Digitisation in healthcare and the role of communication

Digitisation in healthcare is nothing new, and everyone involved in the health system – in whatever form – must agree that digitisation is changing its delivery.

The goal of digitisation can be roughly narrowed down to improving the quality of treatment and patient care, and this can be achieved in many ways. Here, we will review some of the progress that has been made and what they mean for patients, clinicians, and industry professionals alike, and how we might be able to keep up in a rapidly changing digital landscape and ensure business success through effective communication.

With the global digital health market size reaching over $400 billion in 2022, up from US$145 billion in 2021 (seeing a compound annual growth rate of over 16 per cent), and 93% of healthcare organisations estimated to have a digital strategy, it seems pertinent to delve deeper into what this might mean for the people involved, and how we might be able to optimise things further.

Communication plays a critical role in the digitisation of healthcare. With the rise of technology, healthcare has become increasingly reliant on digital communication tools to improve patient outcomes and streamline processes. As a starter for ten, here are just a few of the ways in which communication is important in the digitisation of healthcare:

  • Improved patient-provider communication: Digital communication tools such as telemedicine, secure messaging, and patient portals enable patients to communicate more easily with their healthcare providers, improving access to care and providing opportunities for better health outcomes
  • A wealth of online information: Available health information accessed through a number of channels can contribute to enhancing patients’ autonomy in handling their condition, and has the potential to improve overall health literacy
  • Enhanced collaboration between healthcare professionals (HCPs): Digital communication tools can facilitate collaboration between different providers, enabling better sharing of information, collaborative working, and efficient workflows to provide better care
  • Data sharing and interoperability: Communication between different electronic health record (EHR) systems is crucial for seamless data sharing and interoperability across systems, allowing healthcare providers to access patient information more easily, potentially allowing more informed treatment decisions
  • Remote monitoring: Communication technologies such as wearables and remote monitoring devices allow healthcare providers to remotely monitor patients’ health and communicate with them more effectively, allowing patients with chronic conditions requiring ongoing care an additional level of freedom

The Digital Health Index
A tool used to assess the level of adoption and implementation of digital health technologies and solutions within a healthcare system or organisation, the Digital Health Index provides a comprehensive framework for evaluating the use of digital technologies, including electronic health records, telemedicine, mobile health applications, and other digital tools and services.

It typically consists of several indicators or metrics, such as the availability of digital health infrastructure, the use of electronic health records, the level of patient engagement through digital channels, and the use of telemedicine and remote monitoring. These indicators are measured and scored to generate an overall score or index that reflects the level of digital health adoption and maturity within a country’s healthcare system or organisation.

The Digital Health Index is often used by policymakers, healthcare providers, and other stakeholders to assess the effectiveness of digital health initiatives and to identify areas for improvement. By using this tool, healthcare organisations can identify gaps in their digital health capabilities and develop strategies to improve their digital health maturity and achieve better health outcomes for their patients.

Adapted from #SmartHealthSystems (2018)

Judging by the ranked results from a 2018 Digital Health Index study by #SmartHealthSystems as shown above, EU Member States and Organisation for Economic Co-operation and Development (OECD) countries are digitising their healthcare systems at varying speeds. Estonia, Denmark, and Canada rank at the top of the index, whereas France, Germany and Poland trail behind. Whilst it is clear that there are a number of promising initiatives in the e-health sector, a consistent, Europe- or OECD-wide vision is still pending.

While the reasons for these country-wide differences will be vast and nuanced, some of the specific digital health methodologies were highlighted in the study. Canada, for example, uses regular e-Prescription services and electronic patient summaries to store important patient information, and in Estonia and Denmark, health test results, medication information and vaccination data are available for patients to access online. Patients are also able to choose which physicians and other HCPs are able to access their information.

Similarly, in the United Kingdom, ranking sixth on the index, patients are in control of their own medical records through Patients Know Best; a med-tech firm that allows patients to see their full medical record from primary to tertiary and social care providers. An added bonus is that it can fully integrate into any health records system and is available for use worldwide.

This hints at the notion of collaboration and shared decision-making. Co-design and creating collaborative partnerships in healthcare is an effective means of promoting user acceptance, and this can be true whether you are looking at the patient-physician relationship, or that between a physician and a pharmaceutical company. Resistance to the changes inflicted by digitisation is common in many countries. Physicians, in particular, can often veto communication efforts for a multitude of reasons; sometimes due to existing habits, sometimes due to wanting to follow their peers, and sometimes due to a lack of awareness of all options in front of them.

Slow adoption, imperfect decision making and playing it safe
We might like to think that the uptake of an evidence-based intervention or technology in clinical practice would be rapid following its conception. It can, however, take an average 17 years before it becomes part of routine practice and can delay improvements in patient health outcomes and healthcare efficiency. A large, systematic review of barriers and facilitators to the uptake of new medicines found that whilst patient and organisation-level factors impact treatment adoption, pharmaceutical detailing – marketing aimed at prescribers – is another significant factor. Areas where pharmaceutical detailing was restricted “had lower and slower uptake of new medicines”. Here, we must ask the question; what role does the style, tone, and content of the communication play in these rates of uptake?

If we as humans are known for our penchant for taking mental shortcuts to arrive at decisions – also called heuristics – medical communications must be able to meet this inherent behavioural challenge head-on. Some behaviours are so tightly woven into social norms – think about smoking or drinking – that in order to influence them, communication needs to show an understanding of the different biases at play to truly resonate with the audience in question. Altering people’s behaviours without restricting their choices or changing their economic incentives is known amongst behavioural scientists as ‘nudging’, and can significantly influence the behaviour and decision-making of both individuals and groups.

Communicating with patients suffering from debilitating conditions or life-threatening diseases is challenging. The tendency is to avoid controversy and go for the safe option, diluting the communication to be more palatable. But, people respond when communications illicit emotions, resonating with them on a personal level. Sometimes, that means shifting the lens from the clinical to the compassionate, focusing on a more individual, emotive story. Too often, healthcare communication looks for a positive, aspirational tone but will this always work when a patient feels unheard and not understood? Could it be more effective to acknowledge the difficulties, recognise the worries and then offer help, or a light at the end of the tunnel? Perhaps sanitising the message for fear of upsetting or alienating a patient does not produce the best communications to help both patients and physicians feel understood in their challenges, and to adopt better behaviour.

Effective communication: an industry responsibility
Significant accountability sits with the pharmaceutical industry when it comes to optimising healthcare decision making through communication. It was estimated in 2016 that medical marketers spent approximately $20 billion speaking directly to physicians, and over 80% of physicians have a direct industry relationship. With this amount of effort and resources being put in, why are adoption and behaviour change sometimes still out of reach?

For those involved in healthcare communications, we have a significant role to play. How well we can positively influence the behaviour of healthcare professionals, payers, policymakers and the public (to name a few) has huge implications for healthcare outcomes and the adoption of technologies. Good health is underpinned by good communication, yet evidence would suggest the ‘communicators’ of healthcare are failing, and the gap between peoples’ current self and their healthiest possible selves, is widening.

The innovators, the early adopters, and the behaviour change
The technology adoption life cycle describes the adoption or acceptance of a new (technological) product or innovation, and has been used as an example across a wide range of scenarios, to illustrate different buying habits and adoption preferences of different audiences. Understanding these inherent differences and adapting communications to truly resonate with the needs of each is key to encouraging the adoption of technologies and generating lasting behaviour change.

Tech enthusiasts – the innovators and the early adopters – are often the ‘golden ticket’ in communication challenges. Convince them, and the others are likely to follow, and behaviour change will ensue.

In our digitally focused world, we need to take a birds-eye view of the landscape. Digitisation in healthcare requires us to not only embrace changes to patient-physician interactions and our changing access to information, but to also welcome information technology, big data, artificial intelligence, and machine learning. We must acknowledge that this is a big ask, and one that not everyone might be prepared for.

Digitisation is forging an increasingly fluid health environment. But digitisation without communication and understanding can fall flat. To compete in today’s digital age, we must reassess how businesses, patients and physicians prefer to learn and interact. The leaders of tomorrow will be defined by how quickly they adapt today.

By Emily Sidlow, Page & Page and Partners

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