Preparing for health care “e-volution” in Cameroon

Digitizing Healthcare

Communication and information technology is changing rapidly worldwide. This digital revolution will have a profound impact on how physicians and health care delivery organizations interact with patients and populations. Over the coming decade, face-to-face patient/doctor contacts will become less common and exchanges between consumers and providers will increasingly be mediated by electronic devices. 

This rapidly evolving e-health support infrastructure will forever change the way providers and consumers interact. It is essential that clinicians, managers, policymakers, and researchers gain an increased understanding of how this transformation will likely take shape so health care systems of the future can adapt, adopt, and embrace these technologies

The digitization process is gradually underway within our healthcare systems as we can appreciate from startups like Maealth, CamerHealth, Cardiopad, The Giftedmom and more. But over the coming decades, in all reaches of the nation, clinicians, managers, policymakers, and scientists will need to work closely with consumers to plan, design, develop, implement, and evaluate the ever-expanding e-health infrastructure. There are many factors that must be in place for digital systems to be effective. Given that clinician/consumer communication and interaction is at the center of most e-health and Health IT activities, before new technology can become fully ingrained within our health care systems, we must delineate, understand, and resolve many issues that surround this nexus. Some of the critical challenges and knowledge gaps that must be grappled with as these e-health systems are introduced will include: 

1. How e-health will impact traditional communication and interactions between clinical professionals, health care systems, consumers, caregivers, and communities.
2. How to design individual components of the ICT/HIT system to optimize provider/consumer communication and how best to educate and prepare all parties for effective communication within this new environment.
3. How best to integrate the many distinct "digital silos" representing the separate EHR, ICT, m-health, e-health, and IT components into a functionally integrated system that maximizes effective communication and interaction.
4. How to ensure that communication mediated by e-health systems is secure, confidential, and conforms to ethical principles.
5. How to shift from the past medical model of the 15 minute face-to-face, one clinician/one "patient" interaction, towards the concept of population health and wellness support in place 365 days a year, 24/7.
6. How to ensure that the disparities associated with a "digital divide" (i.e., between those with and without e-health tools and e-health literacy) can be surmounted in order to target the benefits of e-health to those with the greatest need (who currently may have the least access).
7. In regard to doctor-patient communication, they’re three key objectives of interaction during traditional (face-to-face) encounters and which are to create inter-personal relationships, exchange information, and to decide how best to treat the problem at hand [26]. In an e-health environment, how can the "inter-personal" human-to-human connection (which is all important to the healing relationship) be maintained, or even enhanced?
8. The design, development, and evaluation of e-health systems will require skills from multiple professional disciplines. How best should we pull together the required expertise which will include specialists with backgrounds in: inter-personal and mass communication, human factors, clinical sciences, health informatics and IT, computer science and engineering, public health/population sciences, and health management and policy?
9. How do we ensure that the design and implementation process is evidence-based? Given the significant cost of e-health systems and limited evidence to date regarding return-on-investment, it is essential that e-health effectiveness research become widespread. This line of work should be sure to incorporate a focus on the domain of provider/consumer interaction and communication. E-health tools are very amenable to the incorporation of fully integrated, ongoing e-supported performance assessment and monitoring, since most data items needed for the evaluation are already captured digitally and in real time [20].
10. Over the next several decades the "e-volution" of health IT, m-health, and other e-health systems will likely embody very rapid change and metamorphosis. In most cases this change will be disruptive to the current doctor/patient communication status quo. We will need to learn how to effectively manage the change and diffusion of e-health tools within professions, delivery systems, communities, and health care systems. For example, we must develop effective private and public e-health change management initiatives such as strategic planning, financial investment, research & development, market facilitation, training & education, evaluation, and regulation. As we plan, assess, and implement e-health systems across the country and around the globe, we must never lose sight of the ultimate end game, which is to improve the health and well being of the individual consumer and society-at-large.