In an ideal world, healthcare would have undergone a comprehensive digital transformation. Today’s readily available technology, such as smartphone applications, remote consulting, electronic records, wearable technology, and artificial intelligence (AI), will unite to enable effective and efficient coordination of healthcare resources, even when facing a global pandemic. Global Healthcare’s Biggest Test As well publicized, Covid-19 has put an enormous strain on healthcare systems around the world, putting a variety of challenges sharply focused. The good news is that technology offers a realistic way to address some of these issues. It could provide new ways to connect patients with caregivers. It provides opportunities to direct individuals to the care they need, rather than to stressful emergency rooms, or even to move care from healthcare facilities to people’s homes. For patients, health technology can provide greater independence and more control over their health and well-being. Here and now we are not in science fiction worlds either. The technology needed to transform healthcare is present, and in some cases, has already proven its value, in both developed and developing countries. However, in many cases, the impact was local, or regional at best. The European Union now requires that cars manufactured after 2018 have a system that automatically sends information such as the vehicle’s location, direction of travel, and the number of passengers to emergency services when an accident occurs. By facilitating a faster emergency response, this could save thousands of lives annually. People with dementia in Scandinavia are increasingly expected to wear location trackers when they leave their homes, so that caregivers and their families know where they are. These wearables can include drop sensors, which send calls for help if a person has an accident. The pandemic has seen a spike in the use of virtual care, especially video counseling, driven by the desire of people to move away from places where they are at increased risk of contracting Covid-19. India, for example, saw a 500% spike in remote consulting in the first months of the pandemic, with the majority of those consultations involving first-time users. Patient satisfaction with telemedicine has been high, with many indicating in a study by Accenture that even after Covid-19, they will receive care more frequently in this way than they were before the pandemic. Wheeled, winged and stationary robots have been used in a variety of tasks in the healthcare field. Drones bring AIDS tests to clinics in Malawi, blood to remote sites in India and Rwanda, and supplies to quarantine areas in China. Inside hospitals, robots disinfect rooms and deliver supplies, care robots provide support to patients, and robotic avatars enable people confined to their homes or families to participate in educational and social activities. The way forward These examples are only the beginning – there are many opportunities to improve healthcare through digitalization. Take patient records, for example. A great number of them are still initially written on paper, and require later copies. Then they are often stored in a single system within a single facility or provider. The shift to a fully digital electronic health record (EHR) or electronic medical record (EMR), where notes are taken on mobile devices, opens up a world of opportunities to improve care and efficiency. Electronic medical record records can be shared between medical professionals and their institutions, to ensure that the person responsible for caring for the patient has complete and up-to-date information about it. By reducing the administrative burden on medical staff, they have more time to treat patients. Distributed ledger technologies (DLTs) are another important part of the mix, as they provide a way to manage interoperable EMR databases, while protecting patient privacy and the confidentiality of sensitive information. DLTs also help formalize the governance of people’s medical records, and thus provide a way to manage permissions about how the data is used. This could mean that patients can genuinely own their health records. Many DLTs operate by storing metadata about data ownership and access rights, rather than the patient data itself, in a ledger. As more and more rich medical data are gathered, its value for caregivers and researchers will continue to increase. DLTs will help them unlock this value, ultimately to improve the care of others in the future. As AI develops further, it will open up new opportunities across healthcare. Many of these will be to assist human caregivers with tasks such as diagnosis and decision making and medical interventions, such as robot-assisted surgery. Additionally, mixed reality offers the potential to change medical education, by enabling students to physically dissect parts of anatomy. Likewise, surgeons can use it to help explain procedures to trainees and patients, and to aid during complex operations when they are in the operating room. Achieving a wider adoption of digital programs with these diverse and exciting opportunities offered. Having proven technology in medical use, what is hindering wider adoption? This topic was discussed in a McKinsey podcast by two of the company’s top partners, prior to the Covid-19 pandemic. They indicated that health care systems are facing pressure from both sides. On the one hand, there are the challenges posed by societal issues, such as population aging and the shift from long-term infectious to non-communicable and chronic diseases, some of which result from poor lifestyles. At the same time, health systems have to deal with ever-increasing costs, driven by a shift in prevalent illnesses and an increase in the prices of treatments and staff. The podcast discussed how competition, which has led to modernization and adoption of efficiency-enhancing technology in other sectors, has not had the same impact on healthcare, generally for practical or emotional reasons. As a result, cheaper or more effective treatments have failed, in some cases, to replace the established modus operandi. Ironically, this has disrupted the disruption that has led to increased efficiency in many other industries. Some of the resistance to technology adoption has come from within the healthcare sector. A truly digitally enabled health system would provide increased transparency around costs, quality and performance. The current ambiguity around costs and pricing may mean that there is little incentive for those familiar with established procedures to change to modern alternatives, even if the cost is lower. As indicated by a McKinsey report promoting digital transformation in the medical sector, adopting digital technology will require changing the culture, mindset, organizational structure and governance of those working in medical technology and pharmaceutical spaces. There is also resistance from outside the medical establishment. Individuals may not trust national health care providers, and may reserve their complete medical history in a central database. The risk of leaks or misuse looms large in the minds of many people, and is reinforced by the disclosure of information such as the recent publication of large-scale personal and medical data about patients in two US hospital chains. Another barrier to the technology transition could be patients’ general lack of interest in considering a variety of treatment options for their conditions: the discussion on the McKinsey podcast mentioned above touched on the fact that many people are happy to follow the course of their first suggested course of action. Then there are more methodological challenges. While the benefits of digital transformation in healthcare have been demonstrated, there is not always clarity about what the return on investment will be. With healthcare budgets under pressure – now more than ever – it is imperative that digital transformation shows a positive ROI. This doesn’t have to be just about cost, of course. There is already a shift underway in some countries from volume-based healthcare to value-based healthcare. The use of digital technologies and new healthcare models can help generate a positive value-based ROI. Instead of physicians and caregivers being paid based on the treatments they prescribe in a “fee-for-service” model, the value-based approach compensates caregivers based on measured patient outcomes, with an emphasis on maximizing health-related metrics and reducing the cost of care. Measuring this way requires data sensors and analytics platforms, as well as standardized metrics to measure patient outcomes. The other must-have for digital healthcare is good governance. This is critical if national authorities are to build the necessary trust among the population. It is also a vital enabler for facilities such as interoperable national EMR databases, as well as for reducing the cost of treatments and drugs, and managing and allocating scarce medical resources, both nationally and internationally. Encouragingly, 58% of WHO Member States have an e-health strategy, and 87% have implemented one or more mobile health programs. The degree to which countries around the world are able to truly benefit from the digital transformation in their health and care systems depends to a large extent on how well everything is managed. Paving the way for the future The ability to respond quickly, whether to a rapidly evolving crisis or to gradual demographic changes, is more important today than it has ever been, given the interconnectedness of the world. The COVID-19 pandemic is causing untold suffering in every corner of the planet. Will it end up being a warning call forcing humanity to raise the bar on health in national and international agendas, so that we are prepared for worse problems in the future? The goal should be to confidently advance towards the ideal world we drew above, where healthcare systems embrace opportunities for innovation and implement new ways of working that improve patient outcomes and reduce costs. If we can get to this point, the benefits for current and future generations will be enormous. By Pelle Svensson, Market Development Manager, Product Center Short Range Radio, u-blox.