Patient Enablement in Healthcare, de Patrick Eugster

27/09/2021
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The areas affected by digitalization in health care are vast, and their possibilities range even further. One aspect of digitalization in health care evolves around the enablement of patients. According to Bell et al. (2016), one in every twenty google searches dealt with health concerns. More and more people use the internet as a source of healthcare information. Concerning this new phenomenon, Audrin-Pontevia et al. state: “People—whether they are more or less educated, sick (or not)—can read, write, and share this medical information, using it as much or as little as they wish, passing it along from OHC [online health community] leaders to followers.” (p.226, 2017). The effect of this phenomenon on global health care is fascinating and relevant for the future of healthcare.

The previous article about digital transformation in healthcare presented the most powerful digital technologies and their impact on society and the healthcare ecosystem. This article will focus on the changes in relationships within the healthcare ecosystem caused by digitalization (Vallo Hult et al., 2019). More specifically, this article will discuss the changes to the role of the patient and its interactions within the healthcare ecosystem. The first paragraph consists of a summary of the digital technologies and changes within healthcare that affect the position of patients. After that follows an analysis of the changes and shortcomings of patient enablement, followed by the consequences of patient enablement on global healthcare.

Digitalization in healthcare has many positive effects and can help overcome several major problems healthcare ecosystems face (Hermes et al., 2020). Patient’s access to electronic healthcare increased community support websites, and physician rating websites are just the most prominent digital technologies that disrupt the role of patients (Gianchandani, 2011). All three digital technologies enable patients to gain more information about prevention, diagnosis, treatment, and recovery. Thereby, there is an alteration to the role of patients and their interactions with physicians and caregivers. Another important patient-related innovation, which does not stem directly from digitalization, but connects to it, is the rise of value-based healthcare. Value-based healthcare involves an adjustment away from classical pricing, known as outcome-based pricing, and the readjustment of the purpose of healthcare treatments (Meinert et al., 2018). Classical pricing in healthcare reflects the costs of research and development of a treatment or diagnosis, whereas outcome-based pricing is only concerned with therapy outcomes (Kokshagina & Keränen, 2021). Therefore, a treatment that does not affect the patient would not have to be paid for, setting the right incentives for treatment developers. Further, the change to value-based healthcare strengthens the cultural shift towards more patient-centered care, where several patient-related parameters are the basis for value (Meinert et al., 2018).

Furthermore, innovations in patient enablement have a considerable influence on the role of patients within the healthcare ecosystem. The facilitation of access to information about healthcare has disrupted how informed, and misinformed patients are (Ruckenstein & Schull, 2017). The facilitation of access changes their relationship with healthcare workers to make diagnoses and treatments more likely to be questioned. Further, due to the patients owning and controlling most of their health data, combined with their self-researched opinion, the roles are altered to have a more decisive influence on the treatment (Neinstein, 2013). Similarly, the rise of value-based healthcare shifts importance towards the patient and away from the existing ecosystem actors. These changes alter the culture and pricing of healthcare treatments, which has a primarily positive effect on patients, bringing their needs forward and the work of healthcare workers becomes more transparent (Vallo Hult et al., 2019).

A downside to patient enablement is the lack of access to the internet for a particular patient, which excludes them from using and being enabled by digital technology (Lupton, 2014). Another downside comes in the form of difficulties of using new digital technology such as telemedicine, as their ease of use is not ideal for a significant part of the patients (Lupton, 2014). Furthermore, general social inequalities, such as lack of education, also influence the access to digitally-enabled patient enablement in the form of lacking knowledge on how to deal with general online health advice (Lupton, 2017). Similarly, value-based healthcare is mainly available to patients and hospitals that can change their payment system.

Patient enablement has a significant impact on the role of patients within the healthcare ecosystem and, therefore, also on global healthcare. Nevertheless, certain groups of patients do not have access to patient enablement due to existing inequalities. Healthcare workers will have to spend more time explaining their considerations for making certain decisions for those who are affected. Similarly, pharmaceutical and medical technology companies must adjust. Their realignment will increase time and costs for additional explanations and extensive research.

Further, there is an increase in patients that are not conforming with the treatments prescribed to them as they have different opinions. One prominent example of this is the ‘Anti-Vaccination’ movement which can jeopardize global healthcare efforts to hinder the spread of viruses around the globe. Those are just a few examples of the effects of patient enablement, which will gain increasing importance throughout the following years. Therefore, public healthcare institutions must prioritize enabling as many patients as possible correctly.

References

Audrain-Pontevia, Menvielle, L., A. F., & Menvielle, W. (Eds.). (2017). The digitization of healthcare: new challenges and opportunities. Springer.

Bell, David, Brian Fox, and Ryan Olohan, Pharma 3D: Rewriting the Script for Marketing in the Digital Age (The Wharton School, Google, and McKinsey & Company Inc, 2016), 75.

Gianchandani, EP. Toward smarter health and well-being: an implicit role for networking and information technology. J Inform Technol 2011; 26: 120–128.

Hermes, S., Riasanow, T., Clemons, E.K. et al. The digital transformation of the healthcare industry: exploring the rise of emerging platform ecosystems and their influence on the role of patients. Bus Res 13, 1033–1069 (2020). https://doi.org/10.1007/s40685-020-00125-x.

Kokshagina, O., & Keränen, J. (2021). Institutionalizing value-based healthcare in a service system: a policy and document analysis over three decades. Journal of Business & Industrial Marketing.

Lupton, D. (2014). Critical perspectives on digital health technologies. Sociology compass, 8(12), 1344-1359.

Lupton, D. (2017). Digital health: Critical and cross-disciplinary perspectives. Routledge.

Meinert, E., Alturkistani, A., Brindley, D., Knight, P., Wells, G., & Pennington, N. D. (2018). The technological imperative for value-based health care. British Journal of Hospital Medicine, 79(6), 328-332.

Neinstein, AB . From “pull” to “push”: a transformation in medicine: comment on “participatory surveillance of hypoglycemia and harms in an online social network.” JAMA Intern Med 2013; 173: 352–353.

Ruckenstein, M, Schüll, ND. The datafication of health. Ann Rev Anthropol 2017; 46: 261–278.

Vallo Hult, H., Hansson, A., Svensson, L., & Gellerstedt, M. (2019). Flipped healthcare for better or worse. Health informatics journal, 25(3), 587-597.

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