遠隔医療を含め、医療システムのデジタル化を推進すべし

Digital healthcare can be a catalyst for greater health equity

Shobana Kamineni / Executive Vice Chairperson, Apollo Hospitals Enterprise Limited / 20 Jan 2022

This article is part of the The Davos わたしのnoteにおいては、最新の科学・経済・社会等の問題に関して、英語の記事を引用し、その英文が読み易いように加工し、「英語の勉強ツール」と「最新情報収集ツール」としてご利用頂くことをmain missionとさせて頂きます。勿論、私論を書かせて頂くこともしばしです。

• The pandemic has accelerated the uptake of digital healthcare solutions.

• This shift to digitalization can be a powerful force in achieving health equity.

• To do so, we will need to rethink the fundamentals of healthcare delivery.

本記事においての「key word」は、「health equity (公平) 」であり、それを達成するために「digital technology」は非常に重要なツールであると述べている。

The digital revolution was well underway even before COVID-19, but disruptive technology needs to be widely adopted before society adapts to it. However, the pandemic and the subsequently enforced lockdowns helped catalyse the transition to a digital ecosystem.

A McKinsey Global Survey found that companies had accelerated the digitalization of their customer and supply-chain interactions and their internal operations by three to four years. A GlobalData survey, meanwhile, found that 35% of pharmaceutical professionals believe COVID-19 has brought digital transformation in the pharmaceutical industry forwards by more than five years.

Digitalization was critical in sustaining supply and demand in the wider global economy, thus preventing an irreversible shock. In healthcare, too, the pandemic accelerated digital adoption, which has resulted in a significant transformation in healthcare delivery within a short period.

Adopting digital healthcare to improve health equity

Digitalization and the introduction of telemedicine services have demonstrably improved equity in delivering health care services. Digital tech is making healthcare proactive as opposed to reactive, enlarging and enabling access to quality healthcare for communities that were traditionally underserved or marginalised (過小評価する、除外・無視する/mɑ́rdʒənəlàiz).

All these benefits are over and above (～に加えて、～の他に、～の上に) the way digital healthcare enables the delivery of services to previously hard-to-reach communities with the same level and quality of high-end (質の高い) healthcare facilities. The full impact of digital health lies in its ability to both foster inclusion across age, gender, race, and to close gaps in primary healthcare, driving productivity by freeing physicians from repetitive tasks and allowing them to focus on care and spending more time with patients, and moving to personalised medicine.

Digitalization also fosters collaboration that in turn expands the frontiers of digital health research. Looking ahead, it is digital healthcare that will ensure the delivery of value-focused care while improving health with meaningful outcomes. It could even pave the way for making universal healthcare a reality.

Rethinking the fundamentals

However, to achieve true health equity, we need to rethink the fundamentals of integrated healthcare and technology, and not just resort to digitalizing traditional models of healthcare delivery. We need to evaluate and understand the needs of underrepresented populations and create tailor-made digital solutions that will deliver precise, focused health interventions that address their immediate problems. One way is to assess the shared needs of particular groups and curate (必要な情報をたくさんの情報源から収集、整理、要約、公開、共有すること/kjuəréit) a solution using digital tools that will address the challenges and increase the efficacy and efficiency of care.

Staying mindful of disparities

At the same time, we need to be mindful of the barriers to digital access and literacy that may present challenges to health equity. Globally, while a record 4.9 billion people used the internet in 2021, around 37% or 2.9 billion people are still offline. The situation is similar in India, where 61% used the internet in 2021 – a significant jump from the 21% who went online in 2017, but which still leaves 39% of our large 1.4 billion population out of the equation.

An intricate (複雑な/íntrikət) understanding of the interaction of social, cultural and economic realities is needed to overcome barriers to technology access that aggravate (悪化させる/ǽgrəvèit) health inequalities. We need to address connectivity, affordability and accessibility with appropriate investments, innovative and inclusive solutions, and policy support in order to bridge the gaps and create a sustained holistic (全体的な、総体的な/houlístik) healthcare solution.

The importance of vaccine equity

As the world emerges from the pandemic, new variants continue to pose challenges in controlling the infection and bringing the world to normalcy again. There is an urgent need to increase vaccine coverage and ensure vaccine equity. While most developed countries have vaccinated a majority of their population, the same is not the case in many developing and low-income countries.

For example, just over 7.5% of people in Africa have been fully vaccinated; by comparison, more than 55% of Brits have had three doses of vaccine. Equitable access to vaccines will also boost the economic recovery to the tune of a $7.93 billion increase in global GDP for every million people vaccinated. The factors hampering progress include issues with supply, capacity and logistical issues, and vaccine hesitancy. While shipments are on the rise, it will still require technology to ensure optimal distribution of the supply, as well as accurate measuring and monitoring.

Digital tech for vaccine distribution

The logistical challenges include maintaining effective cold chains to maintain potency, ensuring a smooth transition of shipments across international borders, efficient scheduling and monitoring of timely vaccine administration to a vast population. These comprise multiple stakeholders who function in siloes (自己中心的な仕事のやり方、他部門と連携を取らない仕事のやり方) with digital technology providing solutions to bring them all on the same ‘virtual’ page so that the supply chain runs like a well-oiled machine.

Next steps to promote digital healthcare

Digital supply chain management systems provide visibility to stakeholders at all points in the supply chain with flexibility for agile (機敏な/ǽdʒəl) responses to any situation. It is vital to ensure the authenticity (信頼性/ɔ̀ːθentísəti) of the vaccine provided and ensure communications are consistent and evidence-based about the vaccine programme so that COVID vaccination is an equitable and 100% accounted quality intervention in the fight against the virus spread.

Technology can ensure health equity just as it ensured equity in vaccinating India's population; 1.6 billion doses have been administered accompanied by downloadable digital vaccine certificates verifiable by QR codes. As we move forward and embrace digital technology to ensure health equity, we must design solutions that meet the needs of all populations as well as improve digital literacy. To ensure this, the healthcare workforce will need to combine both clinical and technical skills. Digital has the potential to transform the whole supply chain, by integrating design-thinking tech at every step that helps drive value care that is agile and transparent.

The EDISON Alliance recently published a white paper to guide partnerships in digital healthcare, aiming to raise questions of inclusion at the inception (開始) of a project, maximize the opportunities of digitally-enabled medicine and chart a course for responsible and inclusive innovation in connected care. It is only then that digital health solutions will ensure digital health access and truly advance health equity.

日本においても、コロナパンデミック対応の為、オンライン診療が一部認められましたが、医療全体への普及には多くの壁があるようです。診療報酬という既得権益を守り、マイナス影響を及ぼしかねないオンライン診療には、医療関係者が収入減を危惧して、導入に消極的である為、医療のデジタル化を進め、国の医療費全体を抑制していくモメンタムは働きにくい状況だと思います。医療のデジタル化は、遠隔医療に限らず、日本全国医療機関のカルテを共通化して、情報の共有化、疫学研究や最適医療 (コストを最小にし、ベネフィットを最大にする医療) の共有化により、医療費はデジタル化を大胆に推進することにより、現在より大幅に削減できるものと確信しております。