Recently, EY launched a report titled: ‘Embracing digital: Is COVID-19 the catalyst for lasting change?’ The report investigates how providers were using digital solutions to respond to the crisis; what benefits have flowed from these new ways of working; and how digital is likely to alter service delivery in the future. In an interview with Omnia Health Magazine, Mohammad Sear, MENA Digital Government and Public Sector Consulting, EY, discusses key findings as well as what barriers are there to implementing digital technology and what needs to be done to execute these successfully. Excerpts:
What has been the uptake of digital technologies by healthcare providers during the pandemic. How has it increased in the UAE and the wider region?
The adoption of digital technologies and data solutions has nearly doubled during the pandemic. Before the outbreak of COVID-19, just 18 per cent of Health and Human Services (HHS) organisations had managed to embed digital tools in the way they work. Multiple factors supported this change with safety of frontline health workers and social distancing norms being the most important ones. In many places, hospitals and health centres were overwhelmed by the increase in COVID-19 cases, which stretched their capacity in both infrastructure and availability of necessary workforce – contributing to the case of increase in adoption of digital technologies.
According to the EY report, phone and video consultations have seen the greatest uptake by service users and patients, with phone consultations being offered by 81 per cent of HHS organisations (up from 39 per cent before the pandemic) and video consultations available from 71 per cent of organisations (up from 22 per cent before the pandemic). User support tools — from online self-assessment to disease management tools and patient portals — have also increased dramatically. Other tools, including mobile sensors or wearables, have also seen rapid increases, but are still not commonplace among HHS providers.
For staff, the shift to home working necessitated by social distancing was supported by an increase in the deployment of desktop or laptop computers (from 58 per cent to 80 per cent) and the use of mobile solutions for remote access to organisational networks (37 per cent to 67 per cent). The most dramatic change, however, was in the adoption of video conferencing platforms, which soared from 27 per cent to 73 per cent.
Almost two-thirds of respondents to the EY survey reported an increase in the use of these tools. This shows a promising resilience, with the industry adapting to new ways of working under pressure.
In the UAE, 41 per cent of respondents indicated they increased the use of digital technologies and data solutions, while 36 per cent said that it was unchanged for them. The analysis suggests that a higher percentage of organisations were already using digital solutions prior to the pandemic in the country, which may have further helped to establish a number of fit-for-purpose options that could be adapted to other organisations.
Patient service or user portals are offered by 83 per cent respondents, if we look at the resources being made available to patients by HHS organisations in the UAE. This is highest among the six countries studied in the EY report. Chronic disease management tools, mobile sensors and wearables, apps for reporting problems are offered by 79 per cent responding HHS organisations. 78 per cent respondents also provide online self-assessment and patient engagement tools, while 69 per cent organisations also had an AI powered diagnostic tool available for patients to use.
How have these technologies led to increased productivity in healthcare?
The EY report indicates that despite the rapid speed of digital technology adoption and significant disruption to pre-pandemic ways of working, most respondents state that the use of these solutions has had a number of positive effects, including increase in productivity.
This increase in productivity can be attributed to variety of factors such as enablement of a better collaborative working, improvement in operating models through better and digitised process, staff productivity and their ability to quickly adopt digital solutions.
A majority of respondents in all countries reported that digital technologies and data solutions have increased the productivity of staff, ranging from 54 per cent in the UK to 86 per cent in the UAE. On an average, 63 per cent of respondents across the six countries surveyed agreed that staff productivity has improved because of digital tools and solutions.
Furthermore, a majority of respondents, from five of the six countries surveyed (all but the UK), reported that these solutions were effective in improving the quality of experience, access to care, and outcomes for patients and service users.
Encouragingly, a further 66 per cent of global respondents (82 per cent in the UAE) agreed that their staff quickly adapted to using new digital tools since the onset of COVID-19. Around 61 per cent of respondents agreed that their organisations are using these digital solutions more effectively than before the pandemic began and 58 per cent (73 per cent in the UAE) reported that digital solutions have made operating models more efficient.
What are some of the barriers to implementing digital technology in healthcare, and why?
Prior to the pandemic, practitioner concerns — including the potential for increased administrative duties, loss of interactions with service users and reliance on data insights over professional judgment — were most prevalent among our respondents, with 40 per cent citing this as a barrier to implementation.
Countries like the UAE and India also highlighted ethics and privacy/data protection (using technology in making decisions about individuals and ability to protect an individual’s identity and personal information) as a major barrier which can also impact the future adoption. Nearly 40 per cent of respondents from both countries listed ethics and privacy concerns as a prevalent barrier to its implementation. However, responses from the U.S. (20 per cent) and the UK (11 per cent) indicate that data privacy is not a major barrier for HHS in these countries. Although the reason behind this variation needs further exploration, it is likely to be combination of cultural factors, citizen attitudes, and information governance policies and infrastructure.
Other major challenges include IT interoperability and adaptability, lack of funding or reimbursement for digital services, lack of skills and expertise, and lack of overall digital strategies by HHS organisations.
One of the primary reasons behind these challenges is that digital technologies have found it difficult to be part of long-term strategies by HHS organisations. Adoption of technology has been more of quick fix solutions rather than a strategically planned integration into operating models and the value chain of the healthcare industry – which we are now seeing change.
Mohammad Sear
What needs to be done to ensure digital technologies are implemented successfully and the momentum is maintained?
The extraordinary circumstances amid the pandemic have helped HHS organisations overcome some of these barriers to rapidly implement digital and data solutions. Many countries temporarily relaxed regulatory constraints and approved payment for remote or digital services that may not have been reimbursed prior to the pandemic.
However, to deliver long term value beyond the COVID-19 pandemic, we must focus on five actions to maintain the momentum of change:
Prioritise user needs
Service users have become much more comfortable with using digital technologies and analytical solutions during the pandemic, meaning they are likely to be more amenable to these once the crisis ends. People are likely to opt for technologies which are easy to use and decrease wait times. But there is still a lot to learn about the impact of these technologies on patients, service users, and practitioners. Governments and regulatory bodies should therefore evaluate where and when remote care is appropriate, rather than taking a one-size-fits-all stance. Additionally, there must be an inclusive approach to digital health services – making it accessible by all.
Support provider adoption and buy-ins
The EY report found that the need to train practitioners to adapt to new ways of working was the top priority for organisations planning for the future. Accordingly, solutions should be user-friendly and incorporate seamlessly into existing workflows, rather than creating an additional administrative burden. At the Hong Kong Hospital Authority, for instance, new digital tools are designed to be intuitive – requiring no training for staff.
In addition, trainings for effective collaboration and communication through digital tools and channels will support adoption of services such as virtual consultations.
Focus on incentives
Many HHS providers received emergency funding for new digital or analytical solutions throughout the pandemic, but in future they will have to compete with other government priorities. Organisations should leverage the impact created by digital solutions during the pandemic to build strong business cases.
Moreover, governments need to identify cost-effective services and provide incentives for their use. Germany’s new Digital Healthcare Act, which entitles all individuals covered by statutory health insurance to reimbursement for certain digital health applications, could provide interesting lessons for other countries.
Embrace interoperability and data sharing
There is still much to do to enable better data sharing across the wider ecosystem – not just among health and social service providers but other government agencies (such as police, justice, and education) and third parties (such as care homes, non-profits, and community organisations). Data is often locked away in siloed legacy systems that are difficult to integrate.
A decentralised and networked infrastructure, built on common data standards and structures, could unify disparate information from multiple sources and make integration seamless. Estonia, for example, has a digital innovation platform that integrates all health and social care across the country, thereby eliminating interoperability issues.
Rethink attitudes to risk
Breakthrough innovations require a culture of risk taking. However, this doesn’t mean lack of protocols in place to ensure risk management and service-user safety – especially exploring technologies such as AI.
The actions of regulators, payers, service providers, vendors, and service users over the coming months will further affect the use of digital technology and analytical tools within HHS organisations across the world. It is imperative that these parties work together to address the challenges and maximise the potential benefits of these solutions to deliver improved services to all citizens.
What are the major healthcare market segments that are likely to expand this year, and why is this so?
We can expect recovery and expansion in all major segments including healthcare services, medical devices and hospital supplies, medical insurance, as well as pharma and diagnostic services. Most of the recoveries are expected in the second half of 2021.
Although the pandemic is far from over, large scale vaccination programmes and fall in mass infections are likely to encourage people to go for costly medical interventions that were delayed and postponed in 2020. Similarly, hospitals and healthcare facilities are expected to re-align their resources as the number of COVID-19 patients drop.
Capital expenditures may remain flat on the back of strained revenue and additional capacity creation during 2020 – with exception to investment in digital tools and services which are likely to continue over the next three years. However, reinforced focus on public health by governments following the pandemic will provide an impetus to demand across all key segments. For instance, India announced an increase of 135 per cent on healthcare in its FY2021/2022 budget.
If we look at pharmaceuticals, they continued to perform relatively well unlike hospitals and healthcare service providers, and this is unlikely to change in 2021. Increased use of telemedicine and availability of online providers of prescription medicines are expected to provide cushion to any shocks resulting from further lockdowns.
