Harnessing digital innovations to transform health care

This article is authored by Somesh Kumar, country director, Jhpiego, India and associate faculty, Johns Hopkins School of Public Health, JHU.

The Covid-19 pandemic was a wake-up call for the world. It highlighted the importance of preparedness, surveillance, and response to global health emergencies. It revealed gaps and weaknesses in public health systems worldwide, including the need for stronger health infrastructure, and more investment to ensure access to quality health services.

An illustration of the novel coronavirus seen next to a health care worker at a Covid-19 testing centre. (Sanchit Khanna / HT Photo)

 

There is a universal realisation that, care as delivered today continues to be distributed inequitably. Care remains uncoordinated and cannot be tracked through fragmented health systems. Further, care can only be sought not consumed for the vast majority of marginalised and disadvantaged populations.

 

These lessons from the pandemic, will drive the future of public health and guide the development of policies and strategies of the future. Investments in public health are no longer merely moral imperatives. Governments are now taking steps to prioritise health care and make it an integral part of their economic policies as well.

 

Technology played a vital role in enabling health care providers to respond to the pandemic, improving the efficiency and effectiveness of healthcare delivery in the face of unprecedented challenges. With the growing demand for health care services, there has been a corresponding increase in the use of technology, including telemedicine, electronic health records, wearable devices, mobile applications, and combinations of devices, drugs, and software. Digital health undoubtedly has the potential to transform healthcare delivery and improve patient outcomes. More importantly it has the promise to enable equitable, coordinated, continuous care delivery across life stages for the population. It has the potential to take the power of health care consumption closer to families and individuals.

 

However, the way technology is implemented can dilute its ability to leapfrog systemic barriers. Not infrequently, digital health programs are designed in silos today. This results in different applications used by different stakeholders not talking to each other, leading to duplication and disjointed vertical implementation of digital health. If this fragmentation is left unchecked, then there are growing concerns, that these digital health interventions could, in fact, exacerbate existing challenges in the healthcare ecosystem including an accentuation of inefficiencies, disparities and errors.

 

In order to make the most of a digital transformation, we must therefore commit to a forward-looking vision to create a unifying architecture for digital health solutions. Health care programmes must coordinate efforts and embrace an enterprise architecture approach to mitigate risks. An enterprise architecture refers to the systematic alignment of information technology (IT) systems with real world processes and goals. In the context of public health, this means creating a holistic, coordinated plan for how technology can be used to improve health care delivery at scale. This approach is essential because healthcare systems are complex with multiple stakeholders, including patients, providers, payers, and policymakers.

 

The enterprise architecture approach involves taking stock of existing infrastructure and determining what needs to be developed or improved in order to achieve the following goals:

• Interoperability: The architecture should enable the seamless exchange of information between healthcare providers and patients. This will allow healthcare providers to access and share patient information, regardless of where the patient was treated. Interoperability must eventually be achieved at a semantic level to be meaningful in the open-ended and evolving ecosystem that healthcare is.
• Scalability: The architecture should be designed to support growth and expansion, and be flexible enough to accommodate changes in the healthcare landscape. Sustainability: The architecture should ensure that it can be maintained over the long term, and that its benefits can be sustained even as health care and technology evolve. It must seek to leverage and upcycle publicly available infrastructure and fold-in legacy systems and data.
• User-centeredness: The architecture design should meet the needs of all stakeholders including health care providers and patients, and be easy to use and accessible. Adoption is the acid test that it must pass to serve large populations that public health seeks to serve. Unlike more transactional domains, health care is more organic by nature and requires being mindful of its nuances. Human centric design needs to be a cardinal principle to ensure adoption, optimise and total cost of ownership.
• Standardisation and single source of truth: The architecture should be based on globally recognized standards and a single source of truths for key resources like facilities, professionals and beneficiaries. This will ensure its compatibility with other health care systems and technologies

 

India amongst other nations is building the pillars of an enterprise architecture approach to public health. The National Digital Health Blueprint folds in the above principles and has laid the foundation for the Ayushman Bharat Digital Mission (ABDM). The ABDM is helping to create an at scale digital platform for delivering healthcare services, enabling the exchange of patient information between providers, and improving the quality of care. The ABDM is a perfect example of how an enterprise architecture approach can help to improve healthcare delivery, by providing a foundation for integrated, patient-centred care that is accessible, affordable, and effective.

 

The importance of enterprise architecture extends beyond just the national level. In the context of the G20, countries can work together to achieve a shared vision of democratising health care information. By pooling their assets and expertise, G20 countries can create a more integrated, efficient, and effective health care ecosystem, one that truly meets the needs of patients everywhere. Just as political will is paramount to achieving universal health coverage, it is also essential to ensure leveraging technology innovations for health care transformation.

 

Countries must commit to create an enabling environment that prioritizes investment in healthcare technology and encourages the development of innovative solutions. We must also ensure that the necessary legal, regulatory and policy frameworks are in place to support the integration of technology into health care systems. By combining political will with technological innovation, governments can create sustainable healthcare systems that provide universal access to quality services, drive better health outcomes, and empower patients with greater control over their own health.

 

If we want to transform health care and make the most of technological advances truly, we must embrace an inclusive, open, free architecture approach to public health. This approach will allow us to create a more integrated, efficient, and effective health care system, one that can deliver high quality care to patients everywhere.

 

This article is authored by Somesh Kumar, country director, Jhpiego, India and associate faculty, Johns Hopkins School of Public Health, JHU.