Digital health technologies accelerate broad changes in the health sector on two key fronts: shifting the care model to preventive, personalized and participatory and the care location to anywhere, anytime. But to date, uptake of digital health technologies has been somewhat messy, with pockets of activity directed either toward a specific condition or an operational or administrative problem.
The market and policymakers clearly anticipate that the future of health care lies with digital. In the US, around US$8.1b venture capital investment was directed into digital health startups in 2018, a rise of 42% over the preceding year. The Netherlands and Estonia have made great strides in digital heath, and government agencies in the UK and the US have been encouraging advances through deep investment in digital health technologies and care delivery systems.
Nevertheless, in our four-country NextWave Health survey of consumers and physicians, consumers say there is room for innovation. At best, one in four judge their health system to be innovative compared with other digitally transformed industries such as retailers or banks. What’s more, both consumers and physicians consider that health systems lag in introducing digital health technologies.
There are five trends to understand to unlock the power of digital to improve health outcomes:
- Data will be better connected, combined and shared across the health ecosystem.
- A “digital backbone” will emerge across the industry, transforming the patient-consumer end-to-end experience.
- Workforce engagement and patient interaction augmented by virtual agents (often behind the scenes) frees up valuable face-to-face time.
- Digital underpins the shift in care location to the home.
- A demand-driven global marketplace based upon digital platforms will deliver network effects, value and benefit.
The case for change is clear, driven by a curiosity about how to meet people’s health needs by doing things better, smarter and faster and, at an acceptable cost. Thinking needs to shift to a more tactical focus: how to introduce and realize the benefits of digital technologies in a complex care system as a central pillar of business-as-usual.
Both consumers and physicians in our survey consider that remote monitoring technologies and artificial intelligence technologies will be central to health care provision within the next 10 years. The management of chronic and complex diseases will likely be underpinned by digital technologies that enable remote teams to care for people in their homes.
While a mobile device is of limited benefit in isolation, it provides real value when it’s connected to a suite of services through a platform. Both consumers and physicians expect that the smartphone will become a portal — the gateway by which we access data, make informed decisions and interact with the health care system.
What gets in the way?
While there are some clear success stories around how digital health technologies can effectively improve care quality and enterprise efficiency, there are some considerable barriers to adopting such technologies.
Health care organizations are not naturally digital natives. Their strengths typically don’t lie in building new businesses that combine digital know-how with clinical, administrative and health system expertise. A dynamic marketplace and a policy environment that requires safety and quality to be confirmed inevitably has broad-ranging barriers to uptake and diffusion. Some of the constraints:
- Big-picture policy issues concerning the definition and regulation of digital health technologies
- Differing perspectives regarding evidentiary standards (gold-standard randomized controlled trial evidence versus the “fail fast and often” approaches of entrepreneurs)
- The timing and scale of capital investment required, not to mention cost and reimbursement
Human factors such as clinical appropriateness and the fit with the patient are paramount. Key influences on digital health technology adoption or abandonment include cultural resistance to changing practice patterns, professional roles and career trajectories; clinical concerns around efficacy and potential liability; and staff and patient digital literacy.
Pressing forward with an innovation and change agenda
It was clear in our research that, over a relatively short time, health care is expected to be digitally driven. Consumers and physicians view the widespread deployment of these technologies as convenient and beneficial. A growing body of evidence suggests positive clinical and operational outcomes.
At the same time, health care systems and consumers are still learning, but are open to and accepting of vastly different new care models that are technology-driven, such as virtual hospitals. Clearly, one future and vital challenge for the health industry to address is how to retain the human touch of health care while absorbing all the many advantages that digital innovations will offer.
Health care organizations need to have more than just a strategy for innovation. Getting the technology elements right more often demands a great clarity around what is being solved and clear articulation of what success will look like.
The road ahead
A change in culture is vital. Health organizations will need to become more agile and look to build, buy or partner for solutions that bring the organization up to speed and are compatible with the organization’s purpose.
Health care organizations and health systems contemplating change will need to weigh three conditions that we believe are necessary to achieve this:
1. Creating an overarching strategy of digital transformation.
A new digital ecosystem will demand a new operating model built around digitally enabled products and services, routinely and efficiently used in daily practice. Technologies and innovation systems are needed that move services and facilities from connected, to digital, to smart.
2. Optimizing performance through agile business transformation.
Design, digital and data must work in combination to focus on enterprise performance and support operations and care delivery through intelligent automation of front- and back-office processes. Build, buy or partner to create an ecosystem to bring the best services and solutions to the patient-consumers and population.
3. Pursuing deep-seated cultural change.
Through user experience strategies and human-centered design, deeply understand the customer — the health care consumer, the physicians and administrator stakeholders. Embed trust, risk management and cybersecurity into products and services from the outset to deliver end-to-end consumer and staff return on experience.
The road ahead is shaped by several givens — people will always form the core of why health and care exists, and technologies will always improve and open new horizons. Pivoting toward a new future requires establishing a solid base of foundational and advanced digital health technologies that turn promise into practice.
Consumers are unlikely to wait for the health system to catch up — with their ever-present and always-on devices, they don’t have to.
About the survey
In 2018, EY undertook a four-country online health survey. Total respondents were 688 physicians and 8,541 health care consumers in Australia, England, the Netherlands and the United States. Physicians included GPs/primary care practitioners and specialists, and respondents worked in a variety of practice settings including solo, group and hospitals. Consumer data were weighted to reflect population and geographic distributions.