The drivers of digital transformation in healthcare

Healthcare systems across Europe are facing unprecedented pressure. While the quantity and quality of care has improved, the scale and complexity of healthcare needs have grown, together with public expectations of more personalised and convenient services.

At the same time, healthcare staff and resources have become increasingly constrained and the gap between supply and demand has grown. Most countries are looking to digital transformation to close this gap but progress has been slow and the digital maturity of providers, both within and between countries, varies widely.

Over the past six months, the need to respond swiftly to the COVID-19 pandemic has accelerated the use of digital health technologies, but more remains to be done to ensure the equity and sustainability of healthcare.

Perspectives of our survey of clinicians on digital transformation

To explore further, we launched a survey of 1,800 clinicians to assess the use of digital technologies across seven European countries. Its aim was to understand the views of frontline clinicians working across primary and secondary care about the challenges they face and the benefits they are seeing from technology adoption.

When asked about the current state of digitalisation in their country, the most frequently mentioned negative words were ‘Slow, Complex and Bureaucratic’. The three most frequently mentioned positive words were ‘Fast, Innovative and Efficient’.

Overall, those surveyed were hopeful about the future. The majority of European clinicians feel that it will take less than five years from now to achieve a fully digital healthcare system. Their expectations are also largely positive. The top three words they hope to use to describe the system in five years from now are ‘Fast, Efficient, Simple’.

Challenges to digital transformation

Our primary research shows that the benefits from digital transformation adoption vary widely. To realise the benefits, infrastructure, cultural and operational changes are needed including improvements in the education and training of clinicians. They also need to adapt to the fact that patients are becoming better informed and more demanding than in the past.

Responses to the survey identified the top three challenges organisations face in implementing digital technologies as: bureaucracy in healthcare (57.4 per cent), the cost of technologies (50.3 per cent) and finding the right technologies (49.0 per cent).

While the responses were broadly similar across the seven countries, the top three challenges included training staff to use technology among clinicians in Italy and Portugal, and sharing patient data among those in the Netherlands.

Furthermore, majority of clinicians across Europe said that their organisation is ‘very well’ or ‘reasonably well prepared’ to adopt digital technologies, with Denmark was most prepared and Germany the least.

Challenges

Key actions to close the gap

Based on our research for our UK ‘Closing the digital gap’ report, and developed further during our research for the European study, we identified two overarching themes (changing the mind-set and liberating the data) and five actions needed to help deliver digital transformation at scale now and in the future:

• Infrastructure: create a robust health IT infrastructure that includes connectivity (Wi-Fi, fibre optic, broadband etc), safe data storage and consented access to health data and data sharing.
• Open EHRs: implement accessible and integrated EHR systems and invest in the basic digital technologies that accelerate digitalisation.
• Interoperability: address the challenge of interoperability through development of shared local or national records with a single patient identifier and transparent consent processes, and embrace secure, cloud technology, placing critical IT infrastructure in virtual off-site data centres underpinned by agreed interoperability standards.
• Governance: establish a robust governance framework to support change management and a culture of digital transformation, including clarity over data ownership, cyber security, patient consent and patient education.
• Leadership: develop digital leadership skills and improve the digital literacy of staff and patients.

Improving citizen’s experience of digital health

Increasing numbers of citizens across Europe are no longer prepared to be passive recipients of care: instead, they expect to have choices based on trusted advice and reliable information. They also wish to own their healthcare data and decide who to share it with, and for what purposes.

While use of digital technology to measure fitness and health improvement goals, receive medication alerts and book medical appointments is increasing in most European countries, some challenges remain.

Adoption of fitness trackers and smart watches is biased towards affluent millennials and those with a higher socio-economic status. This ‘digital divide’ tends to disadvantage the same groups of people who are already at risk of social and health inequalities. Figures show that 80 million Europeans never use the internet either because they don’t have a computer or due to the cost. Around 29 per cent of Europeans lack basic digital skills, rising to 70 per cent of retired adults. Access to fast and reliable broadband, especially in rural areas, is also an issue.

Addressing health inequalities by improving people’s digital health literacy and access is crucial in ensuring that digital transformation fulfils its transformative potential.

Increased adoption of technologies in response to the COVID-19 pandemic

The COVID-19 pandemic has affected billions of citizens and millions of healthcare staff across the world. Health systems had little time to prepare and in the shortest of time frames and had to reorganise services, train staff to work in new ways and in unfamiliar teams, and protect staff well-being.

This was done in the absence of any known treatments and a need to reduce the risks of infection to staff and patients. The response has been an unprecedented change management programme implemented in weeks that would otherwise have taken years.

Moreover, the pandemic has accelerated the digital transformation of healthcare.

In fact, nearly 65 per cent of survey respondents said their organisation had increased its adoption of digital technologies to support clinician’s ways of working and 64.3 per cent said their organisation had increased its adoption of digital technologies to provide virtual support and ways of engaging with patients in response to the COVID-19 pandemic.

The SMART characteristics needed to encourage adoption at scale

As digital technologies collect and analyse patient level data, data privacy and security are paramount. Moreover, if digital technologies are to help healthcare systems thrive in the post-COVID era they should ideally meet the following SMART characteristics:

• Straightforward and easy to use
• Measurable impact
• Agile solutions
• Reliant on industry collaboration
• Tailored to end-user needs

The ongoing development of healthcare technologies that meet the SMART characteristics will be crucial for the sustainability of healthcare systems, including ensuring that they are better prepared to cope with future infectious disease outbreaks.

Shaping the future of healthcare

The COVID-19 pandemic has accelerated the digitalisation of healthcare by at least a decade. Indeed, the legacy of the pandemic is likely to be new relationship paradigms based on collaboration, ‘good will’ and heightened levels of trust. Attitudes to care have changed and boundaries that have been in place for a long time have been removed creating the opportunity for new health care behaviours.

Moreover, in catalysing digital transformation and the adoption of technologies at scale, key stakeholders will increasingly collaborate to realise a future for healthcare that is truly predictive, preventive, personalised and participatory.

Just as experience in other industries has driven consumer demand for digital on-demand accessible, personalised services, the COVID-19 pandemic has driven European citizens’ expectations for care anywhere, anytime and an acceptance that care can now take place outside traditional healthcare settings.