Health systems have had to cope with myriad challenges ranging from new waves of the COVID pandemic, delivery of mass vaccination programmes at scale and speed, coping with diminishing workforce and a significantly increased burden of non-communicable disease as an unexpected consequence of the pandemic.

The past year has been notable in that elements of digital transformation have appeared across the globe and in some places have moved beyond telehealth to encompass data driven decision making. The following four broad areas will inevitably become the major areas of interest in the coming years.

• Sustainability  

The urgency with which governments globally are looking to transform their services to become more sustainable has been expedited as the climate emergency becomes more real and the effects of climate change more apparent. The provision of healthcare is a significant constituent of a country’s carbon footprint, and it is no surprise that sustainability in the provision of healthcare is now a big-ticket item.  

Despite advances in making therapeutics more sustainable and less harmful, exemplified by the changes to propellants in inhalers for instance, there is much to do. Digital modalities and blended approaches to managing care will assist in cutting down unnecessary patient journeys and there are changes which will no doubt be required to supply chains for materials and to better manage ever expanding, COVID-fuelled clinical waste. There are governments making these changes a priority, and no doubt, more will follow.

• Health security

Security is now the subject of growth and great interest as a result of the pandemic. Health security is largely the responsibility of governments whose pact with citizens includes keeping them safe from public health incidents, whether infective, like COVID, or chemical or radiological. Increasing adoption of digital modalities has raised the potential for more joined up surveillance and preparedness and we are seeing examples of cross border initiatives to ensure we are better prepared when the next pandemic arrives. Health security also includes better managing antimicrobial resistance. Sadly, just because our attention has been elsewhere, this increasing and global problem has not disappeared.

• Workforce

It is inevitable that workforce scarcity will remain a high and increasing priority. Care providers have had a torrid time over the past few years as a result of COVID and burnout rates have increased as a result. Furthermore, the usual waves of migrant workforces have not been as available, deterred by crossing borders and in some cases exhausted and wishing to remain in their native countries with their families. Rushed digital implementations have exacerbated these already challenging workplaces and we still do not support our workforce as effectively as we could or train them in the new skills required for the personalised blended healthcare provision, developing all over the world. 

• Life course approaches to better manage non-communicable diseases

Health systems are inexorably moving from “remediation” of symptoms and disease to also include delaying symptoms, and in some cases the diseases themselves, as they address the needs of people better. This trend is being exhibited worldwide and prevention of disease and the financial metrics that drive health systems to better deliver value rather than volume, the new frontier.  All this is made possible by the increasing distribution of health information exchanges, some within health systems and some within countries or even beyond.  

Digital transformation and deployments make these changes possible and whole new industries supporting health and wellness have sprung up as a result, engaging people more and activating them to take more responsibility for managing their lives. We will be seeing more large-scale attempts to encourage these trends, some of which will also include gamification to be the nudge to deliver extrinsic motivation until people develop their own internal motivation to manage their healthy behaviours better.

What will the new world look like? 

We can look forward to a world where the benefits of artificial intelligence and a better understanding of all the factors that influence health will lead us to have the opportunity to lead healthier and more productive lives. Health systems will be personalised to support all these changes. Not all is rosy, however. We still must come to terms with this pandemic and get much better prepared for the next one and we still have very significant inequalities to overcome both nationally, and globally. Only then can HIMSS' vision be better delivered – To realize the full health potential of every human, everywhere.

Dr Charles Alessi is Chief Clinical Officer at HIMSS.