Why Your Clinic Needs Digital Health: What the Science Says
The pandemic revolutionised healthcare and the world. But today, as face-to-face care is returning to its former state, is there still room for digital health in clinical settings? Find out below.
don’t take our word for it
The shift to digital healthcare technology started long before COVID-19, but the pandemic accelerated this shift. During the pandemic, healthcare providers were compelled to consider alternate methods of delivering care to those who needed it. Today, COVID-19 is receding from view and we can once again deliver face-to-face care. With that in mind, is there still a place for digital health in clinical settings?
At first, digital transformation can feel disruptive; integrating new tools into old routines is challenging. But through an initial investment in time, you’ll quickly reap the benefits. Digital health can improve accessibility and reach, boost patient outcomes, all the while creating time and cost savings.
According to the WHO’s Global Strategy on Digital Health 2020-2025 report “by accelerating the development and adoption of appropriate, accessible, affordable, scalable and sustainable person-centric digital health solutions” health could be improved “for everyone, everywhere”.
The benefits are also backed up by the science. So, let’s take a look at the evidence.
What is digital health?
First, let’s make sure we are talking about the same things here. As per WHO, digital health can be defined as “the field of knowledge and practice associated with the development and use of digital technologies to improve health”. In other words in the context of physiotherapy practice digital health is for example using EMRs, electronic scheduling and triage tools, wearables, ePROMs and monitoring, Telehealth including video calls, exercise and education prescription using e.g. online programs and mobile apps for exercise and education delivery and (a)synchronous messaging, and so on.
Benefits of digital health in general healthcare
1. It’s person-centered
The evidence suggests digital health saves both money and time. This could be through reduced transportation costs, reduction in unnecessary healthcare resource utilisation or improved time management. Crucially, digital health has the potential to improve patient/person-practitioner communication and information sharing - as well as communication and information sharing between professionals. Digital health can also assist shared-decision making and promote patient/person-centricity.
For example, an Australian qualitative study by Hinman et al. (2017) in physiotherapy settings found that the therapeutic relationship power balance can shift from therapist-focused towards patient-centred when rehabilitation intervention (including exercise and education) is delivered using videoconferencing. The patients - with persistent pain related to knee osteoarthritis (OA) - appreciated the undivided attention and the supportive friendly relationships developed during the rehabilitation process. It is suggested that, by participating in a home environment, they are more relaxed. This means rehabilitation can become an empowering, confidence-boosting experience.
“Digital health interventions can increase satisfaction, but also reduce burden and anxiety among patients as well as in their carers”
2. It's accessible, accepted and effective
Digital health interventions are reported to be highly accepted by patients. There is also potential for digital health interventions to promote better higher quality care that is in line with current guidelines. Digital health can also benefit patients through reduced wait times and more convenient, focused and accessible care. Current evidence suggests that, in physiotherapy settings, videoconferencing as a physiotherapy delivery method can improve access to care, be more flexible and time-efficient for the patients, and also improve quality of life.
The COVID-19 pandemic has taught us that face-to-face consultations with healthcare practitioners can be supported - or in some cases replaced - by digital health interventions without compromising safety or quality. For example, exercise is the first choice of care for many complaints physiotherapists and health care practitioners (HCPs) see every day. A recent systematic review concluded that exercise interventions delivered via videoconferencing are effective in improving exercise capacity and quality of life.
Physiotherapists working with knee OA patients have also reported that remote rehabilitation enables them to focus more on facilitating the self-management of the patient than during traditional face-to-face appointments. They felt there was no need to spend time on hands-on treatments which are not even considered the first choice of care for the management of knee OA. As a bonus, remote rehabilitation provided a physically less demanding but effective option for physiotherapists.
One Dutch study by de Vries and colleagues (2017) compared the effectiveness of online app-supported physiotherapy (blended care) with traditional face-to-face physiotherapy in adults with knee or hip OA. The study reported that the intervention group with a digital component resulted in less face-to-face appointments and less passive hands-on treatments. Plus, even with less face-to-face and hands-on treatments, they found that both interventions were effective; both groups improved and there were no significant between-group differences in physical functioning and physical activity levels at follow-up. This shows that physiotherapy can be at least partly replaced with remote interventions using digital tools.
In addition, a Swedish study by Jönssön et al. (2022) showed that people with knee or hip OA can benefit from exercise and education intervention delivered via mobile app to the same extent as face-to-face intervention with twice-a-week supervised exercise training. This study also included older adults, showing that the flexibility offered by digital health is not only available to the younger population.
"Young patients are keen on taking advantage of the digital tools and use mobile for health education, but also to receive support from HCPs during health care interventions."
Digital health interventions can be as good as traditional care, if not sometimes slightly better when it comes to clinical outcomes. Adherence has often been considered to be one of the key factors for reaching these successful outcomes and adherence to treatment has been reported to increase with digital health interventions.
As an example, in adults with MSK conditions using mobile applications featuring two-way communication as a component of physiotherapy has been shown to improve patient confidence as well as increase adherence to exercise therapy.
A Dutch study investigating the effectiveness of online app-supported physiotherapy (’blended care’) compared to traditional face-to-face physiotherapy in adults with knee or hip OA reported high adherence to the digital component. Over 80% of the participants adhered to the digital component.
3. Environmental factors
There is also evidence that digital health interventions have the potential to be the greener strategy for the healthcare sector.
In another Swedish study by Holmer and colleagues (2014), teleconferencing was used with the objective to reduce travel for patients and HCPs. Replacing face-to-face appointments with telehealth resulted in up to 40-70 times decrease in carbon emissions.
If you adopt appropriate digital health solutions to your clinical practice your clinic can:
Achieve higher levels of satisfaction among clients
Offer flexible, convenient and accessible services that are as effective as traditional interventions
Use data to improve care quality
Be more cost- and time-efficient
Be more environmentally friendly
Did you know?
Using patient-reported outcomes and outcome measures (PROMs) in clinical practice can improve care quality by improving practitioner-patient communication and patient satisfaction, assisting in monitoring the efficacy of treatment response, and even by helping to identify previously unrecognised problems.
However, using paper-based PROMs can be impractical in clinical practice. Digital health reduces barriers to PROM use in clinical practice by enabling more effective and timely data collection, analyzation and easier monitoring.
For example, the use of electronic PROMs has been reported to result in better outcomes such as quality of life, symptom identification, and management among cancer patients. Among young pain patients, pain monitoring using a mobile application resulted in better adherence and accuracy.
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