Does your organization have a digital health strategy?

Everyone knows Moore's law - that the number of transistors on a semiconductor and hence their performance will double every 18 months.  It is the reason why the iPhone in your pocket has more computing power than the world’s fastest supercomputer from twenty-five years ago.  What people may not realize is that the doubling of computation has been going on since at least the 1850's through more than five different technologies from Charles Babbidge's mechanical difference engine, through the electromechanical calculators used in the 1890 U.S. census, to the Colossus, the Allies code-breaking, vacuum tube computer, past the transistor-based machines used in the first space launches,  all the way to the silicon semiconductors that Moore's Intel was manufacturing, and that power of current generation of computers.  This phenomenon was described by Ray Kurzweil, who went on to realize that the doubling of performance was not just isolated to computation, but was a function of the evolutionary nature of technologies.  He called this the Law of Accelerating Returns that results in what others call exponential technologies.

"Evolution applies positive feedback in that the more capable methods resulting from one stage of evolutionary progress are used to create the next stage. Each epoch of evolution has progressed more rapidly by building on the products of the previous stage." – Ray Kurzweil

A business or industries capacity to harness this law of accelerating returns depends on the degree to which it is completely digital and information enabled.  As Salim Ismail writes in “Exponential Organizations”:

"Once any domain, discipline, technology or industry becomes information-enabled and powered by information flows, its price/performance begins doubling approximately annually. - "Exponential Organizations" - Salim Ismail

This is the point that we have arrived at in healthcare.  For over 30 years, we have been digitizing health.  While progress has been slow and frustrating as we have taken existing processes, many of which were never optimized, and digitized them; we are almost through the digitization phase.  Parallel to this, consumers are now carrying supercomputers in their pockets and we are all connected to the internet all the time.  Understanding that most information is now digital, that all the end-points of healthcare interactions are using digital devices, and connectivity is ubiquitous, then you can see that healthcare is on the precipice of becoming information enabled and subject to exponential forces.
 
If you lead a healthcare organization, the realization should be even clearer.  The efforts to put EHR’s in place and the struggles to digitize physician workflows were not an end unto itself but are the beginning of a digital strategy in health.   
 
What I mean by digital strategy, is one where you are able to leverage digital infrastructure to transcend the limitations of:

• Time
• Distance
• Presence 

Put another way, a digital strategy in health is one where every interaction is analyzed across these three transcendent digital dimensions:

Is the interaction best delivered

• in person or remotely
• in real time or asynchronously
• ​by a health practitioner or through technology (ie. Remote monitoring) 

​When each interaction is viewed through these lenses, and every interaction is measured and that information is fed back to improve the next, then healthcare has truly become information enabled.  Once healthcare organizations start this process, they will begin to deliver exponential improvements in health outcomes.  The changes will be small at first, but they will continue to double every couple of years, transforming healthcare.
 
Embracing a digital strategy for health, allows for audacious goals like Lucien Engelen’s vision for Radboud UMC in the Netherlands to remove 70% of services from the hospital in the next 10 years.  These services will either be done elsewhere, at home or in the community, or they will not be done at all because of prevention strategies that address the health need upstream.
 
Leaders in healthcare organizations that embrace and develop real digital health strategies will have massive transformations in the next decade that will improve health outcomes in unimaginable, exponential ways; sort of like those who imagined twenty-five years ago that the world’s fastest computer would one day be in a device they carry in their pocket.