In the past, they have been the only option for people seeking treatment or support. In the future, with a digitally enabled healthcare system – supporting the transition towards more preventative care, and more treatment delivered in the community and remotely – hospitals will become one of several options.

This will prompt a rethink of how buildings are designed and services organised, giving us an opportunity to consider how to address inequality and promote social inclusion. A ‘good’ patient journey looks different for different sets of people. Age, socioeconomic status, ethnicity and physical ability all influence how people interact with healthcare.

Future provision will need to better reflect this, and can, if patient and social outcomes are embedded into the design and delivery of infrastructure and services from the outset.

Better data, better outcomes

Better sharing of data between acute and primary care sectors, and beyond to social care providers, is essential to provide personalised healthcare: by building up a complete picture of the medical history and needs of individual patients, clinicians and practitioners will be able to tailor treatment and interventions to meet those needs.

With better data, managers will have greater insight into how their organisation is performing and can make informed and timely decisions. This is crucial to making more efficient use of capacity and putting staff and resources in the right places to meet demand, all of which will enable an improvement in health outcomes.

Digitalisation will drive greater transparency and access of patient data, increasing people’s knowledge and confidence, and empowering them to become active partners in the management of their health and wellbeing.

Kerry Scott

Global lead for environment and society

And the provision of more information can also help people to improve their own health. Digitalisation will drive greater transparency and access of patient data, increasing people’s knowledge and confidence, and empowering them to become active partners in the management of their health and wellbeing. Those that do are more likely to adopt healthier behaviours, leading to better clinical outcomes and lower rates of hospitalisations.

Equal access to health

Providing more services outside hospitals and closer to home will make it easier for people to access health services when and how they want to, and to deliver services based on local needs.

Telemedicine and virtual services will be attractive to many groups including younger people, working adults, and those who live in hard-to-reach places or without the ability to use private transport. But those without digital devices or connectivity, or without the ability or confidence to use technology, are less likely to benefit from virtual consultations, so there will always be a requirement for face-to-face appointments. Digitalisation can be the means to address health equity and improving access, but if not deployed correctly could widen disparities in health systems.

The future introduction of technologies, therefore, should be characterised by increased choice of, and interaction with, healthcare, not by the replacement of one system with another, so that no-one is left behind. There must always be equity of access to infrastructure and services. If we abide by this principle, digitalisation of healthcare will benefit everyone.