For too long, eHealth strategies have focused on pushing people to accept, often as an article of faith, promised high level benefits which do not fully materialize. We might rather, take inspiration from successful pull movements which attract and harness the power of the crowd. The explosion of social networking is perhaps the greatest example of how individuals are pulled together to rejoice in the power of the crowd. Increasingly therefore, tech-savvy clinicians need to be seen not as a block to be won over but as a catalyst to be nurtured and supported. This approach will deliver sustainable success and avoid costly failures.
At the moment the 'T' in Information Technology is pretty much solved. The real challenge for the future of healthcare is how do we get a grip on the 'I'. In other words, how do we extract reliable information out of all the data that will be available?
Based on KPMG's global experience and interviews with 39 eHealth leaders, planners, experts and implementers around the world, we have developed three concepts that – in our experience – will help eHealth participants to develop and implement a holistic and integrated approach.
This change can be facilitated with three basic concepts:
- Crowd accelerated innovation suggests that eHealth becomes more sustainable based on the size of the program and breadth of stakeholder adoption. Participants will need to share a clear vision, strive for full transparency in processes and objectives, and use the power of the crowd – of bringing doctors and patients together – to create an economy of scale to cut costs and bolster innovation.
- Collaborative alignment recognizes the importance each player has in the healthcare continuum and places a high value on their active participation in the development and operation of the system. Aligning the interests and efforts of stakeholders is key to the success of eHealth, and to enabling its lasting presence in healthcare organizations.
- Creative dislocation, thanks to eHealth's transformative nature, is essential. The introduction of new methods will make many legacy processes and approaches redundant. Stakeholders must be prepared to change the way they work, rather than just seeing eHealth as an 'add-on'. This is the best way to integrate eHealth into the fabric of the healthcare environment.
How will eHealth programs move beyond the pilot stage through implementation to a state of sustainability?
The truth is that there is no single global path to eHealth transformation. Each jurisdiction will need to face the specific challenges and complexities in their own markets to find a unique path to success.
A good example of these concepts can be found in the Hong Kong Health Authority. In this Chinese Special Administrative Region (SAR) clinicians, facilitated by executives, have developed a high value, relatively low cost eHealth tool which provides personalized, preventative and purposeful care for patients. The system, known as HARRPE (hospital admission and risk reduction program for the elderly) provides algorithm based data extraction of 44 key sentinel social and medical markers to analyze – every night – patients that might be vulnerable to re-admission. Nurse-led outbound and inbound care, advice and support reduced re-admissions by 25 percent. More remarkably, this system, which is gradually being extended across all 7 million citizens in Hong Kong, takes an average of two, twelve minute calls from a nurse practitioner: 24 minutes to reduce admissions by 25 percent.
This successful example also reinforces the three key basic requirements that were repeated time and time again by our respondents. While separately these requirements are patently obvious, it is still surprising to see that they are not always managed together.
- Create a strategic plan,
- Focus on core elements, and
- Healthcare professionals and patients in the lead.
Across this spectrum of successes and failures, there are a number of key lessons to be learned by eHealth pioneers which will help refine strategies throughout the industry and narrow the focus of eHealth programs. Indeed, for eHealth to deliver on its promises it must not only be implemented – it must also be sustained. This means evolving eHealth from a lab-bench innovation in healthcare into a full scale and sustainable model that ultimately leverages the power of the crowd and transforms the whole industry.
Case Study: Kaiser Permanente and the Care Connectivity Consortium (CCC)
Case Study: Denmark: Sundhed.dk
Case Study: UK Department of Health: Whole System Demonstrator (WSD) program