How public readiness can drive Ireland’s digital health transformation

The EY Ireland Consumer Health Survey 2023 indicates that when considering the attributes of the health system in Ireland people here place most value on access to care, cost effectiveness, and achievement of better health outcomes.

When considering the attributes of the health system in Ireland, people place most value on:

While concerns regarding health system performance centre on access to care and cost effectiveness, these issues have been acknowledged by Government and the health service and steps are being taken to address them. Notable examples include the signing of the chronic disease contract with GPs in 2019, initiatives to enable direct referral for GPs to diagnostics in the community, the implementation of the HSE’s Enhanced Community Care (ECC) Programme, the establishment of the Community Health Networks (CHNs), and the design and implementation of Modernised Care Pathways. In addition, it is intended that new surgical hubs will be developed at a number of locations across the country as well as the planned construction of new elective hospitals in Dublin, Cork and Galway.

“Our survey findings demonstrate the need to press ahead with the implementation of Sláintecare, while simultaneously advancing a data-led, digital-first agenda for healthcare. In doing so, we can deliver on the Sláintecare vision of right care, in the right place, at the right time,” added Dr. Ronan Glynn.

Notwithstanding concerns around access to care, there are indications that people’s experience at the point of care is positive. The survey reveals high levels of satisfaction among the 866 respondents who had engaged with the health service in the previous 12 months. Of these, 95% had an in-person consultation with a medical professional and more than 60% of them rate their care experience as good, very good or excellent across almost all areas assessed.

The survey findings also highlight an important societal perspective as demonstrated by the emphasis on cost effectiveness and the fact that one in three respondents highlight the importance of a healthy and fair society. The latter is a further reflection of the solidarity and buy-in to public health measures seen during the pandemic and suggests that the public want an equitable health system that prioritises the needs of the most vulnerable.

People in Ireland also have a strong sense of personal responsibility when it comes to their own health and wellbeing. 87% of respondents believe responsibility for achieving good overall health lies with them or is shared with medical experts. That rises to 89% for respondents aged 18 to 29, and 90% for retirees aged 65 or over. However, despite this just 42% feel fully included in decisions about their healthcare.

These findings show that the Irish public want a health service that is focused on proactive engagement rather than just reactive care. They want to be provided with tools to keep themselves well and avoid requiring expensive care. This represents an opportunity for the health service to co-create a healthier Ireland with the public. We can improve our population’s health by placing a sustained focus on prevention and early intervention, by viewing the public’s health as a national asset and as fundamental to a healthy economy.

Our survey indicates a strong appetite on the part of the public to move towards a digitally enabled healthcare system. Respondents envision a future in which digital-first models of care and new technologies will transform how healthcare is delivered in Ireland.

The results of the survey demonstrate that people in Ireland are open to technology-enabled care for more personalised and better healthcare experiences. There is a willingness to engage with genetic testing, personalised medicines, and care in non-traditional locations, including at home and in retail settings.

Actions people are prepared to take to monitor and/or improve their health:

Respondents in Ireland demonstrate significant openness to the use of smart pills and wearables. Indeed, almost one in two people (48%) are open to having a health condition treated with a high-tech product such as a smart pill that travels in their bloodstream and transmits messages to the health system via their phone. A similar proportion is willing to allow an approved device to provide them with a diagnosis or drug prescription.

Also worthy of note is the willingness of older people to embrace new technologies and care formats. Of respondents who had retired, 81% say they would undergo genetic tests to assess predisposition to certain diseases or disorders, 80% would allow wearable devices to collect and transmit their health data, and 75% are amenable to being treated in non-traditional settings.

If planned and implemented correctly, older people stand to benefit the most from the introduction of digital-first models of care.

Given the demographic challenges facing us, this should provide an impetus for policymakers to advance the digital agenda in healthcare.

The survey findings demonstrate widespread appreciation amongst the public of the importance of data as the currency to drive transformation in healthcare. There are understandable concerns around data security and the need for transparency, with 82% of respondents agreeing that organisations have to be very clear how they protect and use people’s health information.

However, the survey also shows that people trust the health service with highly sensitive personal data with the majority willing to share biometric, lifestyle and genetic data with the healthcare professionals managing their care. Furthermore, 72% of the respondents agree or strongly agree with the automatic electronic sharing of their medical information with the different parts of the health system in which they receive medical care.

These findings reveal both a high degree of openness to the use of health data to improve patient outcomes as well as a high level of trust in the health service to store and use their information properly.

Almost one in two respondents expect that artificial intelligence (AI) will be commonly used in healthcare over the next decade.

The openness of survey respondents to digital transformation of the Irish healthcare system provides an opportunity to take a blended approach to the design and implementation of new care models, incorporating hybrid and virtual elements where appropriate.

If sufficiently resourced and utilised, hybrid and virtual technologies have the potential to increase access to care, foster early detection and intervention, and help patients avoid hospital admission. Balanced integration of both virtual and in-person elements can also support early discharge and proactive management of chronic disease in the community, thereby placing patients at the centre of care and improving their care experience.

According to our survey, 64% of the respondents agree that digital technologies will be used to monitor patients at home in the next 10 years, while 63% expect that hospital-at-home as an alternative to in-patient care will be a feature of the Irish health service over the same period.

However, it must also be recognised that notwithstanding this potential, virtual and hybrid care models will not be appropriate in all circumstances. This is reflected in the findings of the survey which suggest that while 77% may currently consider virtual care instead of an in-person consultation in primary care, this would be in the context of relatively straightforward engagements such as for prescription renewal, to discuss test results or for minor medical conditions to save time. Conversely, 86% of respondents noted that they prefer in-person consultation where they have a physical issue that needs to be examined.

While there is broad support for virtual and hybrid models of care, further work will be required to raise awareness of the potential benefits of these approaches and to ensure that patients are amenable to them. It can be argued that the enabling processes and environment to support a holistic approach to virtual and hybrid care, much of which was stood up rapidly in the context of the pandemic, are not fully in place yet.

A roadmap for digital transformation in healthcare

Digital technologies provide a unique opportunity to redefine and strengthen healthcare delivery in Ireland. The response to the pandemic demonstrated the ability of the healthcare system to successfully design and deliver digital solutions at scale, across acute and community settings. The results of our survey demonstrate that there is public appetite to build on this success and achieve digital transformation of our health services.

Digital transformation can reshape public and patient experience and engagement with the health system, improve workforce retention and recruitment, transform our approach to population health and keep people well in their communities, and ultimately, deliver more accessible, better integrated, more cost-effective and sustainable, person-centred care.

The following steps need to be taken to achieve these goals: