If health is wealth, then what is digital health? Potential wealth on steroids that is under-invested in!
Health is wealth, and each individual should be investing in good health to prevent the onset of disease for as long as possible. However, we have a quasi-social health system that gives Australians the comfort in knowing that everything will be provided either for free or with small financial contributions. That system makes it difficult for people to invest in their health even if the government encourages them to do that. The best thing within that system is to improve health monitoring by leveraging on the latest technology.
Under the quasi-social health system, some people are only covered by Medicare and get medical care in public hospitals, while those who can afford private insurance can either go to private hospitals or to public hospitals as private patients. It is natural to assume that the insurers, both government and private, would monitor people’s health to maintain health and prevent unnecessary hospitalisation. Yet, even private health insurance providers do not give the same incentives that home insurance providers give. If you have home insurance and you buy an alarm system with back-to-base monitoring, they give you a discount. Show me one private health insurance if you buy remote monitoring equipment with back-to-base monitoring that gives you a discount.
It is a fact that we are in a digital age in which remote monitoring could add a lot of benefit to the system. It is also a fact that we endorse virtual care in various forms. To that end GP clinics are even getting grants that they should use for IT and by now they should be state-of-the-art digital health centres. Yet, many of them are lagging behind even though the nation has spent a lot of money on the eHealth initiatives. As a result, Australians who do their shopping and banking online for convenience are expected to queue for health care, and even drive long distances from rural areas to cities for specialist care while feeling sick! Why? Since the introduction of eHealth many years ago, by now we should be using digital health care to focus more on patients, and investing in eHealth rather than new hospitals and beds, making healthcare more patient-friendly, and making it more convenient for patients to access services.
The Covid-19 pandemic showed us that we do not have to do many things person to person any more unless it’s absolutely necessary. Telehealth should have been the post-pandemic launching pad for a lot more investment into digital health by the government and the private sector. After all, the Covid-19 virus has not disappeared entirely and elderly people are particularly at risk if they are hospitalised too often. Monitoring them at home and providing care remotely can reduce their risk of infection.
In case people doubt the effectiveness of telehealth, a study conducted by Donelan et al (2019) shows that patients’ satisfaction with Telehealth has increased by 62%, and they agree that Telehealth is the same as in-person care. This should now be publicised so that more people demand telehealth services. Hopefully, if demand for telehealth increases, more healthcare service providers will provide it.
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GPs need the whole health record of each patient at their fingertips. They cannot be effective and efficient if records are compartmentalised. This is particularly crucial if a patient is not able to answer questions due to incapacitation. There is no reason why this is not happening. The Australian government is already committed to digital health. 1. It introduced My Health Record system which is managed by the Australian Digital Health Agency (formed in 2016). 2. It gave Standards Australia the responsibility of creating and maintaining eHealth standards which are in line with international standards. 3. It uses the Healthcare Identifiers Service, a national system that uniquely identifies individuals and healthcare providers. Meanwhile, technology keeps evolving and we now have AI, blockchain, the internet of things, and other tools that automate a lot of processes and protect data from loss or theft. Therefore, there is no reason why we do not invest more in digital health in order to take advantage of such government initiatives and advances in technology.
For sceptics, I wish to point out that remote patient monitoring (RPM) has benefits. It provides better outcomes through early identification of health deterioration, and can help to reduce unnecessary hospital admissions. It also empowers patients with chronic conditions to be more proactive in managing their health. This is what we have been trying to do for years. Research by the CSIRO5 has shown that RPM provides cost savings for the healthcare system and improves patients’ quality of life and understanding of their own medical conditions. It enables patients to stay connected with health professionals outside of formal care delivery settings (such as hospitals and GP clinics) and can allow older patients to receive care in their own homes for longer. This ties into Self-Management Support nicely. Yet the government doesn’t fund the equipment and or monitoring for most patients, nor is private health proactive in the matter. This needs to change.
Indeed, health is wealth and we need to educate people on the benefits of taking responsibility of their health, and investing in it which is not easy. Digital health is wealth on steroids yet we are not investing enough in it. The best thing we can do as a nation is to improve the way we monitor people through telehealth. That way we can reduce unnecessary hospitalisation and thus reduce the pressure that the healthcare system is currently under. We should also allow GPs to become primary care providers with community-based specialist services that are accessible for a low fee. In order to achieve such transformation, we need to reform political determinants of health in policy and financing. We also need to reform social determinants of health by having care accessible and equitable. If we can have large monitoring centres for home security, we can have large public and private health monitoring centres that operate 24/7. If all these suggestions are implemented, we will have less people developing chronic illnesses, and less sick people needing to be hospitalised. Overall, we can reduce the cost of healthcare in Australia.