Three issues that digital health should be adressing
Written by Ronald Scheffer and Hugo van der Wedden, 21 March 2021
The Corona pandemic has given an enormous boost to the use of digital care. Even the most conservative doctors are now contacting their patients virtually. But so much more is possible. If we really want to take full advantage of the opportunities within healthcare, it is essential to talk about the issues that matter.
Together with my colleagues from the growth circle, I am responsible within Luscii for upscaling remote patient monitoring processes worldwide. With more than 20 million registrations across 7 countries, I am happy to share some of our recent findings.
NOT the technology itself, BUT embedding it in practice
The healthcare landscape is currently flooded with all kinds of ICT solutions, from apps to wearables. Yet all that technology is worthless if it isn’t embedded into daily practice. Naturally, it is a basic requirement for technology to work safely and intuitively. But how do we redesign healthcare processes? And how does this change the way in which doctors and nurses carry out their work? This is what we should be talking about.
Sometimes, hospitals implement telemonitoring without adjusting their care processes. Everyone carries on as usual, leaving one or two nurses at the outpatient clinic monitoring a number of patients remotely, on top of their existing workload. As a result of the extra work, such projects rarely have an impact. There is no support among professionals and no room for growth. Essentially, nothing changes.
A great example of an alternative approach is the OLVG Heart Centre app. The hospital set up a regional medical control centre where all home measurements and contact requests are received. Algorithms continuously analyse the data and, in the event of deterioration, an alert is triggered immediately. And if more expertise are needed? Then the notification is forwarded to a specialised nurse or cardiologist. The many home measurements have also adopted a central role in the treatment. After all, a clearly defined curve is much more reliable than a one-off measurement at the hospital. The new care process is continuously evaluated with the healthcare professionals involved and optimised based on what we learn.
Doctors and nurses are experiencing impact and control over the new process. The digital cardiology clinic, which has only been operational for a few months, already supervises hundreds of patients daily.
NOT just reducing admissions, BUT the value of experience and trust
Lower costs, fewer admissions: we often talk about what e-health should deliver. But what we should be talking about instead is how patients and healthcare providers experience digital technology. If they use technology in a pleasant and natural way, the positive effects will follow automatically.
This is partly about accessibility. A healthcare app must be easy to use, and all the necessary data must be available without an additional login. For that very reason, we are currently creating an ecosystem of apps and software that work together seamlessly. The Luscii app, for example, is already integrated with BeterDichtbij, Chipsoft, Epic and Informed.
And part of it is about trust. That the caregiver knows that their patient will be visible when necessary. And that the patient knows he or she will receive help when required. This allows standard check-ups to be replaced with customised care, at the right time and by the right caregiver: virtually if possible, physically if necessary.
A wonderful example is the All Together Better Alliance approach in Sunderland, North England. Here, the NHS has set up a virtual ward that supervises ‘revolving door’ patients as part of a collaboration between the hospital, GPs and community care. Instead of admitting them again and again, specialised nurses from the Recovery at Home team use Luscii to literally keep a 'virtual finger on the pulse'. Patients are visited at home if necessary and supervision is maintained from a distance. Caregivers experience more control over their work because they can identify deterioration at an early stage. Patients feel more secure at home because they know they are being watched over. This is how we make a real impact. Added bonus: the number of admissions and emergency room visits has fallen sharply.
‘Doing things differently’ means relying on something you have no experience with, which is naturally a little daunting. But I truly believe that practically every patient and caregiver has the ability to master digital care. Practice makes perfect. Once the fire has been lit, as we see every day with caregivers and patients, it is mainly a question of repetition. For those in doubt, I’d recommend reading: ‘The Talent Code: Greatness Isn’t Born, It’s Grown’.
NOT the costs, BUT the quality of care
It is logical that the debate over the future of healthcare often revolves around finance. The same applies to the rise of digital technology. Who pays for it? What will it deliver? However, this is often viewed at such a micro level and in the short term that it is quickly overcalculated in a spreadsheet. And then promising initiatives get stuck in the pilot phase because the money dries up. A terrible shame.
As a businessman, I understand the importance of a financial business case. Within the healthcare sector, we all share a responsibility for this, which we pay a lot of attention to here at Luscii. It is no coincidence then that our founder Daan Dohmen (from the 15th of April, you can read about this in ICT&health 2, 2021, ed.) has chosen to focus his professorship on funding models in digital healthcare, among other topics. That's precisely why I think we need to look at the bigger picture. Healthcare organisations are often still paid per transaction.
A successful telemonitoring care path can therefore cause a hospital’s income to fall. This paradox is a senseless barrier to development. In the near future, we really need a model in which we pay for quality and results. Place the financial stimulus on the movement and offer caregivers the opportunity to help more patients within existing frameworks. Just like what’s happening at the OLVG, in Sunderland, and at dozens of other places. If we involve patients more in their own treatment, and can supervise them remotely, this will automatically translate into lower costs. That is, if the financial incentive to summon patients disappears.
About this article and the authors
This article was written by Hugo van der Wedden and Ronald Scheffer. Ronald is co-founder of Luscii and Hugo is our voice of Luscii. Ronald studied Economics and International business, both at the University of Groningen. He joined FocusCura in 2015 to lead its international expansion. With the split-off of Luscii into an independent company, Ronald joined Luscii as one of it’s co-founders, responsible for growth both national as well a international. Hugo is a nurse and medical sociologist. He loves to write stories and helps patients to be more independent. In Luscii’s Medium publication, people working at Luscii share their experiences on creating a company that is not only successful from a business point, but also creates sustainable societal impact and strives to be a really great place to work and grow for individuals. More on Luscii can be found by clicking here.
