Digital health is a new approach beyond the e-health model. E-health was introduced with supply systems, but lacked patient interaction and connection of various systems. Digital health starts with the patient providing empowerment, and can result in better outcomes.
Digital health is a set of tools that work in the existing system. Clients can access information regarding their own health, and data can be shared directly with physicians and teams. This information can easily be shared with caregivers. With 95% of care occurring in the home, several issues can be addressed concurrently (e.g. obesity, mental health and isolation are often occur in one patient.)
The introduction of the cellular phone made technology once available only available to affluent members of society readily available and accessible. However, it can add to the negative aspect of data silos. The capacity for data sharing with cellular phones is far beyond its current uses. For example, data received by a physician triggers an appointment to prevent a crisis, or medication instructions are shared with a patient or caregiver.
Ten critical measures for data sharing were highlighted:
1. Healthcare needs will not change in 3-5 years like financial services.
2. Data silos must be avoided.
3. Data streams must be filtered before reaching doctors to avoid overload.
4. Current funding and policies currently do not support the model.
5. A new label on an old data system will not work.
6. Apps must have physician input, but be professionally developed by software experts.
7. The idea of robot doctors and magic wearable technology must be discouraged.
8. Patient reported outcomes must be acted on, not treated as data.
9. The importance of changing behaviours and beliefs is as important as technology development.
10. Human contact is still the basis of healthcare, and cannot be lost in technology.
Dr. Leonard advocated for keeping people at the centre of providing good healthcare. Technical processes are important, but culture impacts patient satisfaction and/or burnout for doctors or nurses. Culture allows an offensive approach as the best solution, ahead of systems, reactivity or unmindful function (the worst case scenario).
Various studies and their findings were identified tracking hospital culture. There must be an assurance of safety, education and feedback. One study revealed that one-third of nurses were hesitant to express a concern over patient safety. 47% of healthcare staff reported burnout, and 25% of registered nurses leave during their first year in practice.
The culture of a hospital reflects behavior and beliefs within the organization. Data shows when performance is tracked at less than 60%, patients report 50% satisfaction, and staff only slightly higher at a 55% rate of satisfaction. Above 60% performance tracks very differently with the patient experience at 98% and staff experience at 91%. More tracking clearly results in healthier outcomes for all.
Statistics in various studies repeatedly show that psychological safety of staff is directly correlated in all wards of a hospital to infections, deaths, successful surgeries, etc. Systems on bulletin boards in departments initiated years ago tracked problems and solutions with timeliness with a red, yellow and green system. This improved department morale and patient care, and has now been updated with cellular phone apps for real time tracking. Technology makes data entry immediate and easy. A commitment to learning and continuous improvement must be integral elements of the culture in a healthcare environment.