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Digitalization of healthcare: How far have hospitals got?

Our hospitals are in a state of crisis! Nothing new about that. And yet, there are plenty of local innovations aiming to improve our healthcare system. Let’s take stock of the situation. How long will it take for digitalization to become more widespread and for healthcare professionals and public institutions to start using it as a matter of course?

Multiple players and solutions

While the pandemic boosted the introduction of virtual healthcare, for the past several years, the digital healthcare ecosystem has been developing steadily, providing many solutions to cater to the needs of patients and professionals. Many startups are focusing on digital health, collaborating with hospitals on joint projects to produce the most effective tools to manage and care for patients.

L’Assistance Publique – Hopitaux de Paris (AP-HP), Paris and its region network of hospitals, set up the Hub Innovation to encourage projects by professionals in the 38 hospitals in the network, whether produced in-house or with external structures (startups, entrepreneurs, universities, scientists, institutions, patients, family members, carers etc.).

Furthermore, taking a more curative and preventive, customized and participatory approach, digital health improves care while cutting costs. From this perspective, Dr Dougados, a rheumatologist at Hôpital Cochin, insists on including patients in their care pathway and raising their awareness of it, especially for chronic diseases. “As soon as you onboard a patient for treatment, you improve their state of health. Chronic disease last for a long time, sometimes several decades. It’s the case not only for rheumatism but also diabetes, high blood pressure, heart failure, MS, diseases of the digestive tract etc. Most of these chronic pathologies require treatment on several fronts. Firstly, we need to inform the patient about their disease and treatment, secondly, we need to get them on board to monitor their disease, with tools to help them track symptoms themselves. What does need to be done, is train the patient physically, in person, to use these devices. Linking in-person training with digital is indispensable.”

Formaric: when digital serves patients and healthcare professionals

The Formaric project is managed by staff at Hôpital Cochin and Observia1, and aims to improve care for patients with chronic inflammatory rheumatism (CIR) using a training and information platform for patients and healthcare professionals. “It gives access to simplified information that has been approved by professionals. The platform is fun to use, so people can easily understand the issues, pathologies and treatment despite sometimes being quite complex,” explained Ornella Conort, the hospital pharmacist at Hôpital Cochin in charge of the Formaric project at the hospital.

Patients use self-assessment surveys available on the platform to take stock of what they know about their pathology on their own. Depending on their results, customised recommendations are issued to help them find out more about the themes they are less familiar with.

For chronic conditions, Patient Education is about providing the patient with the knowledge and information they need about their disorder, in order to improve their quality of life. Using digital sources, patients can learn from home, or wherever they wish (outside the hospital), gleaning customised information and finding out about new habits to learn to manage their disorder better.

Furthermore, as Ornella Conort explained, digitalization of healthcare also makes up for a lack of trained professionals. “This fills a gap today, since patients cannot get specialist appointments quickly nowadays. Support is digitalized but it is not just a platform on a computer, it can also be used on a tablet or Smartphone. This tool helps to delocalise information. People can learn anywhere and everywhere.” Healthcare professionals need to cut down on time spent performing time-consuming tasks that do not help their patients (admin, logistics, searching for information in patient files etc.) so that care-givers can spend as much quality time with them as possible (listening, gaining insights into their needs, giving them key information for their profile etc.).

Fostering multi-disciplinary collaboration and teamwork between hospital staff and GPs

Formaric also aims to optimise communication between healthcare professionals, “especially facilitating communication between hospital staff, especially hospital pharmacists, and those working in private pharmacies, for they play a key role in treatment. In the case of CIRs, for example, we doctors only see the patients every six or 12 months whereas the pharmacist will talk to them once a month,” Dr Dougados pointed out.

Digitalisation improves the collecting and sharing of information, and also helps to secure and adapt the patient’s treatment quickly and effectively. For example, with the Formaric project, liaising documents are not just digitised. Depending on the patient’s profile and the document recipient, information is customised (according to the pathology, treatment, survey scores, the recipient’s profession etc.). “This means we can prepare for their consultation better.” (Ornella Conort).

Transmission of information among healthcare professionals is especially important with chronic pathologies such as CIRs, because “several different specialists are involved. The various healthcare partners will need to discuss the patient at the hospital but also with professionals working in private practices (pharmacists, GPs, rheumatologists, psychologists etc.). The many necessary links can be set up via a secure platform. For us, professionals, this affords plenty of flexibility, smoothing the patient’s care pathway, even when a high number of players are involved” Ornella Conort added.

Strengthening ties between private practices and hospitals also means that all healthcare professionals can offer their patients better care, since they have access to training tools. The Formaric platform acts as a portal providing clear information that has been approved by specialist professionals. It caters to healthcare professionals, providing answers to very specific questions and self-learning opportunities. “Patients with a CIR have to deal with all sorts of healthcare professionals who don’t always have the time or energy to find out about rheumatology. And yet at some point they will need some knowledge to be able to adapt their practices and avoid harming the patient’s care.” Ornella Conort added.

Fostering networking and liaising among healthcare players, and their diagnoses, improving interactions among healthcare professionals and the patient and optimising their involvement throughout their care pathway, digitalisation leads to better all-round, efficient care.

In much the same spirit as Formaric, the interactive educational platform Atoutcoeur provides customised training courses on therapy to improve patients’ lives during cardiac rehabilitation and help them to adopt a healthier lifestyle. Launched in 2016, further to close collaboration between the Cardiac Rehabilitation Department at Hospital Léopold Bellan and Observia, this tool for caregiving staff and patients has had excellent results. A 2022 survey of 1,198 patients having used the platform showed a 2.8 points improvement in overall quality of life for patients2. Six years after its launch, 98.4% patients using the platform stated that they were satisfied or highly satisfied with the programme. Kamel Abdennbi, cardiologist and head of the cardiac rehabilitation department at Hôpital Léopold Bellan, pointed out that for the care-giving team, “nowadays, Atoutcoeur is seamlessly integrated into our department’s workflow, as a tool for working and coordination that we all appreciate. It has helped improved care for cardiac rehabilitation patients on an ongoing basis.”

Leaving the pilot version to set standards

There are many local solutions like the Atoutcoeur project in hospitals that have proved effective. Furthermore, nationwide initiatives are popping up to develop and promote French digital health such as French Care and PariSanté Campus. On top of these initiatives, there are also government measures such as Ségur de la santé, which aims to modernise and improve the French healthcare system. An envelope of €19 billion is being invested in the healthcare system to improve patient care and the caregivers’ working conditions. This includes €50 million a year (€400 million spread over 2021-2028) to support and boost French research and €600 million for the mass development of digital to catch up, after lagging behind for years.

For Dr Dougados “there are more and more digital initiatives and solutions, but we need more structure to roll them out throughout the entire hospital network. We really need to centralise and have the various tools communicating with each other. If you need to log in to several platforms for results, you waste several minutes for each patient. That time could have been spent talking with our patients. Digital tools also need to be more ergonomic because it’s too complicated using several different tools.” What’s the solution? We need to create interoperable software to retrieve the right information, at the right time, for the right specialist, and smooth transmission to other software. Dr Dougados added that: “of course, these tools raise security issues, as well as personal data concerns.”

Data security: a crucial digital health concern. An issue that Observia pays special attention to. For ten years now the firm has fulfilled all security criteria, leveraging its experience and expertise, with the legalities of personal data protection, especially the GDPR, at its fingertips. Observia has an AFNOR-certified DPO (Data Protection Officer) and all the data collected by the firm is hosted by ATE, which has been approved for healthcare data.

To wrap up, Dr Dougados warned that some tools may not last, and they need to be designed with input from all healthcare professionals. “Generally speaking, people take pride in rolling out new software, but they tend to forget the next stages which involve assessment, distribution, implementation and updates. If this has not all been planned out from the star, it won’t work properly. Ongoing use of software needs to have been planned so that it doesn’t just disappear after six months. When solutions are rolled out, healthcare professionals need to be involved from the outset. For example, Formaric was developed in Paris. Doctors need to be involved, but also those in closer contact with the patients, such as the patient’s local pharmacist. The local pharmacist may have difficulty getting on board, but it works more smoothly when they get a heads-up when the patient first goes to the hospital.”

The healthcare system is switching to digital and there are plenty of projects and solutions available. Nationwide, the ball has been set rolling, as seen with Mon Espace Santé (personal accounts for all citizens). If they are to last and leverage the entire healthcare system, local initiatives need lasting support, especially from local financiers, who know what local needs are. An effort to set up structure which is also indispensable for digital solutions to be rolled out more in institutions.

Things are now speeding up with the integration of key elements by various players: tools need to work seamlessly together and be user-friendly to appeal to healthcare professionals, as well as ensuring healthcare data security to reassure patients.
Many innovative solutions have proved to be valuable for all stakeholders, and the usefulness of digital solutions in healthcare now goes without saying. Usage needs to be more widespread, so that all healthcare professionals can leverage the advantages of digitalization, and truly improve patient care.

[1] In partnership with RESAH (the hospital buyer network), the Ile-de-France Region, BPI France and Medicen (a business cluster for Biomedical engineering)

[2] SF12 survey, 2022 Observia survey

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