Future-proofing healthcare

The pandemic has placed a magnifying glass on the challenges facing the healthcare system and shown the need to enhance the digital healthcare ecosystem

While healthcare in China has made considerable strides in the past decade, we must look ahead to how we can suitably equip our clinicians, so that they can provide optimal patient outcomes. There are three key challenges within the current healthcare system that we should look to address to support the workforce and improve the future patient experience. As we look to tackle these issues, we should endeavor to reassess and create a more holistic view of the system, enabling fresh perspectives on possible solutions to these challenges.

First, the digital ecosystem for health has been evolving at an ever-accelerating pace in recent years. By evaluating the state of current processes and assessing how they support current care delivery, as well as the clinician's complex clinical decision-making, there is great potential to refine it or redefine it altogether.

For example, the Action Plan to Strengthen Basic Research "From 0 to 1", jointly issued by five ministries and institutions in March 2020, has called for strengthened national support to advance the digital systems adopted by clinicians, including innovation in high-end medical devices and artificial intelligence. The assumption has been that electronic medical records are the cornerstone of the digital system for healthcare, and there have been several key benefits since their adoption. Besides serving as a medical data repository, electronic medical records also support the transaction and delivery of medical services, vastly improving the efficiency and reliability of order processing.

However, there are no requirements that they support the clinician's assessment, diagnosis, and formulation of treatment plans. The lessons from the COVID-19 pandemic should inspire us to step back and not be constrained by the current status quo. We should aspire to apply a solution that will support our intellectual reasoning and clinical decision-making, to help provide the best possible experience for patients.

Second, there is also no hiding from the fact that two of the biggest challenges to the nation's healthcare sector are the shortage of medical professionals and burnout. Although the number of nurses in China has increased, it is thought that the country still needs an additional 450,000 general practitioners and 10 million nursing staff (including elderly carers). This shortage will continue to grow as the general population gets older, so the resulting pressures and inevitable fatigue in this essential workforce will also increase. As such, we should continue to strengthen the education and cultivation of innovative people that can devise new solutions to support our workforce.

The 14th Five-Year Plan (2021-25) has similarly requested improving both the quantity and quality of healthcare professionals in China. In 2018, the State Council, China's Cabinet, released guidelines to accelerate the training of high-quality general practitioners across the country by upgrading the medical education system, improving practitioners' compensation and enlarging the teams of practitioners in rural and remote areas. If these three areas continue to improve over the next decade, we can hope to nullify the shortage and burnout of clinicians.

Since last year when the COVID-19 pandemic hit, the nation's public hospitals have been essential in combating the virus, but as we look ahead to the next decade, we should commit to strengthening healthcare infrastructure at all levels. In this digital era, technologies have the potential to improve patient access and continuity of care, as well as effectively allocate healthcare resources, such as medical professionals. When adopting new solutions, we must always take an approach that prioritizes the needs of clinicians. Technology should be an enabler for clinicians to work effectively, wherever they work.

Future clinicians will need the support of a clinical knowledge platform that integrates the ever-growing body of heuristic knowledge with clinical decision support capabilities, to assist in their delivery of patient assessment, diagnosis and treatment.

Third, patient data is often fragmented among thousands of local clinics and hospitals, making diagnosis, treatment and effective public health policy implementation more complicated. This has widened the disparity in levels of service and the cost of healthcare, creating mistrust from patients in the system. Building trust between clinicians and patients is a crucial part of the medical process. We must think about how we can build this connection when providing virtual care.

As healthcare shifts to this more digital-prominent era, it's imperative that clinicians do not lose sight of the human element. We must utilize innovations and digital health technologies that best enable two-way trust between ourselves and our patients. Additionally, the historical lack of trust between patients and grassroots medical institutions has led to a healthcare system that is reliant on overburdened large hospitals in urban areas. Fostering trust between patients and clinicians will not only improve patient outcomes, but also help reduce system pressures across the nation.

When looking to the well-being of patients, we must also look at upskilling clinicians to help them build better connections with those reliant on their care. Traditional teaching, and the development of interpersonal skills through practice, are both built upon the assumption that we will always be face-to-face with our patients. However, our experiences throughout the COVID-19 pandemic have shown that we are required to relearn these skills for use in the digital environment. Having the right clinical knowledge is of course necessary, but the ability to connect with our patients and influence their decision-making is equally important. Ultimately, this connection facilitates personalized medicine and the best possible care.

By better supporting the workforce, adopting appropriate digital solutions, and rethinking our approach to building trust among clinicians and patients, we can empower the workforce within large hospitals by reducing fatigue. Furthermore, utilizing digital systems which facilitate both the cognitive work and decision-making of clinicians will leave them more time and space to build sufficient trust with their patients, and ultimately help deliver the best possible patient experience and outcomes.

The author is global chief medical officer for Elsevier. The author contributed this article to China Watch, a think tank powered by China Daily. The views do not necessarily reflect those of China Daily.

Contact the editor at editor@chinawatch.cn