The democratisation of health: Placing citizens at the centre of healthcare
Considering the seemingly relentless streams of innovations emerging across the healthcare sector in the 21st century, Dean Fathers, Chair of Nottinghamshire Healthcare NHS Foundation Trust, explains what these progressions could, and should, look like for individual patients.
At a time when parliamentary democracy is illuminated in the media spotlight, it is easy to forget that plebiscite democracy has, through the millennia, come to challenge the power of the ruling classes. Just as the plebeian of Ancient Rome fought to overcome the antiquated ways of the old Patrician rule, so might we be about to see a changing of the order in the system hierarchy of the current national and global health systems.
This revolution doesn’t come from civil unrest, though it might in some parts of the world, but instead from the relentless and unstoppable advances that are being achieved by the exponential growth of technological developments derived from computer processing.
This progress might soon enable genomic and phenomic intelligence to be contemplated as a norm, not an aspiration, and assist rich data to be generated on the human biological system at scales that bring new solutions to the physical and mental health challenges our mortal being presents.
Social media can indicate our mental and physical wellbeing. Likewise technology can be used to place us in the specific environment where we as individuals exist so as to help address the unique weathering impact on each of us within the wider context of our population base; empowering the intelligence of individuals through the creation of holistic knowledge pools where facts and feelings can be taken into consideration equally.
This way the level of each citizen’s specific satisfaction with the real experience they have as an individual service user within the system can be evaluated as a distinct outcome and valued as such for its uniqueness.
The digitisation of health is not about creating electronic medical records, as many believe, to enable practitioners to make more effective decisions about the care of patients. It is about enabling the democratisation of healthcare, placing the citizen at the centre of the health, not the sickness, process. It is about enabling us to see the whole individual in the context of their current, past and future life experiences and expectations.
It is also about how clinical and medical support teams play a part in advancing the well-being of citizens to enable them to live with dignity in a place and style of their choosing. This new paradigm will enable the life course of the population to be enhanced through artificial intelligence and human empathy – the value of the latter increasing even more significantly in the future as the importance of mental health is more knowingly recognised as a key outcome.
Do not believe, however, that this new paradigm is about to be adopted straightaway. There are many constraints, resistance factors and belief systems to be overcome, some more dogmatically held than others. Take for instance the Hippocratic Oath.
No one would argue that we should ignore the “first do no harm” principle, but the covenant taken within the oath, not to share the “precepts … and … learning” of medicine with the uneducated and illiterate, can no longer be considered to be defensible and could in fact be argued to be counter to the rights of today’s citizen, who expects to have no decision taken about them without being party to the democratic process.