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Salzburg Global Fellow Louise Schaper discusses the "global problem" of paper-based health care systems and the need to move toward digital health care

The field of digital health falls at the intersection of technological advancement and health care delivery. According to the World Health Organization, digital health provides opportunities to accelerate progress in achieving the health-related Sustainable Development Goals, particularly Goal 3, Good Health and Well-Being.

Whereas traditional health care systems have run mostly on paper for data and information collection, digital health care systems, as the name suggests, aim to digitize data collection, improving the process for health care seekers and providers alike.

Salzburg Global Fellow Louise Schaper has worked in the field of digital health for the past two decades. She has spent the latter decade as the chief executive officer of the Australasian Institute of Digital Health (AIDH). Schaper says the Institute "provide[s] a much-needed space for the entire digital health community of Australia to come together and collaborate on projects to advance the cause of digital health in Australia."

The Institute works toward the creation of a connected health system and digitally competent health workforce. Schaper says, "It's a global problem that health care in 2020 in many places across the world still runs on paper."

Founded in February 2020, the Institute is the result of the merger of the Health Informatics Society of Australia and the Australasian College of Health Informatics. The two organizations had been working closely for years, and shared many common goals and objectives.

The Institute operates on an individual and organizational membership model, and hosts accessible programs and services on digital health and related topics. Seeking to “develop collaborative partnerships, elevate the voice of consumers and build an empowered health workforce delivering care in a digital world,” the Institute promotes the exchange of ideas and information from Fellows and members.

Despite being less than a year old, the Institute already boasts a community of over 36,000, over 1700 members, over 100 industry partners, and over 3000 events attendees, with a vision to expand further.

Practically speaking, digital health care systems are much more efficient than their paper-driven counterparts, where practitioners often only collect information for a singular purpose or visit. Schaper notes information doesn't "flow easily" throughout the health care system, often requiring each member of a person's care team to collect the same data. But despite the efficiency, digital health care systems are not the norm, primarily because of the tremendous costs associated with implementing such a system.

"In developed countries like Australia… huge amounts of money are required. So if you want to take your hospital that pretty much runs on paper, and put a full[y] electronic system in, you need hundreds of millions of dollars… That's why we don't have these systems as widespread as we'd like because it's usually expensive."

Implementing digital health care systems is already a difficult task in the developed world. In developing countries, it might seem near impossible, owing to the lack of technological infrastructure. However, Schaper says this isn't the case.

"Developing countries, in a lot of aspects, do better than us in the Western world…  If you've got [lots] of money, then you think…to solve this problem that's in front of me, I need to throw money at it, I need to hire people, I need to buy software… And when you don't have money, you have to be creative and innovative and resourceful, and resilient. All of those things which I don't think are lauded enough… So there are lots of examples in developing countries that they do better [because] spending hundreds of millions of dollars on an IT system is… just not even worth considering. So there's a lot of open access software [which is] very, very low cost and that you can put in place."

Schaper believes integrating digital health into university curricula is an effective way to ensure future health care practitioners are exposed to this subject before they even begin their careers. Traditional curriculum in Australia, she says, does not always include modules on digital health. When it does, the modules are often elective. This arrangement means scores of new health care practitioners who join the workforce every year are unfamiliar with the subject and not always likely to pursue it further. Schaper stresses health care practitioners should not think of digital health only as a technology issue. "It's really about improved patient care and quality of outcomes," she says.

The COVID-19 pandemic has reaffirmed to Schaper the importance of having a digital health care system and a digitally competent health workforce. Looking ahead, she hopes digital health can become commonplace so health care workers can better use the information to provide high-quality patient care, and not just focus on digitizing it.

"The fact [is] that we don't have good systems in place… the way that we build organizations, build protocols, build collaborations across countries, they're not there. So this information isn't where it needs to be so that we can act on it quickly. … I would hope that [AIDH] can contribute to that journey."

Schaper recognizes the importance of having diverse perspectives to be able to solve a problem, something she was lucky to find during her time in Salzburg. A Fellow of Session 553: Toward a Shared Culture of Health: Enriching and Charting the Patient-Clinician Relationship, Schaper says, "The only way we can solve problems is by bringing people together from diverse perspectives, who have diverse journeys, who have diverse knowledge and experience to bring to the table, and by drawing from that diversity and having that diversity as a strength to collaborate on solving problems."

Schaper has many goals for AIDH over the next decade. One, in particular, is her hope the Institute has to rename itself. She says, "I'd love in 10 years if we have to rename ourselves… because digital health doesn't exist. I would love to see [if digital] health care can become just health care and remove the "digital" … it seems ridiculous to refer to it as such because that's just how we do health care now."