August 10, 2021 Digital Transformation in Healthcare After COVID-19 COVID-19 boosted digital healthcare, now as we push forward, it’s critical to make the systems easier for both patients and providers. Denny Royal Chief Design Officer Though it has been a growing effort in many industries for some time, digital transformation in healthcare has lagged behind. That is, until 2020. COVID-19 caused worldwide devastation, but in the case of healthcare, It also spurred needed change. As patients and doctors sought ways to maintain care relationships under lockdown, digital solutions came to the fore. Now, the question becomes how to leverage that progress to design a digital transformation framework for the future. Digital transformation is the strategic integration of digital technology into an enterprise, to significantly change the way it operates. When the COVID-19 pandemic forced the world to go virtual, it essentially advanced digital adoption in healthcare by about 10 years. However, there is still a lot more work to do. Right now, patient satisfaction with US healthcare system interactions ranks somewhere below interacting with the government. It’s critical to make the system easier for patients and their advocates, but also for providers. COVID-19 nudged us, and continues to pressure the system, but now we need to be all-in to achieve this goal. Digital Transformation in Healthcare: Telemedicine For most patients and consumers, the most visible example of digital transformation in healthcare during the COVID-19 pandemic has been telemedicine. Virtual doctor visits have been around for a while, but they have been underutilized. The pandemic increased both patients’ and providers’ willingness to use video visits. More importantly, it also forced regulatory waivers to make access easier and to expand reimbursement. The effect was huge. Pre-COVID, only about 3% of patients used virtual visits, but in a very short time, that usage rate exploded to 23%. It seems clear that demand for telemedicine will only increase. It is needed, patients like it, and really, why would we want to go backward? It’s a common assumption that primary care requires in-person contact, and that telemedicine is inadequate. We’re seeing now that those assumptions are not true. Virtual visits are easier, more convenient, and safer—for both patients and providers—but there are other benefits, as well. For instance, virtual interactions can give a doctor a more complete look at a patient’s home and community. They can give insights into environmental factors that might be impacting the patient’s health and wellbeing. With an in-office visit, the doctor has no insight into those environmental factors. Accessibility is another consideration. If a patient has transportation challenges, or difficulty taking time off of work for appointments, telemedicine can relieve those pressures and cut down on appointment no-shows. Increased convenience could also encourage more consistent access to routine and preventative care, leading to better patient outcomes. Other Digital Interventions While telemedicine is obviously beneficial in routine and primary care, it is also increasingly applicable to specialists and for ongoing treatment of chronic conditions. With commonly available technology, such as cameras, patients can communicate more effectively with providers about their symptoms. Design becomes important here, as we also try to identify who are the hard patients—who telemedicine cannot serve—and how to plan systems for best treatment and outcomes. Digitally-enabled apps and the Internet of Things allow for remote monitoring of many more patients than a single provider can see. Medical devices such as digitally-enabled scales, blood pressure monitors, or glucose meters, can enable real-time information, such alerts and feedback. Such low-effort, high-contact scenarios can help both patient and provider in the treatment process. And anything that improves the treatment experience can also have a positive influence on outcomes. COVID ushered in some other exciting applications for remote monitoring as well. Some hospitals were able to set up remote teams, command-center style, to monitor patients and support on-the-ground teams in emergency rooms and intensive care units. Going forward, this kind of structure could increase quality of care in understaffed treatment settings, by keeping providers from becoming overwhelmed. Digital Transformation in Healthcare for the Provider Role Designing for patient-centered progress is extraordinarily important to advancing digital transformation in healthcare, but paying greater attention to the provider experience will also improve patient outcomes. As design thinking has spread through industries, there is finally more attention being paid to the user experience. Consumer expectations for experience are very high, but we also need to think about staff experience. For instance, empathy is a pay-it-forward sort of thing. If we are designing systems and tools that frustrate doctors and administrative staff, that frustration will carry through into patient interactions. And that moves beyond the clinical setting, as well. Billing and payment structures have tremendous impacts on healthcare satisfaction. Providers feel pressure to pack their schedules and have little time to invest in unproven solutions and workflows. And imagine surviving the fear, pain, and uncertainty of cancer treatment, only to be brought to tears by trying to figure out your medical bills. There is great opportunity for digital transformation to drive improvements in patient and provider advocacy if we design systems with empathy in mind. Forging the Digital Path Forward Digital transformation is on the mind of every CEO in healthcare, as the pandemic has made it clear that every healthcare business must be a digital business. Amid the profound challenges, many providers made do with temporary digital solutions and workarounds, but these tools are not robust enough to be permanent. They need to be redesigned with an eye toward sturdy, dynamic, and sustainable solutions. While we might see some backslide from the advances of 2020, consumer demand is prompting healthcare executives to take their digital transformation projects and plans for the next 10 years and compress them into 2–3 years. Scale is a factor, of course. The bigger the system, the longer it will take to change, but that doesn’t mean that healthcare digital transformation can continue to lag behind other industries. Updating an electronic health record system, for instance, is a multi-year effort, while updating an AI chat bot will be an easier shift. Still, it’s necessary to invest in building a solid foundation that can support a dynamic technology stack capable of moving with the times. Legacy technology, even if it was cutting-edge in its day, is a drag on the enterprise. Digital Transformation in Healthcare — Final Thoughts COVID-19 demonstrated that even in an industry as huge (and slow to adapt) as healthcare, rapid change is possible. Patients and consumers have also come to realize how many more digital and virtual options they have and how much more flexible their healthcare can be. At the same time, availability of stopgap technology solutions doesn’t necessarily mean that we have solved any of the underlying problems and frustrations. Of course, we need to continue to push forward and expand on the gains we’ve made, but in that effort, we need to advocate for both patients and providers in order to realize the greatest overall benefit. We have to design for empathy, and we have to go all-in. 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