https://orcid.org/0000-0002-3193-6800
The Digital Transformation of the Healthcare System: Healthcare 5.0 describes ideas for a new healthcare model driven by digital solutions to empower patients as the primary owners of healthcare data and the main stakeholder in healthcare-related decisions. Of note, the book builds on experience and challenges observed during the COVID-19 pandemic, to emphasize why and how the current healthcare model needs to evolve to improve patient care and outcomes. The author, Dr. Katarzyna Kolasa, is a digital health researcher who has led efforts to increase the understanding of the need for healthcare system reorganization in the era of digital transformation. She is closely involved with the Digital Health Special Interest Group at the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and education initiatives in this field.
In the first chapter, the author starts by describing the history of the modern healthcare model from an economic perspective. For readers unfamiliar with modern health economics, important arguments originally presented by Kenneth Arrow in his landmark paper Uncertainty and the Welfare Economics of Medical Care were summarized and an extensive discussion was provided on the concept of efficiency, how it aligns with welfarism and utility maximization, and its context in the healthcare system, by drawing on prominent economic theories. Criticism was then leveraged on the paternalistic approach of the current healthcare model, which places the power to allocate healthcare resources on a third party, often the government, which may have shifted decision-making away from individual patients. The author argues that the original principles that underpin the modern healthcare system may no longer be valid, and a paradigm shift is needed.
This is followed by bold suggestions in chapters 2 and 3 on why and how we should move towards a new healthcare model, coined as Healthcare 5.0, which is envisioned to be housed in a virtual ecosystem with the majority of healthcare services provided remotely. There are no geographical restrictions in Healthcare 5.0, where patients and healthcare providers are perceived to be connected virtually with a constant flow of data and information sharing. In the vision described in the book, new digital health technologies and the internet of things will lead to better patient outcomes and diminish the role of third parties in the allocation of healthcare resources. More importantly, the author believes that the adoption of Healthcare 5.0 will shift the focus from disease treatment to prevention due to improved use of data and empowerment of patients. A strong emphasis is placed on a change in mindset in order to progress to Healthcare 5.0 and the author provides some recommendations, drawing from real-world studies that evaluate patient engagement strategies and value assessment frameworks that attempt to look beyond the immediate benefits of healthcare interventions. The author believes consistently that technological advances in the digital realm will facilitate this shift to Healthcare 5.0.
Individual areas of Healthcare 5.0 are carefully outlined in chapter 4, such as disease prevention, ambulatory care, hospital care, evaluation of new health technology, financing, identification of unmet needs, patient engagement and the role of digital solutions. In each section, lengthy discussion is attempted to illustrate how Healthcare 5.0 would differ from the existing model and lead to better patient outcomes with specific examples provided for each section, some supported by data from clinical studies, opinions from experts or the global community or even the author’s personal experience. However, the reader may struggle to connect the isolated points presented. For example, the author suggests that healthcare insurance can be strengthened by incorporating genetic information, healthcare data and feedback to improve health. However, whether the actual actuarial impact of these changes is significant remain uncertain, especially on a population level, and how this would affect the reimbursement of healthcare services is unclear.
The final chapter presents a case study testing the feasibility of the implementation of Healthcare 5.0 among potential users. It does so by assessing the preferences of digital healthcare models among 320 young adults from Poland, showing a higher likelihood of choosing a digital healthcare model compared to an analogue one. The author further compares the findings to those of similar studies in the literature and allows the reader to better understand, by example and findings, preferences related to the transformation of the healthcare system. The book ends with concluding remarks emphasizing that data will serve to fuel the innovation and make it possible for new technologies to become affordable and more reliable.
Overall, the book was an interesting read. For the most part, the content provided was appropriate to the subject matter. The book has very bold arguments. It remains uncertain how the current health infrastructure can be repurposed for the new healthcare model or how the transition can be funded, especially in view of the wide range of competing priorities the global community faces in healthcare. However, as compared to other books on this topic, Dr. Kolasa’s fared better because she provided not only a convincing vision, but many creative solutions backed up with a case study at the end to help the reader better engage in the topic and learn through the case examples.
Pharmacotherapy Outcomes Research Center, Department of Pharmacotherapy, College of Pharmacy, University of Utah Health, Salt Lake City, UT, USA
Department of Internal Medicine, University of Illinois College of Medicine at Peoria, IL, USA
[email protected]
C. J. Tan
Pharmacotherapy Outcomes Research Center, Department of Pharmacotherapy, College of Pharmacy, University of Utah Health, Salt Lake City, UT, USA