Why digital transformation in healthcare is so difficult and long-overdue

Overcoming numerous barriers will become a necessity of our time to ensure a viable future for healthcare — especially for further crisis situations.​

In the face of the current COVID 19 situation, the digital immaturity of the healthcare system reveals itself. All of a sudden it becomes clear how important networked patient data and the use of digital health services would be to relieve hospitals on site. But why has it been so difficult to implement appropriate digital solutions for our healthcare system while almost all other areas of life from food and transport to clothing and holidays have managed to do just that?

Let’s take a short look at human history to get started

The development of mankind is characterized by new technologies and innovations that changed our lives forever. The turning points in our history are well known and range from the development of simple tools for farming and weapons for hunting, to the invention of book printing, up until the industrial revolutions of past centuries which brought us disrupting technologies such as electricity, mobility, and the internet.

When it comes to our healthcare system science and technological innovations have always been the driver for innovations such as modern sanitation, penicillin, vaccines, and magnetic resonance imaging. With the advances in technology nowadays we can push back the boundaries of diseases even further:

  • Telemedicine enables people to experience healthcare from wherever they are.
  • 3-D printing is revolutionizing the production of medical devices, orthotics, and prosthetics.
  • Machine Learning and AI can predict possible disease outbreaks and optimize health services
  • Malaria, HIV, and diabetes can be tested on the spot and do not have to be sent to laboratories first.

These are just a few technologies that are currently transforming healthcare as we know it. Harnessing these digital technologies is essential if we want to create a future where healthcare is accessible for everyone around the globe and driving incremental value to our medical status. Dr. Tedros Adhanom Ghebreyesus, Director-General at WHO cuts to the chase of the matter:

“Such technologies are no longer a luxury; they are a necessity."


But reality looks different.

The use of digital tools for diagnosis, treatment, and management, for example, has been modest. The electronic medical record (EMR) is still not integrated into routine care. According to the Electronic Medical Record Adoption Model, usage ranges from just 3 percent in Europe to 35 percent in the United States. The root of the problem is not the technology itself but rather the cultural-mindset, organizational structures, gorvernment regulatory, skilled personnel, and others.

The annually conducted European e-health survey from McKinsey and HiMSS examined the current challenges in digital health per country. The infographic shows the main challenges European healthcare providers have to face in different countries.

@medudoc based on HIMSS Analytics, eHealth Trendbarometer “Annual European eHealth Survey 2019”, published November 2019

@medudoc based on HIMSS Analytics, eHealth Trendbarometer “Annual European eHealth Survey 2019”, published November 2019

Germany and Switzerland state that both struggle with getting sufficient funding for digital innovations as well as having sufficiently skilled employees. Also among the top three challenges, both countries see IT security as a major threat establishing digital systems and products in their daily business. In the Nordic countries as well as in the Netherlands and Italy the challenge of setting up interoperability standards is considered a major barrier of implementing digital tools.

So how do we overcome these challenges in digital healthcare?

McKinsey conducted research from over 30 countries and refined a set of conditions that can ease the path toward a successful systemwide digital transformation in healthcare.

  1. Governments have a key role to play in establishing digital transformation in healthcare systems: Governments are closely connected to their healthcare systems. Based on the findings of the survey governments and markets that promote digital transformation actively have the most digitally advanced healthcare system. On top sharing IT infrastructure with other public services, such as citizen-ID and consent-management systems, can accelerate the progress. Creating such platforms encourages patients to adopt digital services more easliy. Estonia, for example, is considered the country with the best digital healthcare system. Why is that? The Estonian Electronic Health Record is part of the country’s Health Information Exchange platform and is associated with helping to simplify the implementation of healthcare interconnectivity.
  2. We need to rethink healthcare regulations: Regulations in healthcare play an important role in protecting patient safety. When it comes to the implementation of digital processes a lot of patient data is being processed and needs to be handled carefully. But to improve processes and the productivity of healthcare services some regulations need to be updated or entirely replaced. In Germany last year Federal Health Minister Jens Spahn presented the “Digital Health Care Act (Digitale Versorgung Gesetz — DVG)”. It provides, among other things, for insured persons to be entitled to digital health applications. These can soon be prescribed by doctors and should gain access to the primary healthcare market. Besides, health insurers will be able to participate in the development of digital health applications as venture capitalists and thus assume a stronger role as drivers and designers of innovative healthcare.
  3. Invest in the right mix of skills to accelerate and sustain long-term transformation: We’ve already stated that Estonia in Europe’s leader when it comes to digital health. As a country that is considerably small and has a rather low GDP compared to other European countries how did they manage to get to this top level position? In the 1990s, Estonia tapped into transferable skills among former aerospace engineers to build its first eGovernment system and later the X-road system, a solution that ensures secure transfers of health information and other digital infrastructure for public services. This enabled the country to exceed its neighbors in terms of their level of digital maturity by providing a basic interconnectivity infrastructure. Digital leaders need to make strategic investments in the right workforce-skill mix to deliver technological innovations. Considering this if providers are to encourage electronic prescribing and broad adoption of digital therapeutics, then physicians must have a skill set at hand needed to understand the advantages and shortcomings of innovative technologies. Therefore, healthcare payers may need to consider further investment in workforce-education and -communication programs to promote a mind-set transformation toward digital.
Collaboration of all stakeholder is the key to a successful digital transformation in healthcare

Although numerous ountries have achieved promising digital-adoption rates in healthcare, the full power of a digital transformation of the sector remains challenging. Health systems have been incapable to meet quality, access, and financial gaps, even as their budgets continue to grow. More determination and effort are required to achieve success. And last but not least to establish strategic long-term digital solutions in healthcare all respective stakeholders have to work collaboratively.

About the author:

Mona Ciotta is working as Strategic Business Development Manager at the digital health start-up “medudoc” in Berlin. Coming from a digital marketing background she is now working on bridging the digital gap of evolved patient expectations, arbitrary regulations and economical pressured healthcare providers like hospitals and doctors. Through video animation, medudoc digitizes, automates and standardizes the analog and tedious practice of patient education before a medical intervention. You can contact her via mail (mona.ciotta@medudoc.com) and LinkedIn.