Adoption, resistance, and breakthrough in digital health

Ireland can move from a laggard to a digital health leader in Europe by 2025 if available digital solutions are embraced, says Martin Curley, the HSE’s Head of Digital Transformation and Open Innovation.

Expanding on a popular theory by MIT’s Michael Schrage that innovation is not something that innovators do but what customers adopt, Curley says that momentum built up over the pandemic must be maintained if Ireland is to fulfil its potential as a leader in digital health.

The HSE’s Head of Digital Transformation and Open Innovation regards the Covid-19 pandemic as a catalyst for digital innovation but stresses that many of the solutions implemented had previously existed.

“What happened with Covid as a catalyst was that the adoption curve dramatically accelerated and shifted left. We experience around a decade’s worth of adoption happening in a matter of weeks,” he explains.

Curley identifies two reasons for big bang adoption. The first, he says, is that necessity is the mother of invention. “We had no choice,” he states. “Within 48 hours of Covid being in Ireland we had developed a remote monitoring solution for Covid-19 which kept patients at home or allowed them to discharge early. That was phenomenally successful and empowered patients.

“Similarly, the demand for electronic prescriptions existed for more than a decade. Within two-and-a-half weeks, and with some secondary legislation progressing through the Dáil, electronic prescribing was here and is routinely used today.”

The second factor flagged by Curley was decreased resistance to innovation.

Despite being a top 12 economy, with the top 10 MedTech companies, top 10 pharma companies, and top 10 tech companies, Ireland is ranked 80th in the CEOWORLD Magazine Health Care Index, which rates healthcare systems relative to factors that contribute to overall health.

“The demand for electronic prescriptions existed for more than a decade. Within two-and-a-half weeks, and with some secondary legislation progressing through the Dáil, electronic prescribing was here and is routinely used today.”
Martin Curley, the HSE’s Head of Digital Transformation and Open Innovation

Outlining his thesis for circumventing resistance to innovation, Curley points to Ireland’s Digital Health Strategy and Action Plan: Stay Left, Shift Left, 10X, which he says is increasingly getting global attention. “Stay left is the idea that we can keep people well using digital technology to manage healthcare from home. Shift left is about moving patients as quickly as possible from acute care to community care to care at home, using digital technology.”

Curley observes that the application of digital technology within healthcare, an information-intensive industry, allied with exponential innovation methodology – or Open Innovation 2.0 – enables 10X returns. “10X better, 10X cheaper, 10X faster, and 10X higher volume,” he states.

“One of the key design patterns is design for adoption. Designing solutions so that they are easy to adopt. That means solutions need to have a lot of utility, there needs to be evident value from it, the user experience has to be good, and they have to be ubiquitous.”
Unlike in the past, when risk-adverse clinicians or patients resisted clinical innovations and effectively acted as obstacles to change, Curley believes that the administrative side of the health system is the epicentre of resistance to digital innovation.

However, Curley has adopted German philosopher’s Arthur Schopenhauer’s three stages of truth theory to digital health innovation, which is that “all truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.”

In practice, he articulates, Open Innovation 2.0 hinges on a “shared vision” whereby a community works together to create shared value.

In association with various clinicians, Curley is involved in a number of ‘living labs’ – pilots for disruptive digital technology innovation in a clinical setting – around Ireland. Based on their success to date, several of these living labs have already scaled up.

Regardless, the HSE’s Head of Digital Transformation and Open Innovation believes that Ireland now faces a challenge to maintain momentum.

“The innovation momentum built up over Covid-19, where teams were autonomous, empowered, and highly motivated could be a new normal for our health service. We know how to do it and we have clinically proven solutions but there are blockages in the system.

“We as a society and an economy actually have to make an explicit decision as to whether we aggressively embrace these new digital health solutions.

“By embracing digital health innovation we can move from being the laggard in Europe to being a digital health leader by 2025 and can improve our digital health exports by a factor of 10,” he concludes.