What we are observing in healthcare today looks more like experimenting with digitalisation than actual digitalisation. We are trying to create a completely new organism composed of random elements without any idea how to combine them in the first place. If so, then are we not building something that we will promptly lose control over? Or something that will prove to be merely a disappointing result of high ambitions without a proper plan?
The prologue. Dreams about smart healthcare.
Forty years ago, the first personal computers began to enter the market. The whole world was to change for the better, so was healthcare. In 1988, Apple, today’s global leader in new technologies, released a movie called “Healthcare 2008”. At that time, futurists prophesied that we were on the brink of a great revolution. In 20 years, the state of everyone's health was supposed to be monitored continuously with the use of wearable technologies. Artificial intelligence would analyse data from a patient’s medical record and select the best possible treatment, optimising its costs at the same time. Thanks to computers, doctors would be able to spend less time on dealing with each patient, as it would be enough to ask a question for the software to provide any relevant data, perform all required calculations and find the necessary information, even in the case of long-term medical records. In other words – healthcare of the future. There have been many predictions like the ones above, and more still are created every day. And yet, even though the technology is developing exponentially, these visions nonetheless remain a mere dream.
Today, 5 billion people in the world already own a smartphone, which in its essence is a miniature computer that is always at hand. Artificial intelligence accompanies people at every step of their lives. In the health care industry, AI makes diagnoses, conducts medical research and even advises patients on how to stay in good shape, both mentally and physically. Data that was once stored on paper is now being transferred to electronic databases. Technologies such as virtual reality (VR), augmented reality (AR), Internet of Things (IoT) and wearable devices measuring health parameters have been introduced into the healthcare market as well. However, despite this, healthcare has not undergone any significant revolution. The number of hospitals has not changed, mortality in the case of non-communicable diseases has even increased, and doctor A still does not have access to patient data recorded by doctor B. Hence, it would be difficult to speak of any tremendous progress.
Action. Everything has spiralled out of control.
The construction of a new, modern healthcare system began with the digitalisation of medical files. This process is still ongoing as of today. Hundreds of IT companies creating different software based on various standards, or in some cases no standards at all, were supposed to help medical professionals in their job somehow and make it possible to automate certain processes. In reality, the only thing that happened was that keyboards replaced pens and computer screens replaced sheets of paper. But the most ironic is the fact that in many cases, the electronic data has to be converted into a paper version anyway. Badly-functioning analogous processes have been replaced with badly-functioning digital processes. We have created a digital Frankenstein, and we immediately lost control over it. Though the hero of Mary Shelly’s 1818 novel had a good heart, he was still rather frightening. Similarly, in 2019, doctors are equally terrified of the digital revolution, even though its ultimate intentions are good.
VR, AR, AI, IoT, robotics, etc. are introduced without any strategy or a systematic approach, solely in the hope that the entire system will eventually start working smoothly entirely on its own. It is a good thing that more and more breakthrough technologies emerge every year. Nonetheless, they are but single pieces in the complicated puzzle that is digitisation. They will not fit into a sector as complex as healthcare without a good plan, vision, strategy and proper standards. It is akin to making dozens of Lego blocks of stunning shapes and colours, none of which match any other blocks. In the end, no one will be able to build anything using them. The most visible proof that something went wrong is the lack of the synergy effect that digital tools usually bring. In individual cases, they might have streamlined some processes on a local scale, but, if we were to use the Frankenstein analogy, they are merely well-functioning organs which are not connected to the rest of the body.
The epilogue. Something that lives its own life.
Contemporary visions of future healthcare are still stuck among the dreams from decades ago: centralised databases automatically gathering all the necessary information, which is then analysed and processed to create actual knowledge that is helpful to both the doctor and the patient. In this fantasy world, there is no need to input data into a computer, no printers are needed either, and the doctor is not sitting on the other side of a computer screen, away from the patient. There, in modern and quite ascetic rooms that look more like offices, large monitors display the most important of the data collected, all in a clear and understandable form. Healthcare is focused less on healing and more on prevention.
Is the introduction of such a system a matter of 10, 20, 50 or perhaps 100 years? Although we have made a huge mistake by leaving digitalisation to its own devices, anything is fixable with appropriate effort. We already know that this is not about technology per se, but rather about transformation – a process that should be carried out in a coordinated and well-thought-out manner. For now, we have only managed to create a digital entity that is developing chaotically, whose individual body parts are sewn together ad hoc, and which appears somewhat functional. This is not something we want to have. What is worse, our dreams of harmoniously-digitalised healthcare are no longer threatened just by the lack of data interoperability, but some new issues as well, including the commercialisation of patient data, lack of transparency regarding algorithms and unethical principles in building artificial intelligence solutions.
It was not digitalisation that turned out to be too much of a challenge for the healthcare sector. Conversely, it was the healthcare sector that overwhelmed digitalisation with its enormous and incredibly complex challenges. In order to remedy this, we began to make its components digital step-by-step. However, as of today, this monster still remains incomprehensible to many doctors and patients alike. For everyone to truly witness its good nature, it is necessary to piece it together and properly plan its further development.