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April 25, 2019
SCALABLE DIGITAL HEALTH INITIATIVES – HOW TO GET THERE (PART I)
By: Shannon Tobolov

In my last blog I identified the gap remains between what consumers want from a digital health experience and what they get: demand is far outpacing supply. The next question, quite obviously, is how to narrow the gap.

There are several barriers that organisations will need to overcome to implement scalable digital health initiatives. One of these is fragmented service planning, with many layers of the health ecosystem working in isolation (such as acute, primary care and social services), with a lack of supporting policy and payment systems to change. Another is Inconsistent standards, terminologies, identifiers and directories, which inhibit interoperability and system integration across organisations. Then insufficient user-centric design reduces the value-add of technology and lowers consumer and provider engagement and adoption. Despite increasing costs and a growing shortage of healthcare workers, there is a lack of a digital workforce and inadequate use of digital tools and automation. Finally, there is a gap of value-based care and outcome driven performance measurement to demonstrate results and Return on Investment (ROI) at both an organisational and Health Ecosystem level.

In today’s highly digitally interconnected world, ecosystem-thinking helps all health organisations to address these barriers and capture more value for their customers. This is accomplished by thinking through connected end user journeys beyond the walls or scope of one’s own organisation. These experiences may be linear as we see in transitions of care settings (e.g. between primary and acute care) or non-linear, which is more common in the context of an individual’s everyday self-management, including interaction with other social services such as the National Disability Insurance Scheme.

Ecosystem thinking enables organisations united by a common purpose to find value in sharing resources and information by forming alliances to solve common problems, thereby joining up channels into coherent systems of engagement. For example, in the UK, the organisation, “Collaborate,” has brought together local government, the National Health Service, civil society and the private sector to tackle social challenges.1 In the US, the "Live Well San Diego" campaign has garnered more than 300 partners focused on helping residents live healthy lives.2 This has been driven by the San Diego County’s Health and Human Services Agency, which has transitioned from being merely a service provider to a leader of the ecosystem, facilitating collaboration and effective partnerships to advance the "Live Well San Diego" framework.

Similarly, in Kentucky, which had the third-highest overdose mortality rate in the United States in 2015, stakeholders from the 120 counties in the state, academia, and the private sector collaborated and promoted data sharing to gain a sophisticated understanding of the opioid crisis in order to predict risk and design better prevention and treatment programs.3 Examples of ecosystem thinking are springing up between industries as well. For example: Apple partnered with retailers, including Nike and Hermes, to corner the wearables market by focusing on people interested in fashion and an overall fitness experience.4

We have identified six capabilities that all organisations need to survive in the dynamic evolving Health Ecosystem, using a metaphor of the human body (as demonstrated in the figure below).

  1. Data Intelligence (Brain): the ability to effectively capture, manage, utilise and secure data for strategic insights;

  2. User-centricity (Heart): the ability to deliver exceptional user experiences and family-centric outcomes;

  3. Agility (Muscles): the ability to adapt and successfully respond to change

  4. Innovation (Blood): the ability to develop creative solutions to overcome problems;

  5. Platforms (Skeleton): the ability to build an integrated portfolio of digital experiences that exchange value across a variety of end user channels; and

  6. Partnerships (Whole Body): the ability to work collaboratively in new ways to maximise health and business outcomes.

Health Ecosystem Survival Kit

Look out for my next blog when I’ll go into more detail on how to leverage these six capabilities and get closer to scalable, successful digital health initiatives.


1 Collaborate for social change
2 The power of a generative ecosystem in health and human services
3 The 2017 health and human services summit: Creating the future of outcomes and impact
4 The Apple Watch has a secret weapon that helps it dominate the market

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