The eHealth Center recently launched a new initiative to engage in conversation about the future of digital health with every stakeholder involved: the eHealth What If Forum. The second session focused on Catalonia and the changes that new tools and digital solutions are causing at every level of the health system.
The session was moderated by Carme Carrion, the associate dean for research at the UOC Faculty of Health Sciences, who touched on some ongoing initiatives, such as La Meva Salut and eConsulta, and questioned how transformative these tools truly are and whether they work as designed.
The panel of experts consisted of Oscar Solans, functional manager of eSalut, and Jordi Piera, director of the Office of the Digital Health Strategy of Catalonia, both from the Government of Catalonia. Joining them were Mireia Sans, director of the Comte Borrell primary care centre in Barcelona and president of the Collegiate Section of e-Health Physicians of the Barcelona Medical Association, and Unai Sánchez, co-founder of HumanITcare, which markets digital health services for patient monitoring.
As we had seen in the first session of the What If Forum, the experts agreed to highlight the catalytic effect of the pandemic on the mass deployment of tools like La Meva Salut which are now over ten years old and have seen a huge spike in users, from 600,000 to 4,300,000, in little over a year.
With the health emergency more under control, in-person appointments are gradually returning to the mainstream. A change is being consolidated, a hybrid model that needs to be locked in and endowed with resources. The basic idea, the experts said, is a more profound transformation: for example, a single treatment plan, which spans from primary to hospital care. This transformation improves patient safety and encourages rational use of medications.
The portfolio of digital health initiatives that we will see implemented in the coming years is wide: all connected ICUs, digitization of the obstetric process, integrated chronic patient monitoring and transplant management, homogenization of mental care and, for the first time, a single integrated model for all outpatient care.
However, this transformation must also encompass the actual use that citizens and professionals make of the system, and for that to happen it needs political support at the highest level.
The all-day access offered by La Meva Salut has led to a sense of immediacy and the perception of health conditions, such as grief or menopause, which are natural and do not necessarily require specialized or immediate care, as diseases. The solution requires both user empowerment and support from the community, with broad-based health awareness and prevention programmes.
In addition, health professionals, especially those in primary care, have undertaken a series of bureaucratic tasks, digitalizing data and processes, without the support of resources or the necessary training.
Universal and equitable access to health services, both for the most isolated populations and for the most vulnerable groups, is now more possible than ever. However, making this a reality requires knowing the needs of each user at all times and the resources available to be able to offer the best service in each individual case.
Among the tools that experts consider key to evolving the system are natural language technologies, medical technologies and wearables, and artificial intelligence algorithms. But the challenge, the experts insisted, is not so much technological as organizational and cultural.
Digital tools must not perpetuate the barriers of the current system, which derive from the management structure of current health services; rather, they must establish longitudinal models of care, in which different professionals can interact with the patient both organically and efficiently.
We therefore need a single model with one sole budget that is both scalable and flexible. The experts do not believe that this solution can be fully developed within five or ten years, but trust that it can be advanced quickly enough so that this same time period sees significant changes and the full potential of the digital transformation of the Catalan health system harnessed.
You can also listen directly to what the experts said when answering questions such as the following:
- What if we are still far from the profound and global transformation that the Catalan health system needs? Regarding our current system, what works and what needs to be improved?
- What if digital transformation is key to maintaining universal coverage and ensuring the fairness of the health care system?
- What if thanks to COVID-19 we are now more aware than ever of the importance of this transformation? Are we really at a turning point that will see everything on the fast track from now on?
- What if the health system is really very different in the coming years thanks to digital transformation?
- What if the digital transformation of the Catalan health system, at least so far, has been markedly pioneering? What's happening in other regions of Spain or Europe?
- Questions from journalist Xavier Pujol: Have the big questions been answered? Where are we heading? Who decides the strategy? Do we have the necessary resources?
- Questions from Albert Barberà, director of the eHealth Center: Is the cultural shift that digital transformation requires understood at all levels?
- Questions from the audience: Are we working to get users to adapt to the changes required for the digital transformation of health? Do we have to think of different models depending on the user?