How health systems worldwide can build and benchmark their digital maturity
For all the progress made over the past decade when it comes healthcare IT infrastructure and digital savvy – and despite the myriad innovations happening each day in all corners of the global health ecosystem – there are still significant gaps and blind spots in most health systems worldwide.
A look at the numbers shows that many healthcare systems around the globe "have not been achieving all of the outcomes of their mandate – which is to keep citizens healthy and well," said Dr Anne Snowdon, executive director of clinical research at HIMSS Analytics.
Consider the fact that medical errors are still a leading cause of death, more than two decades after the US Institute of Medicine's landmark To Err is Human report kickstarted efforts to consign paper-based processes to the dustbin of history.
Or that most providers are still prescribing medications that may only be useful for one in 25 patients who take them – and very few health systems have the digital infrastructure to help them distinguish exactly who should be receiving the right drugs to achieve the best value, said Snowdon.
All this, while healthcare consumers are more knowledgeable, connected and empowered than ever: "We go to school online, we bank online, we book our travel online," she said. "But healthcare and healthcare delivery models have not been as digitally enabled."
Striving for an optimal patient and provider experience
To keep pace in this world – and to make good on their mission of delivering accessible, high-quality, cost-effective care, while offering optimal patient and provider experience – global health systems "really needed to think about a transformative agenda," said Snowdon.
On 9 September, as part of the virtual HIMSS & Health 2.0 European Health Conference, Snowdon – along with colleagues Tim Kelsey, senior vice president of HIMSS Analytics International, and HIMSS chief clinical officer Dr Charles Alessi – offered insights into how health systems and ministries of health worldwide can build out that connected health ecosystem.
In the session, Digital Maturity: Improving Outcomes, Building Resilience, they explain how hospital-centric technology strategies, which don't always enable seamless connection with other key stakeholders can hinder efficiency and efficacy of care delivery.
By embracing new technologies, workflows and data-driven processes – and having more open communication with patients, their caregivers, and other support organisations outside the four walls of the hospital, health systems can drive better outcomes at lower cost.
And a valuable roadmap to help steer those strategies is the HIMSS Digital Health Indicator, unveiled earlier this year. (HIMSS is the parent company of Healthcare IT News.)
As Snowdon describes it, the DHI is "simply a measure of the ability of a health system to have the capacity to deliver digitally enabled care."
Built, in part, by drawing upon HIMSS Analytics' many existing maturity models, the DHI is meant to help health systems around the world track their progress toward digital health maturity – toward insightful, secure, sustainable and outcomes-driven care processes.
By focusing on four key imperatives – person-enabled health; predictive analytics; governance and workforce and interoperability – the tool gives organisations a deeper understanding of their position, and points toward opportunities to improve it.
"Digital health is viewed as an opportunity to optimise health system performance and achieve financial sustainability," said Snowdon. "If we could track and trace every individual patient and know who achieves value from [particular] therapies, or which medical devices work well, we could not only achieve quality and safety but also financial cost savings."
The challenges, she said, is that "when you talk about digital health, there's actually very little evidence and literature in terms of what it actually means."
Achieving real-world processes
The HIMSS Digital Health Indicator takes a methodical approach to showing how those goals should translate into real-world processes.
The DHI measures four "dimensions" of digital health maturity: Person-Enabled Health; Predictive Analytics; Governance and Workforce; and Interoperability. These are essential building blocks of a digital health ecosystem.
"At the basis, there must be strong governance and a workforce able to deliver digitally enabled care – and work in environments where data is mobilised, so they know what patients received in terms of care, has it worked or hasn't it, and how can we make sure every patient gets access to the best care possible," Snowdon explained.
Democratisation of data – "the exchange and movement and flow of data from clinician teams to patients so, as a patient, you know exactly how you're progressing toward your health goals, and you're easily able to connect to your care teams" – is another must have.
But even beyond that, it's essential to have "analytics to make sense of it, and identify outcomes, not only at an individual level but at a population level, and you have the data infrastructure for traceability – that's when you actually move toward a digitally enabled ecosystem," said Snowdon.
The post-pandemic era
The COVID-19 crisis, with its surge in demand for healthcare, workforce safety challenges, product shortages and rapid shifts to virtual care, has offered an object lesson in the value of "analysing data in real-time to proactively prevent some of these very challenging circumstances," she said.
But in the post-pandemic era too, "it will be all that much more important to be able to track and trace and know who's at risk for a recurrence of a COVID-19 infection," she added. "Which of our health professionals are at greater risk, and in what settings and what jurisdictions, of becoming infected?"
HIMSS Analytics' Tim Kelsey echoed that sentiment.
"Everybody of course is focused today on maintaining that momentum, as we either work towards resilience for potentially another wave of pandemic, or as we come past pandemic, looking forward to the future where governments and health systems are able to see where telehealth does provide a means of greater equity of access," he said.
But in the meantime, the public health emergency has shone a spotlight on the inadequacies of many global health systems as they exist today.
"The idea that you can run a health service – a safety critical industry, where quality is measured by the degree to which it avoids accidentally harming people – not running itself intelligently, not knowing just how well it's performing, not knowing what it's outcomes are, these are just no longer acceptable features of modern health services," said Kelsey.