The evolution of healthcare

Computing and the use of information has become tied to the advancement of healthcare globally, says HIMSS President Hal Wolf

The evolution of healthcare has always been fuelled by data and information. HIMSS has been on the same journey from day one and continues to help accelerate information and technology as a part of healthcare. This vision dates back to 1961 at Georgia Tech, a technical university in Atlanta, and was the brainchild of the head of the computer science department who saw that hospitals could use data and information to help run themselves better.

It’s important to recognise that HIMSS is a society - a group of people with like-minded goals around a particular discipline, but not just a single discipline or a single component. As a result, today HIMMS encompasses physicians to nurses to technologists, and everyone in between.

Our mission is to reform the global health ecosystem through the power of information and technology based upon a fundamental vision, which is to realise the full health potential of every human, everywhere. And so those pieces come together around health equity and the goals of the organisation, which is that every human, no matter where they are, should be able to reach their full health potential. And the critical component of the methodology is the utilisation of information and technology.

So, how do we utilise information and technology for the betterment of the delivery of care for every person everywhere? In the last five years, HIMSS has grown from under 80,000 members to more than 120,000 as computing and the use of information has now become incredibly tied to the advancement of healthcare. It’s not just about access but about information to improve quality, and we have comparative data and information as never before with the dependencies such as interoperability that sit underneath it, where we have to be able to have the information exchanged on a fundamental basis. But when you look at the bigger picture of healthcare and the challenges of healthcare overall, they have remained largely the same.

The changing face of healthcare delivery

We are dealing with an ageing population, the silver tsunami and the baby boomer generation, who are developing more chronic disease burdens which we are much better at diagnosing. There is also the lack of knowledge about the burden of Long COVID. Within this framework, we have the issue of geographic displacement - you can live in the shadow of some of the greatest hospitals in the world but it doesn’t mean you have access. Geographic displacement is both a world issue as well as an urban issue and there are fundamentals behind it. First of all, it takes a heck of a lot of funds to build

Hal

President & CEO HIMSS

Harold (Hal) Wolf is the president and CEO of HIMSS, a global advisor and thought leader supporting the transformation of the health ecosystem through information and technology. Wolf is respected internationally as a healthcare and informatics leader, with areas of expertise in mHealth, product development, integrated care models, marketing, distribution, information and technology, and large-scale innovation implementation.

a system, and secondly, you’ve got to have the people to man them. And there is another chronic problem, a shortage of people to manage healthcare systems around the globe.

So we use digital health to be able to extend care or diagnosis of care to individuals as they move forward. We now have an educated consumer group - one of the silver linings of the COVID era was that people realised they could do a number of things to support their health online without sitting in front of a nurse or a doctor. Equally, systems learned that they had no choice but to do that so the whole world of digital health has changed dramatically.

We see an app ecosystem which continues to develop. We see the beginnings and the utilisation of AI as well as machine learning tool capabilities in order to support it, both of which have a huge impact in supporting systems as they exist today. They also impact health equity and are really starting to break down the barriers on that geographic displacement.

The recognition is emerging that there is almost too much physical infrastructure, and healthcare has to be delivered di erently in societies that have been built on the encounter-based paradigm. I call it the anomaly, meaning that we’re trying to define normal at the individual level or predict an anomaly against the norm at the population health level. Traditionally we would run tests and then put the patient into a defined care pathway. We have always carried out preventative tasks where we ask people to come in and have blood taken for example, or try to define risk through behaviour.

Digital health has seen the development of predictive modelling in anticipation of the anomaly before it occurs. This could be via an app or machine in the home that can detect and decipher that an anomaly has occurred, which may not even be recognised by the individual themselves. This is where the substitution of digital health starts to transition itself into the delivery of care, both within and outside the institution.

Overcoming geographic displacement globally

I would say digital health is a critical complement to the encounter-based paradigm, and they have to work hand in glove with each other. It will help both with the identification and the prioritisation of where those highly valuable resources in the encounter-based paradigm should be utilised and focused. It will then extend beyond the walls of that physical infrastructure through digital capabilities to the person in the remote village or wherever the case may be, so that geographic displacement can be overcome.

The need for human to human contact will always be there. But if we can maximise utilisation of digital health, if we see the development of the health ecosystem and we allow the utilisation of data and information to be de-identified, highly secure information will be able to work with us on predictive modelling.

And surprisingly, the countries with the least healthcare infrastructure will be able to take advantage of these new systems first. They are not burdened by the albatross of legacy health care systems. The days of building computers in the basement of a hospital are long gone. I believe emerging economies will build cloud-based infrastructures that sit in one place within their country – for example a lightweight electronic medical record that uses 3G up, not 5G down. Once it is in the field with a minimal level of bio capability IDs, they can track an individual’s basic state immunisation record and deliver simple pharmacy alone which is a massive upli . It’s critical for maternal health and it’s critical for health equity.

I’ve spent time in villages in Africa and other places, and I’ve talked to many a physician with Doctors Without Borders. I think the absolute forefront of digital health is to build these cloud-based infrastructures that are secure and flexible, using algorithms to li these fundamental economies up by having better health. Any society that has a healthy society produces more, lives longer, does a better job and has a chance to grow. The second we improve healthcare and make it more universally accessible, we give life. And that’s the truth.

A large scale primary care provider based in the UK

Supporting international health care providers to deliver best in class primary and step down care

Providing partnership opportunities for investors looking at building international and UK based portfolios