Digital Transformation in Value-Based Healthcare Systems

Digital transformation, propelled by the revolutionary new healthcare provision models that have now become crucial in our post-pandemic world is the new buzz word in health-tech circles. Covid-19 has seen a surge in rapid innovation and adaptation of health technology platforms and processes as healthcare systems across the world strived to ensure care continuity for patients. According to analysis conducted by McKinsey & Company, the COVID-19 pandemic in April 2020 saw telehealth usage surge to 78 times higher levels compared to pre-pandemic levels in February 2020. As of July 2021, telehealth utilisation has stabilised at levels 38 times higher than before the pandemic.

It is evident that this disruptive health technology transformation is here to stay and will continue to induce improvements and changes across a range of healthcare arenas that impact health system and health service operations, structures and business strategies. Changes in the areas of health information management, provider and patient communication and health connectivity across systems and contexts are part of the increasing tide of digital transformation in healthcare.

Another such transformation that has been increasingly gathering momentum on a global and national scale is that of value-based healthcare (VBHC). VBHC, a concept coined by Michael Porter, involves transforming health care systems with the primary goal to maximise value to patients. In order to achieve value for patients, health care delivery needed to be organised around the medical conditions patients have, accurately measure the outcomes that matter to patients, and measure the cost to achieve them.

Several essential elements are purported as necessary to develop and embed a value-based healthcare framework, all of which are underpinned by the need to measure, analyse and integrate various systems of health information and health data. Value-based systems thinking in healthcare is nothing short of a seismic shift for most global health contexts, an even greater shift will be the role of digital transformation and technology required to facilitate and enable this conversion. Technology already plays a growing role in the measuring, analysing, reporting, and benchmarking of patient outcomes and healthcare quality metrics. We are seeing rapid adoption of consumer-driven convenience-based healthcare demand, such as the ability to book appointments online, and access medical records via smartphones.

Value-based healthcare transformation is likely to accelerate the pace of digital transformation currently underway as we come to recognise that healthcare can and should increasingly move outside the traditional hospital and physician office settings. A key outcome of value-based care is to improve a patient’s well-being, health outcomes and level of engagement with managing their health collaboratively with healthcare providers. New app-based digital patient engagement tools are expected to play a key role in this regard.

In moving existing clinical models to outcome/value-basedframeworks, healthcare providers could come under increased scrutiny with respect to being evaluated on their performance. An example of this is the type and level of post-operative recovery patients will have following treatment or surgery at a particular health service, which has the potential for widespread application of digital transformation-supported rehab therapy. This will require technology supported remote home monitoring, app-supported physical therapy exercises designed to sustain patient motivation and track progress and rapid connectivity between the patient, their carer(s) and the multiple healthcare providers.Wearables technologies with the capacity to not just track fitness, but to measure objective health indicators such as blood glucose levels, heart rate trends will likely become increasingly smaller and more affordable, and could continue to see intensive care unit level health monitoring capacity brought to the patient’s homes. This will undoubtedly see linkages to personalised health records, and multi-user accessible electronic health records.

"Changes In The Areas Of Health Information Management, Provider And Patient Communication And Health Connectivity Across Systems And Contexts Are Part Of The Increasing Tide Of Digital Transformation In Healthcare"

Digital transformation in the areas of data comparison tools such as accurate and real-time price transparency tools including out of pocket cost estimate tools and health services’ and/or specialists’individual clinical outcomes transparency tools, will allow meaningful and informed comparisons to be made prior to, at the point of or at any time during the patient’s healthcare journey.

Artificial-intelligence guided decision support in the areas of diagnosis, image analysis and or treatment regime recommendations is another facet of the digital transformation accompanying value-based health care modifications.

In order to enable true adoption of value-based health care systems, strong foundational infrastructure construction in information technology, inter-operability capability, cyber-security, assured privacy and confidentiality of provider and patient health data is crucial.

While digital transformation may facilitate and guide our transition to value-based care models, clear and committed leadership, behavioural change in operational and clinical governance and genuine engagement with stakeholders cannot be overstated. Regarding and adopting digital transformation within a closely aligned integrated framework with the transformation to value-based health care models could assist in the creation of a new and transparent healthcare ecosystem capable of achieving value for patients, better clinical outcomes, and financial benefits for health providers.