Reimagining healthcare in the 21st century … Is it possible?

The VitalSign Series: Why have an English doctor from the United Kingdom and a Canadian technologist from Australia come together to write a blog series? Because healthcare and technology are equally complex, and it’s challenging enough to stay at the forefront of one industry in this rapidly evolving digital era — let alone two. In the VitalSign series, Ben Bridgewater, MD (the English doctor) and David Pare (the Canadian technologist) join forces to present a point of view on health systems in the 21st century and demonstrate the extent of what is possible.

Different industries find themselves at varying stages in the disruptive cycle. Some — such as retail and banking — have been transformed beyond recognition and are now truly “digital first”. Others, such as healthcare, continue to follow 20th century models. Although digitisation is happening in areas such as radiology and home care, it is mostly confined to the back office rather than being widespread at the forefront of care delivery. Through our work with organisations from various industries globally, we have come across three main questions that are top of mind in the push to realise digital transformation:

  • Are we maximising the benefits and savings of new technology, and is our core IT set up to benefit our customers (patients) and our organisation?
  • Is our organisation set up to reach citizens (both patients and the healthy) and exploit the potential enabled by faster innovation cycles as a result of digital approaches?
  • Are we moving in the right direction with our business model and truly delivering products, services and experiences that customers (citizens/patients) want and need in a digital world?

We find that there are far more similarities than differences when it comes to digital transformation across industries. Healthcare is not as different as many who work in it would have you believe. We believe that healthcare would benefit from the same approaches that have been shown to be successful in other industries.

This starts with transformation of the individuals leading and working within the sector (both managerially and professionally), and here it is useful to consider the Leading Edge Forum (LEF) 21st century models, including the Human Upgrade Programme. The 21st century health organisation needs to develop a compelling personal digital brand and purpose, upgrade digital tools and abilities, exploit digital to enhance productivity, collaborate at speed, lead by example, and listen, learn and apply value-based leadership.

The LEF has also defined the characteristics of successful 21st century organisations, and it is illuminating to review healthcare providers against this model. While the objective — to keep people well and treat disease — is inspiring, unfortunately most providers remain in the 20th century with their digital brand. For example, hospital websites are usually portals for displaying chosen content to patients, rather than a bi-directional channel of patient/citizen engagement and activation. This is in stark contrast to organisations in more digitally mature industries. In this current landscape, many hospitals still aim to provide the majority of clinical services in-house rather than leverage digital remote approaches for clinical and support services. Yet digital approaches do exist, such as teledermatology services that provide online services, as for example, the Royal Free London service demonstrates.

Source: The 21st Century Human Upgrade Programme, Leading Edge Forum

Of course, healthcare services should be for the benefit of those who need them, not for professionals, the organisations or their employees. That means organisations must acknowledge and gear their capabilities towards the rights and preferences of citizens, ensuring consent for data sharing, including what can be shared with whom and for which purpose, backed up by rigorous security and audit trails. Organisations and their IT departments must earn the trust of citizens and ensure that they remain trustworthy by using effective technology approaches. There is great interest in the use of blockchain in this regard, and we will return to this in a future blog.

Tied to the 21st century model and a citizen-centric approach is current thinking about precision (or personalised) medicine with the objective of ensuring that care delivery is targeted to the specific characteristics of the individual and his or her disease. Digital approaches and artificial intelligence (AI) underpins precision medicine, and it is common to consider this from the perspective of genomics, cancer cell lines and customized therapeutic regimes.

However, the diseases creating the greatest impact on population health and the health economy are those directly related to “western” lifestyles. As research in the field is starting to show, social and behavioural characteristics are probably more important in determining health outcomes than genetics.

Evidence is also starting to show that these factors can be modified using digital approaches, including social network activation with the application of cognitive behavioural therapy and coaching. These new approaches to digital therapeutics are likely to become among the most important factors in optimised products and services delivered by a 21st century healthcare provider.

Although the pace of technology change is growing at unprecedented speed, the pace of change in the delivery of medical care remains slow. The typical medical innovation cycle from basic research to practice change is an average of 17 years. But digital approaches can dramatically shorten this time frame by using agile methods and approaches, more akin to product life-cycle management approaches in Silicon Valley start-ups than the traditional medical model. The 21st century health organisations will need to become much better at ensuring that research and development (R&D) are implemented quickly, effectively and at scale. In a future blog, we will explain how health organisations can use agile and lean approaches to accelerate medical development.

We will also explore what the new, re-imagined 21st century digital health organisation will look like from a patient’s perspective. The benefits that a 21st century healthcare model will bring to patients will also be enjoyed by healthcare organisations through lower costs, accelerated innovation and better outcomes than the traditional vertical health delivery model.


Ben Bridgewater, M.D., was the director of global advisory for DXC’s Healthcare and Life Sciences Build organisation. He is an expert on health informatics, national clinical audit, clinical governance, healthcare transparency, patient-experience measurement and digital transformation in healthcare. He is now chief executive of Health Innovation Manchester.



David Pare is the chief technology officer for DXC Healthcare and Life Sciences in Australia and New Zealand. He is an innovative thinker with 20 years of experience in business and technology management consulting, helping organisations through their digital transformation.






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