Health and wellness are an increasingly dominant topic of discussion in all countries because of the remarkable social and demographic changes, rise in chronic diseases, and the need to improve efficiency and quality in health care delivery. Identifying approaches and framework conditions to achieve a smarter, more efficient and responsive delivery of health care has, therefore, become a key preoccupation of governments, especially in the present economic and financial context.
The Organisation for the Economic Co-operation and Development (OECD) and the US-National Science Foundation (NSF) built on discussions at this workshop to identify strategic directions for the future, from both a technological and a policy viewpoint.
The workshop explored the potential of a wide range of technological developments and reviewed progress across OECD countries. The workshop considered what is needed to move forward with effective deployment, the social and organizational innovation that will be necessary, the challenges encountered in redesigning processes of care, access and privacy issuesand the sustainability of the new business models and their impacts, including the benefits to individuals and the savings that can result from well-designed interventions.
The sections below summarize the main messages emerging from discussions at this workshop.
- New high-speed and mobile applications, connected devices, social networks, and related cutting-edge technological developments provide unique and unprecedented opportunities for developing an environment and services that can support a range of new smart models of care.
- It is possible today to personalize therapy in wholly new ways, to support remote care, including ubiquitous real-time monitoring of patients, increase patient access to health services and information, patient empowerment and self care and improve the way health professionals deliver health services - particularly for chronic disease prevention and management.
- Mobile Health (M-Health) is by far the fastest growing segment of IT-based health care delivery systems. A wide range of devices are utilized for M-Health today, including mobile phones (in particular smart-phones), tablets, global positioning system (GPS) devices, mobile tele-care devices and mobile patient monitoring devices.
- In the long term, the potential is to transform the current health system into a rapidly Learning Health System, where real time feedback can enable timely and improved care strategies by electronically linking patient information (e.g., diagnosis, treatment, survivorship, recurrence, and quality of care) with a learning infrastructure that brings together patients, doctors, and researchers in a smart new environment.
The new models of care require, however, a major shift from traditional practices and radical re-engineering moves. Change is fraught with difficulties. The workshop identified the following six areas where further analytical and policy work at international level could be useful:
- Address the big data and network challenges: The complexity of health data collection and use is growing exponentially. Conventional technology today cannot effectively manage or even capture the many health data streams and ensure that they will be turned into useful and actionable health information. For smooth data transfers, applications also require sufficient capacity, very low latency and high quality of service guarantees in order to work safely and efficiently. The new range of devices and IT platforms has to function seamlessly and adapt to multiple user needs in the health sector and partner sectors.
- Foster meaningful innovation: An open architecture can pave the way for rapid exploration and innovation in this sector, as well as iterative improvement. Innovation, however, needs to be far more than technological innovation. Health care responses, and means of delivering smart services, need radical organisational and social innovation given the multiplicity of ‘actors’ with different cultures and roles.
- Encourage organisational change for a virtual care future: The dual steps of ‘demolishing’ professional or sector-specific silos, and of moving from fixed and institution-based provision of care towards ubiquitous care provision based on M-Health or remote monitoring, are challenging and also require disruptive innovation of many existing processes. This radical change is vital, but must be managed sensitively and constructively. Establishing and sustaining engagement among participants is critical to the success of these initiatives.
- Understand and address potential new risks: With any new technology or other innovation come new risks, and unanticipated outcomes. The challenge for system designers is to balance the inherent benefits of the new smart technologies against the potential new risks, that is, to build systems with user-controlled privacy and verifiable assurances that are flexible with regard to data access conditions and patients’ preferences over time.
- Identify and support sustainable new business models and evidence-based implementation: There is a need to understand the regulatory structures which provide incentives at different levels of the health delivery system to encourage investment in, and use of the new models. New metrics will have to be developed to monitor and assess adoption and utilisation, identify best practices, and generate economic models for planning and analysis.
- Promote capacity-building and training: there is a huge demand for training of health providers in the use of ICTs and for innovative solutions that support community health workers, and improve patient understanding and use of these new tools. Case studies could be useful to identify best practices.