ABSTRACT
Digitalization and digital health technology (DHT) have been slow to come to health care. The use of digital technologies for collecting and using digital data is only just beginning. The explanation for the slow take-up is multicausal, one factor being the challenges faced by non-governmental suppliers in making and successfully marketing different digital services and devices. This chapter summarizes digital developments in Swedish health care and in health services to patients and citizens and considers the rapid changes that will occur in the coming years. It provides an overview based on research and projects carried out by the author and others in Sweden and the United States. It gives particular attention to digital technologies that enable patients to improve or maintain their health (self-care) and to enable more shared decision-making between clinicians and patients. Disruption is considered in terms of independent services disrupting traditional public health care clinical practice and organization, public services being the primary model for delivering health care in Sweden. The chapter proposes that the disruptive potential of new digital services and technologies (DSTs) are partially dependent on the state of development of patient advocacy movements and patient organizations and their dissatisfaction with traditional health care, which in turn relates to attitudes regarding the role of the individual and the state. One conclusion is the need for user-centered design and multidisciplinary research and development of services and digital devices. This is needed to design applications that can be easily integrated into workflows and patients’ everyday lives and also to assess return on investment. There are examples of codesign approaches, especially for smartphone apps, but barriers to connecting consumer devices to public-sector health information technology and to integrating the data into electronic health records. Separate private organizations are rapidly developing applications and devices and it is as yet unclear how the data can be used by clinicians in everyday practice. The chapter considers some of the main hindrances, which include lack of investment finance and the limited skills of multidisciplinary design and development teams.
