In recent months healthcare changed as never before. In this revolution, the widespread role of digital innovation in healthcare has been fundamental in terms of creating value for patients. Emanuele Lettieri, professor at the Department of Management Engineering of the Politecnico di Milano, focused on this point. His intervention during the Digital for Clinical Days was based on the data collected and analyzed by the Observatory for Digital Innovation in Healthcare of the same university.
Digital innovation in healthcare: the need for information
Among the great changes outlined by digital innovation in healthcare in recent times, there is the detection of the great need for information felt by the citizens.
Due to the pandemic, to long days spent at home during the lockdowns and to worries experienced in terms of health risks, the number of online searches has increased significantly.
73% of citizens felt a greater need to contact the network in order to find general information relating to health or more precise data referring to therapeutic options for the treatment of disorders (COVID-19 in particular), for their diagnosis and for the self-medication management.
But beware: this is not the consultation of good old Dr Google. Lettieri notes that the public’s approach is no longer what a lot of common thinking wants to imagine, but that of serious research, carried out by citizens who want to be more active in managing their own health.
An aspect that entails the assumption of responsibility for all the actors involved in the system, such as that of providing quality information capable of answering users’ questions.
In fact, the surveys highlight the fact that citizens often give little value to information found online or do not find answers to their doubts.
The public shows the will to be directed to useful and authoritative sources by qualified health personnel, capable of gaining their trust, but doctors also have difficulty in recommending websites in which to find this type of information.
The problem therefore arises of how to offer correct and valuable communication on health issues, a theme that intercepts the interest of all parties involved.
Omnichannel digital services to the citizen
In recent months, patients have exploited the services made available by healthcare institutions like never before. 66% of them made at least one booking online, 44% a payment, but the most striking number concerns download of medical reports (62%).
These are important data, that we have been waiting for for years, and that now arrived because citizens were forced to use these services. From here on, it is important not to lose the progress made.
As for the vaccination reservation, digital channels have got the lion’s share, with a level of satisfaction with the usability of the platforms that almost reached 10 on a scale of 1 to 10. This tells us that, when a tool is valid, the public makes use of it.
The study clearly shows that those who did not use the service simply were unable to do so. The motivation is not prejudice or mistrust of digital: these obstacles have been already overcome.
From this point of view, it is therefore necessary to make available to citizens simple digital innovation tools, that wouldn’t create segregation in access due to complexity of use.
Talking about these social aspects, Lettieri expresses the hope for the creation not of a 100% digital, but of an omnichannel healthcare, able to combine digital and analog moments. There is little doubt that it is a very complicated challenge.
There is still a lot of confusion on this issue. We have to take into account that the rate of innovation among these solutions is very high. In fact, each 9 minutes becomes available in the stores a new app aimed at health and well-being.
Limiting the analysis to Apps as Medical Devices, doctors on average feel like recommending their use, especially when it comes to tools for improving lifestyle. An aspect of great interest certainly, but which presupposes a clinical validation.
The aim is to make the apps available in the prescribing portfolio of doctors, because when clinicians themselves recommend their use, it means that these instruments have become part of the treatment process. Their role can become strategic especially with a view to improving therapeutic adherence, an aspect in which the already existing solutions are not adequate to real needs.
Home as a place of care
In support of the Apps as Medical Devices, work is being done on the introduction of chatbots on one hand and voice assistants on the other.
For example, a chatbot was used as a prefilter to provide information on how to limit the risk of infection from SARS-CoV-2.
In London, the NHS used Babylon to filter access to the family doctor. However, on this point the Italian doctors are rather worried, because they believe that we do not currently have at disposal sufficiently advanced tools.
A solution to this problem could be to include clinicians in the development of these tools.
In general, there was a very positive opinion on devices that allow:
- lifestyle monitoring;
- compliance with certain dietary restrictions;
- hysical activity planning;
- preservation of sleep and mood balance.
There is still some mistrust, on the other hand, about the indications on the use of drugs.
On the front of voice assistants, the space for optimization of use in Healthcare is vast. The home, in the healthcare sector of the near future, will also be a place of care. On the other hand, we should also keep in mind that one in three families in Italy has a voice assistant. The inclusion of these solutions in the field of digital health therefore represents an incredible opportunity.
The criticalities that emerged in this regard essentially concern compliance with the GDPR legislation.
Also on this point, the positive opinion of doctors focuses on the tools that can help prevention.
Telemedicine: why not just ‘medicine’?
In the last 12-18 months we have seen a surge in the use of telemedicine tools by both family doctors and specialists and even the opening of a debate on the reimbursement of these services.
In particular, the most used tool is the teleconsultation (family doctor vs specialist or specialist vs specialist). But a significant increase was also observed in the use of teleexamination. Telerehabilitation is less used, but there is turmoil in this sector too.
Here too, the omnichannel nature of digital innovation in healthcare will be the real challenge of the coming years: it will be necessary to reorganize paths, skills and processes.
The biggest mistake we can make is to introduce new technologies over old procedures
Maurizio Colombo – Sapio Group
During the last months, doctors’ perception of telemedicine has changed dramatically and confidence has increased. 92-95% doctors now say they are open to the use of this care modality.
The hope is that telemedicine will lose the prefix (which must become a reminiscence of the past) and simply become medicine.
To achieve this goal, however, one cannot live on episodic cases, on pilot projects. The applications of telemedicine must become routine, daily practice, in order to also allow us to obtain data that let evaluate and validate these tools. And the treatment path must be completely rearranged.
In search of new languages
Technology is important, but without new skills it struggles to produce value. From this point of view, the goal is to reorganize the continuing medical education, also declined in digital terms.
It is necessary for the doctors to:
- identify new ways of communication;
- learn a more helpful use of social media;
- go beyond the scientific journal;
- act in favor of patient literacy.
In the analysis conducted by the Digital Health Observatory, the skills were divided into:
- digital literacy: the ability to use digital tools in daily life;
- e-Health competence: the ability to use digital tools for professional activities.
Doctors show good basic digital literacy, but some difficulties emerge in the use of social media, chatbots and voice assistants, linked to the reduced level of knowledge of these resources. On this point there is a lot of room for improvement.
Furthermore, although decision support systems are extremely widespread, doctors do not frame them among the main digital tools at their disposal.
In which directions to work
First of all, there is a clear need to allocate large economic resources. This aspect represents the main limitation to digitization, according to the general managers of hospitals. These are medium-long term projects, structural interventions, which require investments of a certain size, but also a serious and careful evaluation.
It is also necessary to put a hand to governance, to structure the systems’ interoperability, in order to make data available on all fronts.
But, what is perhaps most important, we need to work on digital culture, on favoring a change of paradigm and a coexistence of analogue and digital paths, and on the development of skills.