Removing Frictions through Healthcare Digitalisation

Jan Herzhoff, President, Global Health Markets, Elsevier

India has a great potential to emerge as a digital health leader post COVID-19. This article discusses the opportunities of empowering India’s healthcare workforce with the right technologies in both clinical practice and research to accelerate healthcare digitalisation.

It has been a year since the COVID-19 pandemic started. India faced exceptional challenges – the healthcare system has been stress tested by the high patient volumes and the infrastructural inefficiencies. More importantly, it has brought about a transformation in healthcare delivery via the power of digital health technologies to address these gaps.

Digital health is key for clinical practice, medical education, and translational research. India aims to accelerate innovation and ideas from across the world to rapidly customise and build a sustainable healthcare ecosystem with comprehensive healthcare framework, institutions, and policies. With the successful launch of the National Digital Health Mission (NDHM) in August 2020, India has already laid the foundation for a digital health ecosystem.

The COVID-19 pandemic exposed several healthcare challenges on this journey, such as information asymmetry between the doctor and the patient, high variability of healthcare expenditures, and inconsistent access to healthcare services across regions. It has now become a core priority for nations to address these healthcare challenges to mitigate both the social impact as well as the economic consequences following the pandemic.

Standardising the quality of healthcare with knowledgeempowered technology

The healthcare industry is largely built on knowledge. Transforming the delivery of knowledge through digitalisation is key to truly enhancing the healthcare system of a country. The launch of the NDHM has ushered in a new era of technology-enabled healthcare delivery. Digital solutions are now used for proactive health screening and telemedicine, which has been integrated with statewide health and wellness centres. By empowering these digital solutions with knowledgeenabled technology, it will augment India’s existing public health ecosystem for all citizens across the nation to gain greater access to timely and affordable medical attention.

Delivering standardised healthcare should be supported by clinical decision support systems. By combining technology with most current, authoritative, and comprehensive clinical knowledge base, we can overcome information asymmetry and enhance access to quality care even in the most remote corners of the world. We have seen a major boost in the effectiveness of frontline health workers when they are empowered with clinical decision support systems. For example, Elsevier is currently running a NITI approved primary screening pilot in the Bahreidge district of Uttar Pradesh, using the Clinical Decision support solution to enable frontline maternal and paediatric healthcare workers (ASHA) to conduct primary health screening, provide required advice and create referrals for specialist consultations.

Investing in research and knowledge infrastructure

Globally, the conventional view of strengthening healthcare infrastructure by governments has been investment in medical devices, supplies, infrastructure, and manpower. However, this pandemic has highlighted other gaps such as the availability of latest knowledge as a key missing link needed to cope with an unfamiliar crisis. Over the past six months, Elsevier has seen over 130 million downloads of COVID-19 related research articles on its ScienceDirect platform, highlighting the demand for current and credible information needed to guide clinical decisions across the world.

The increased speed in diffusion of knowledge raises important questions around quality of healthcare knowledge. What we can do now is to ensure that the content shared amongst the healthcare community is from credible and authoritative sources. The winning combination would be to integrate digital infrastructure that equips the healthcare workforce with latest evidence-based knowledge to manage the crisis on the frontlines. Elsevier is supporting numerous hospital systems across the globe with the integration into clinician workflows. It is critical for India to urgently invest in upgrading their research and knowledge infrastructure on the back of the digital health transformation journey.

Creating a digitally empowered healthcare workforce

While digital health transformation is underpinned by digital tools, we must not neglect the users of these tools – the healthcare workers. For digitalisation to effect a positive change in the lives of healthcare workers and their patients, we need to align their needs with the adoption of digital technologies. We can begin by removing frictions and making it as easy as possible for healthcare workers to do their job. Design thinking plays a very important role here and it needs to match what we know from high-end consumer products.

Digital workflows need to be instilled at the start of the medical or nursing professional journey, where students are getting familiar with these tools and are developing important critical thinking and communication skills. This will empower frontline healthcare workers with personalised content; reduce unnecessary testing and overuse of medicines; and improve health outcomes by standardising care.

Elsevier’s learning platforms have seen a 35-times increase in usage compared to pre-pandemic. In particular, skills, simulation and 3D/AR capabilities are in high demand to ensure high engagement during the learning journey. In addition, Elsevier continues to make all COVID-19 articles and research tools freely available within the Novel Coronavirus Information Center and COVID-19 Healthcare Hub for frontline workers worldwide. Digital simulation tools have also been implemented to prepare nursing and medical students for early integration into the workforce, and point-of-care tools have been introduced to support decision making.


India has a great potential to emerge as a digital health leader post COVID-19. There is tremendous opportunity to empower a healthcare workforce when they are adequately supported and enabled with the right technologies in both clinical practice and research. Integrating technology and knowledge will create a strong and efficient healthcare backbone that will support India become Atmanirbhar (self-reliant) in the healthcare space. This needs to begin at medical and nursing schools where we build an optimised digital health ecosystem from the very beginning for seamless integration into the workforce.

--Issue 51--

Author Bio

Jan Herzhoff

Jan Herzhoff is the President of Global Health Markets at Elsevier and is responsible for Health Education and Clinical Solutions segments globally. Jan has a solid track record in strategic business planning and extensive experience across sales, marketing, product development and customer engagement.

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