Transforming Healthcare with Digital Solutions: Insights from Paulus Torkki

Transcript

00:00:08 Carita
Welcome to the E Health 24 podcast, where we explore the digital transformation of
healthcare and impacts of emerging technologies. Today, we're excited to have Paulus
Torkki, an associate professor in healthcare operations at the University of Helsinki,
Paulus specialises in evidence based healthcare services and performance measurements and
improvements in the healthcare sector. Welcome to the podcast Paulus.

00:00:36 Paulus
Thank you.

00:00:38 Carita
Could you start by telling us a bit about yourself and your career path. What's led you
to focus on healthcare operations and digital solutions in healthcare?

00:00:48 Paulus
Well, actually it is a quite funny thing. So originally I was studying industrial
management and engineering and I was having a paper technology as my technical focus
area. During my studies, in the end of the studies, we had to find practical assignment
for a course and we ended up to do that in Töölö hospital and from that from 2003, I have
been working for healthcare sector and it was so interesting and it has been so
interesting so I just followed the project after project and so easy explanation. I have
been in a business side and as a researcher during the years and obviously, recently, the
digital health services, as they have expanded quite heavily and of course they affect a
lot to healthcare operations and that's why I'm also interested to study that how do they
change the healthcare service delivery and what are the impacts of digital health
services in various sectors of the health.

00:01:56 Carita
Interesting. Your work centres on evidence based healthcare. Could you explain what that
means in the context of digital solutions? Why is it important to evaluate the evidence
behind these technologies?

00:02:13 Paulus
Well, I think all health care services need to be evaluated and their evidence has to be
evaluated. So far, we have been focusing a lot of medicines and pharmaceutical products,
but other technologies has not been evaluated as systematically and I think as the same
money and same resources are used in all healthcare sectors. So all the services should
be somehow evaluated having the same criteria for evidence, same criteria for the
effectiveness and cost effectiveness, and I think that is quite a natural explanation of
why also we have to find the evidence for digital health services.

00:03:07 Carita
One of your specialisations in performance measurement in healthcare, how does this apply
to digital health solutions? What metrics are particularly important when assessing
digital tools and healthcare?

00:03:22 Paulus
Yeah, that's a good question. I think as we were talking about the evidence,
traditionally the evidence has been understood as evaluation of effectiveness and cost
effectiveness and maybe also safety, but as the various different digital health
services, they may have also a lot of different goals or objectives. So what kind of
problem are we trying to solve with those digital health services? So I would say that
you should always define a clear goal for a digital health services and from that follows
that, how should you evaluate what metrics are important? Because sometimes you try to
improve access of healthcare services, sometimes you may be for information, better
information for patients. So for example, to enable them to make more informed decisions
in the care pathway and so on.

So you're always should have a clear vision when you are implementing or using a digital
health service that what is the goal? And as I said from that follows that what that key
performance indicators you should follow.

00:04:41 Carita
Evaluating digital solutions can be complex. What are some of the biggest challenges in
determining the real-world impact of these tools? How do we know if a digital solution is
genuinely benefiting patients and healthcare providers?

00:05:00 Paulus
Yeah. That's also very, very crucial question and most of the digital health solutions
are not like a single interventions, but more often they are part of some healthcare
service process, so they are producing some piece of the pathway. That is the first
challenge that how can we really assess that what is the the impact of the digital
solution in the pathway?

And also, as I said, they are not like single intervals, but they are more like enablers
of value co-creation between professionals and clients or patients and that's another
challenge because the impact is not same for everyone. If we consider the patient side,
the patient's motivation and ability to co-create value effects a lot of the impact of
the digital health solution.

So a practical example that we have been studying the users or of the digital health
services are more often young females with a specific kind of health problems, and I
think they can co-create value very effectively and they can have a great benefits from
digital health services but if you think as an example of some older people with some
limitations already in in functioning then the benefit may be different.

So you should always take the context very carefully into account when you analyse the
impact and also think that when you try to scale or make the generalisations of the
results that in which contexts you think that you can get the same kind of results of the
analysis.

00:06:56 Carita
Very interesting. You also emphasise impact-driven healthcare services. Can you give us
an example of how digital solutions might support this shift and how they are being
implemented in current health systems?

00:07:14 Paulus
Yeah, that's a very interesting question, impactive and or value-driven healthcare means
that we focus on health outcomes and especially patient relevant outcomes of the
services.

If you think the digital services, for example, the digital care pathways for chronic
patients or patients who have a a long care pathways there it is quite obvious how the
digital care pathways can support the impact-driven or value-driven healthcare because
first the patient can contact the healthcare system very easily whether he or she has
some kind of symptoms and there is evidence that when the professionals can reply fast,
then you can prevent even emergency department visits or hospitalizations because you can
tackle the problems before they are escalating. So that's one kind of mechanism.

Another is that it's much more easy to collect the outcomes information, so kind of
surveys and information from the patient to understand that are we really are achieving
the patient relevant outcomes. So how is the patient experiencing his state of the health
of functioning or what are the outcomes we are trying to achieve.

So in the summary, I think digital care pathways can improve the continuity of care in
long care pathways and chronic conditions and so they are link to also to to
impact-driven health care.

00:08:54 Carita
As digital health solutions continue to evolve, what future trends do you anticipate will
have the most significant impact on healthcare? Where do you see the interest industry in
five or ten years?

00:09:10 Paulus
That is very very difficult question. Now the digital health services are expanding very
rapidly in primary healthcare.

I think, we can find in five to 10 years the best segment for the digital health services
in primary care. So obviously we are still require physical visits, but now we are trying
to understand that who are benefiting the digital primary healthcare visits, in what kind
of symptoms can we utilised it effectively. So trying to understand that in which segment
the digital health services are the most effective solution in primary healthcare and in
with what kind of symptoms we still require the physical visits. That's one development
which is happening now.

But as I said, at the moment, the most interesting field seems to be the digital care
pathways supporting the self-care in chronic diseases and I think that is the area which
may be evolving quite rapidly. So as now we are having like control visits annually or
two or four times per year. So, I think, a lot of that kind of controlling will be
replaced by continuous digital care pathway where patients are reporting to symptoms more
often and the care interventions may be more individualised based on the condition of the
patient and how it will be evolving.

00:10:49 Carita
Very interesting to see what happens.

00:10:51 Paulus
Yeah.

00:10:53 Carita
Where it will go. What advice would you give to students and professionals who are
interested in healthcare, digitalization and evaluating the effectiveness of digital
health tools?

00:11:06 Paulus
Yeah, I think, the impulse on things is first to understand that the most often, the
digital health solutions are the part of the solution. So they suit best for specific
part of the patients and they suit best for specific kind of problems.

So, you should always start thinking of segmenting of the which patient group this is
most effective, what kind of solutions and how you integrate that solution to the service
portfolio. So taking also so you should not think as it's replacing all the services in
so, well, there may be some fields where you can replace, but most often it's part of the
solution and I think that gives you more effective way to to go forward that you are not
trying to tackle all the problems but you formulate the digital solution very effectively.

And the second thing to understand is that you also always think the context that it may
vary in different areas in Finland. We know that the people in Helsinki or people in
Tampere or in Kaino may be behaving differently and that's one thing and if we go
internationally, of course, there are very big differences in the context, so that is
also one thing you should start thinking that do we try to have the solution be scalable
for different kind of context and how do we have so think the configuration to the
different context?

I think for example, those kind of questions may be quite useful when you when you are
starting to develop new digital health.

00:12:56 Carita
Thank you so much, Paulus, for joining us today and sharing your expertise on evidence
based digital solutions in healthcare. This discussion has given us valuable insights
into the impact of evaluating digital tools and their impact on healthcare systems. Thank
you so much Paulus.

00:13:17 Paulus
Thank you. It was very interesting to discuss.

00:13:20 Carita
Thank you. Goodbye.

00:13:22 Paulus
Bye.