Healthcare Ecosystem

Healthcare Ecosystem

The drivers for accelerating the adoption of digital technology in healthcare have, in the past, been offset by technical and organisational issues that have led to delays and put healthcare digitally behind other areas of life. In our lives as consumers, data supports our decisions and connects our world, but for patients, there are two parallel worlds: the connected world and the unconnected one.

Before we look at the patients’ journey, one symptom that is clearly voiced by patients is how disjointed the system really is.

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To address this, the many caregivers – from clinicians, family members and payers to platforms and technology – must be integrated with a shared health view, centred around the patient. Without this, the patient themselves (or their family) become the care coordinator and the shared health record!

Building A Digital First Healthcare Ecosystem

Exposure to the internet, social networks and mobile systems from an early age has created a generation comfortable with cross-referencing multiple sources of information and options while integrating digital, virtual and offline experiences. And older patients are becoming increasingly comfortable with digital solutions, too – indeed, it is often the older or more vulnerable that can benefit from new technologies.

And from a patient’s perspective, their health journey should be quite simple: they are well, or they are being treated after their condition has been diagnosed. Patients certainly expect the treatments to potentially be complicated and worrying, but not the administrative pathway.

A patient’s expectation is to access services anytime and anywhere they want, yet the healthcare system continues to pull them into an analogue world. This carries a high risk of disengagement, loss to follow-up and reduced compliance with therapies.

The Healthcare Ecosystem

For a connected patient and their clinicians and caregivers, many (and typically most) of the interactions with health providers should be digital.

Let’s look at a typical journey for a patient. The following examples show the patient’s and clinician’s concerns in the unconnected world and how these can be addressed by technology for a connected patient.

Technology: Making patients feel connected to the medical team by using app-based reporting systems which confirm to the patient that their report has been received. Robust and secure messaging and video call services can accomplish this, with potential AI and decision support systems screening cases before they are presented to the medical team.

The Future Is Within Health Ecosystems

Technology: Building appropriately secure and private interfaces between a consumer-facing app and the hospital IT systems is critical. Applying AI and decision support systems can help with screening and more automated, efficient scheduling to benefit both patients and medical staff.

Clinician: Staying current, outcome reporting, communication across organisations, documenting for reimbursement. Data siloes create business challenges. Access to the right information in the right place at the right time is essential to ensure the right care is delivered. The time involved in manually entering data for reporting if it is not continuously collected and displayed.

Technology: Portals and apps for shared records allow patients and clinicians to understand the situation and share information. Interfacing complex data back-end systems, with appropriate security and data privacy concerns addressed, is a challenge and uses up product development resources as the number of disparate systems to be connected continues to grow. Legacy systems also need to be connected, not just modern API- and cloud-based architectures.

Why

India's Current Healthcare Ecosystem

Clinician: Interpreting in context, explaining to patient, responsibility and accountability, managing large data sets from remote monitoring of patient symptoms and biomarkers, managing patient expectations, concerns about diagnostic software and AI bias.

Technology: Building consumer-facing medical devices with the rigor of medical apps while keeping the compliance of commercial apps is critical. UI/UX design experience is needed to navigate these tricky waters. Also, blending regulated software medical devices with unregulated platforms is a critical area, something that both the long-term architecture and the short-term quality processes must consider. This includes change management, post-market surveillance, reporting, traceability, risk management and a host of processes that meet the medical standards of IEC62304, ISO14971 and ISO13485 for Software as A Medical Device (SAMD).

Technology: Expertise in UI/UX is needed to simplify software for patients and to provide only pertinent data to the medical teams at the right time. To develop appropriate clinical software, it is critical to understand the need to have separate controls for software used as a medical device, e.g. in diagnosis, and for software that is the platform to access the data. There must be a clear delineation and supporting organisational approach in technology companies providing the solution.

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Patient: Not personalised, one-size-fits-all, fixed-length outpatient appointments. Lack of choice, not human-centric, lack of clarity and transparency about who to call and when. No way to access services flexibly as expected, e.g. using a smartphone.

Clinician: Wishing to use remote monitoring, video, chat, telephone, triage, multi-disciplinary team, making care bespoke to patients. Patient’s disease progression is only observed through episodic clinical visits, meaning fluctuations in disease progression are not always captured.

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Technology: Software plays a key role, as it can run on the patients’ phones when they are away from the clinic. They can act as a hub for other devices, such as blood pressure or blood sugar monitors or different types of wearables that can connect through the patient phone. Building a sense of connection through a device that the patient is very familiar with and that is usually with the patient is the key to making the patient feel connected to their medical team. The software design needs to consider the requirements related to maintaining compliance and keeping the patient’s attention and interest to avoid device and software burnout.

Download Klick Health's Free Healthcare Ecosystem Mapping Tool

Within the overall context of the health system, the patient journey is complex, but from the perspective of the patient, it should seem simple! Only a digitalised and connected system can provide that kind of patient-friendly, simple experience.

Gillian has over 20 years’ experience as a medical consultant in frontline healthcare delivery, with 5 years as service director, is a recognised NHS innovator in transformational change through digital health technology, and has been awarded innovation funding from the NHS, Innovate UK, and SIBG. She has extensive experience and knowledge of navigating healthcare strategy, regulations, and commissioning from both a vendor and purchaser perspective.Value-based reimbursement models have emerged to encourage new efficiencies aimed at improving population health and lowering the cost of care. With the realignment of incentives, the companies and organizations that comprise the healthcare ecosystem: primarily hospitals, medical groups and payers with connections to medical device, pharma, mHealth and others, have been working more closely than ever before. Some organizations have felt forced into changes while others have embraced the shift with an entrepreneurial spirit. Since this ecosystem largely didn’t exist until a few years ago, this change presents many challenges as well as opportunities.

There’s no better time for healthcare organizations to embrace this movement and surround themselves, both internally and externally, with those who understand the process innovations and new technologies emerging within this ecosystem to support value-based care. Simply put, this matters because the opportunity cost for those who take an overly conservative and siloed approach could be significant.

Building A Digital Health Infrastructure

While technology is extremely important to the evolving healthcare ecosystem, the foundation for growth and increased efficiency comes from process innovation and perhaps something much simpler. When speaking about his company’s legendary success, the late Walmart CEO, Sam Walton famously stated, “We’re all working together. That’s the secret.”

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Taking cues from the integrated delivery system model pioneered by Kaiser Permanente, Mayo Clinic, Geisinger and others, traditional health systems are starting to follow suit. In addition to providing leading-edge care, University of California San Francisco (UCSF) is also innovating in the boardroom. In a recent

“We want to be able to go to the market and offer employers an insurance product and a delivery network that rivals what Kaiser Permanente does in the Bay Area, ” Laret said. “Kaiser has been phenomenally successful in integrating how care gets delivered and doing it in a seamless, patient-centered way. The rest of us who are fragmented really need to change our mindset. So with John Muir Health and UCSF working with 15 or 20 other physician, hospital and other providers in the region, we are looking to be able to take financial risk for the care of populations, starting as soon as 2016.”

Digital Healthcare Ecosystem: The New Era Of Medical Care

Innovation and partnerships in healthcare delivery are also showing up in plain view, right on Main Street. There are increasing numbers of walk-in clinics located inside retailers such as CVS and Walgreens. Staffed largely by nurse practitioners, these settings are inexpensive and streamlined, according to

In fact, Walgreens’ locations in Arizona recently rolled out lab testing services in conjunction with Theranos, the disruptive diagnostics company founded by 31-year-old Harvard drop out Elizabeth Holmes. Profiled in rock-star fashion by

And a host of other marquee publications, Holmes has been compared to another successful Silicon Valley dropout, Steve Jobs. From a tiny drop of blood, Theranos offers customers a range of tests, saving time, money and patient discomfort. Even Sam Walton’s Walmart is getting in on the action. According to

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