The main driver is the democratisation of information. While information and knowledge were once only the territory of the physician, now everyone is able to access the raw information through digital technologies. This does not necessarily translate into personalized evidentially based insights however and physicians are having to spend time with patients assisting and guiding them to make sense out of large amounts of information available. This process necessitates a change in the interaction between physician and patient. Not only is it very different from the often, didactic exchanges in the past where information was imparted, and a few questions answered, but the requirement to assist the patient assess the information they already have gleaned as well as inform them of what is missing and personalize it, is inevitably putting more pressure on physicians in an already crowded consultation.

Patients today can also wholly appropriately be more conscious that care plans need to be personalized to their needs and aspirations. The days of evidence based care which is similar for everyone is gone and the days of evidence based care for one are here. Is this a bad thing? I think not. The more care and treatment plans are personalised, the more they are owned by patients. The more we manage to activate patients to take responsibility for their own health and care, the more traction we get with actually living treatment plans rather than being aspirations which are never wholly achieved.

Patients are also being thought of more as citizens. In systems where socialised medicine is the norm, this is happening faster but this is a global phenomenon. It is even being seen in the new emerging digital public health approaches, where wellness and resilience are being encouraged in the absence of disease.

Here, interactions with citizens are starting long before people become patients. New digital precision, personalized, predictive preventative approaches are using data to personalise health and wellness messaging, often using gamification to deliver these messages to assist behavior change in people.

The effects of these changes can be significant and the health gains that follow are also worth pursuing. Globally, we have seen a reduction in the anticipated steep rises in the number of people with cognitive impairment as a result of reductions in prevalence of smoking, more physical exercise, better and healthier diets, as well as more comprehensive medical care. Although much more needs to be done, these reductions in prevalence are very welcome and a real attestation of what can be done if one truly tries to engage people.

Systems continue to transform themselves to adopt more personalised approaches and there will no doubt be new points of potential difficulty emerging as well as some welcome outcomes. The fact that we are now far more used to the new personal interactions will hold us in good stead as we continue on our journey towards digital transformation. 

Charles Alessi is the chief clinical officer of HIMSS International. This blog was first published in the newest issue of the HIMSS Insights eBook, which looks at redesigning care and empowering patients. Healthcare IT News is a HIMSS Media publication.



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