Healthcare providers deserve a greater role in digital innovations, from development phase to scale-up. Only then can digital innovations actually solve bottlenecks in healthcare. This is the conclusion of researchers from the Rathenau Institute in the report Beyond the healthcare app. According to the researchers, the emphasis in digital innovation is now often one-sidedly on technological aspects, limiting the impact.
"Often technology is taken as the starting point for innovation," says researcher Sophie van Baalen. "But social, economic and legal factors are also important. For example, is there a party willing to pay for use of the innovation for a long time? You also have to look at the healthcare system as a whole. For example, we see that an innovation that reduces the workload for one group of caregivers actually leads to a higher workload for other caregivers. To find structural, sustainable solutions to bottlenecks in care, you have to take an approach that takes all those factors into account."
Practice
Such an approach starts with a greater role for health care providers, the researchers note based on two case studies. The cases are Feelee, an app to help adolescents in forensic care with emotion regulation, and the digital home help system for heart patients The Box.
These two case studies, according to the researchers, first show the importance of involving caregivers in the early development phase. As a result, innovations fit better with the wishes and routines of patients and caregivers.
Complex system
In addition, healthcare providers can act as signposts in a complex system. For external parties, the healthcare system is difficult to access. Each sub-sector has its own legal rules and financial arrangements. The sector is also riddled with protocols, customs, norms, written and unwritten rules. According to Rathenau, healthcare providers can help make healthcare practice more accessible to outsiders by providing access and showing them the way: "They act as a guide or navigator in a world that is highly regulated and institutionalized, but also very heterogeneous."
Scaling up
That role of guide and navigator takes on added relief when it comes to scaling up. "It is striking how difficult the step from small-scale application in a specific local healthcare practice to more large-scale application in a variety of other practices is," the researchers note. "A major reason for this is that the healthcare system is very complex, heterogeneous and fragmented." Healthcare professionals in particular can help innovators adapt digital innovations to all the different contexts of use.
Ethics-by-design
Rathenau also sees "normative reasons" to involve healthcare providers more explicitly in digital innovation. Remote monitoring, for example, has implications for how knowledge about a patient for medical decision-making is created.
Moreover, healthcare providers also embody values that they and their patients consider important. Rathenau mentions solidarity, equality, safety, responsibility, expertise and professional autonomy as well as patient privacy and self-determination. If such values are included in the innovation process from the outset, a form of ethics-by-design emerges, increasing the applicability of and support for digital innovations.
Daily work
Of course, there is also a distinctly practical reason to involve caregivers early. Digital innovations directly impact the daily work of healthcare providers. If caregivers do not accept a digital innovation, successful implementation becomes problematic.
Financial support
Based on all this, Rathenau advises healthcare institutions to deliberately create room for involvement of healthcare providers in innovation. This obviously has financial implications. Politicians and policymakers should make room for this in the financial arrangements. In general, Rathenau suggests making public support for digital healthcare innovation dependent on wider application and scaling up.
