Silver Chain Group

Dr. Sayanta Jana, National Medical Director at Silverchain Group in Western Australia, is a renowned senior health executive and Adjunct Professor at the University of Notre Dame. As Academic Dean at the Australian Doctors Business Academy, he mentors clinician leaders. He combines his 16 years in medical leadership with a passion for medical education and clinical digital health research to enhance patient and clinician experiences.

Through this article, Dr. Sayanta Jana, National Medical Director of Silverchain Group and Adjunct Professor at the University of Notre Dame, addresses the challenges in digital healthcare leadership. Drawing from his 16 years in medical leadership, he discusses the slow adoption of digital health among clinicians, bureaucratic barriers and high implementation costs. Dr. Jana advocates for progressive clinical education and envisions a unified healthcare ecosystem integrating traditional and digital practices.

The clinical education curriculum needs to be more progressive.

Training curriculums must adapt faster to the rapidly evolving digital health landscape in international healthcare, particularly in the medical space. While rigorous scrutiny is rightfully at the heart of medical education accreditation, the rigidity of accreditation criteria and lack of innovative curriculum has meant healthcare graduates are not trained in general digital health principles, theories and practices and on the first day of internship, their first tryst with digital solutions is a rapid orientation to clunky legacy clinical ICT systems, that slow down their clinical practice and workflows and leave them frustrated.

Why such a low uptake of digital healthcare as a specialty among clinicians?

Due to their own adverse clinical ICT experiences, clinicians have gone in two different paths; the vast majority, 95 percent and above, complain and resign that it is too hard to change such systems (despite well-recognized clinical risks). Instead, they create workarounds and pursue traditional specialty disciplines such as medicine, surgery and general practice. Less than 5 percent of clinicians would consider taking up a digital healthcare hackathon challenge and redesigning clinical systems. Only a few in this 5 percent eventually have the tenacity to keep going and succeed against adversity. On the positive, machine learning and AI are challenging the very existence of some clinical practice categories to the point that if you do not embrace digital healthcare (even if it is to improve your clinical practice), be prepared to be left behind!

Bureaucracy is still stifling innovation in digital healthcare.

Rigid procurement policies and slow processes are legacy bureaucratic designs that actively thwart rapid innovation in healthcare (the COVID-19 pandemic being the only exception to the general rule). Many top Organisation for Economic Co-operation and Development (OECD) countries are way behind third-world healthcare systems in terms of rapid digital healthcare uptake and implementation, with some OECD countries lagging one or two decades behind leading health tech-heavy Asian countries. By the time a pilot new health tech trial has reached its conclusions (are pilot trials required in every jurisdiction when the international evidence is so strong?), often the digital solution in principle has already progressed through generational change by then, which makes the trial outcomes irrelevant to more comprehensive system implementation.

"By the time a pilot new health tech trial has reached its conclusions, often the digital solution in principle has already progressed through generational change, rendering the trial outcomes irrelevant to more comprehensive system implementation."

Why is digital healthcare so costly to implement?

This might sound like a straightforward question with some simple answers, but it is a complex problem internationally. The disparity between large MNC and boutique start-up digital health tech companies often detracts from assessing the ‘innovation factor’ and awarding brownie points for innovation achieved at a fraction of the cost. We have yet to see system-wide initiatives, including those at the government level (particularly in high-cost and expensive healthcare systems), focusing on driving down the cost of digital health tech procurement and implementation in Western landscapes. Hence, we see faster progress and uptake of low-cost digital tech in traditionally third-world healthcare systems.

Is my half-glass full?

● It is excellent to see increasing healthcare leaders actively interested in digital healthcare. However, we still have a long way to go in closing the gap between clinicians, frontline clinical practice and the mindset of executive healthcare leaders—the decision-makers. The science of clinician engagement in digital healthcare relies on key executive champions and their leadership styles, constantly advocating for clinicians, clinical practice and patient care.

● We are seeing a recent growth in education curricula to improve digital healthcare foundations and literacy—courses aimed at clinicians and non-clinicians in the healthcare sector. However, the confluence between such general digital healthcare curricula and healthcare professional curricula (such as medical school training) is yet to be thoroughly tested.

● Most large and medium-sized digital healthcare companies, major healthcare providers and management consulting firms have appointed clinicians in key senior digital healthcare leadership positions. Digital health tech companies have a vital role in shaping the future of digital healthcare leadership.

With the advent of machine learning and the pace of AI uptake and implementation in the healthcare landscape, we can only hope that in the not-so-distant future, there will not be any parallel universes and that both traditional clinical practice and digital healthcare will stay as one unified international healthcare ecosystem, resulting in a safer, equitable and accessible healthcare environment.