The Role of Digital in Health System Reform

Our society is becoming increasingly digital. 

Today’s generation of patients and healthcare workers have grown up in a digital first world. Regardless of age, location and person circumstances; everyone knows what great service feels like. It’s simple, quick, responsive, encourages self-service, with easy access to information. 

While there is pressure for digital modernisation, our global health systems are under pressure like never before. The systems that were crafted centuries ago to manage battlefield trauma and infectious disease are not scaling to address the challenges of a population with lifestyle induced chronic disease. And thanks to modern medical miracles, we are increasingly turning acute conditions into chronic disease. In our developed world we simply do not have enough staff and facilities to meet current demand, nor can we scale to meet future projections. And our workforces are increasingly specialised and centralised to metropolitan hubs, while patients are geographically spread.  

We need a new health system paradigm, underpinned by new models of care. We need a way to deliver high quality services that are equitably accessible to patients wherever they are, with the same workforce. Ideally at the same or lower cost. We need digital principles at the core. The good news is that we don’t need to imagine the future. It’s already here, deployed and delivering the outcomes and results we desperately need. Unfortunately, these improvements are not widespread and these pockets of innovation need to be turned into the default approach. These new digital first models of care include: virtual care; self-directed care; preventative care; and precision medicine. 

The healthcare sector must progress beyond eliminating paper and implementing systems of record in healthcare. If all we do is digitise, we are missing the opportunity to transform care. That means using the data that we capture and ensuring that the patient and employee experience is easy and intuitive. One of the most promising technologies is artificial intelligence (AI) which has delivered compelling capabilities in the field of machine vision for diagnostic imaging. Now we have trained models that are finding a ready home in radiology, pathology, dermatology, ophthalmology, and dermatology. Creating an accurate diagnostic model for diagnostic imaging is a matter of clinician input, training data, data science skills, and computing resources, then fine-tuning through reinforcement feedback learning. Beyond medical imaging however, marshaling these inputs has proven a barrier to the broader application of AI in healthcare.  

In only the last year however, generative AI has surfaced, providing an answer to these constraints. Large Language Models (LLMs) have decoded our human operating system and can infer context and content to produce surprisingly insightful responses, even for specialised fields like healthcare. Forget the higher order tasks that clinicians already do well, there is a role for AI to address the estimated 25% of waste¹ baked into how we deliver healthcare today. If we can let clinicians diagnose and treat patients, performing the top-of-license care they are uniquely trained to deliver and get satisfaction from, and leverage AI to mop up the administrative complexity, redundancy, fraud, rework, and error, then we can solve our workforce dilemma. That’s latent productivity – imagine an extra 25% more workforce. If we then couple this with outreach technologies to engage patients, and virtual care models to meet them where they live, now we can address access and equity. 

It’s an exciting time for digital health. Powerful technologies are available to modernise health services, leading to better outcomes for patients and experiences for clinicians. We’ve validated these technologies can be delivered safely and effectively as new models of care. Now is the time to create a future health system paradigm that will help us address the challenges of today and the future. 

¹ “Waste in the US Health Care System. Estimated Costs and Potential for Savings” Shrank et al, JAMA. 2019 https://jamanetwork.com/journals/jama/article-abstract/2752664