Does the digital transformation of health services help or harm health workers?

By Dr. Joanne Peter, Director, Social Innovation, Johnson & Johnson

In 2021, it’s hard to remember a time when going into the physical branch of a retail bank to engage with a teller was commonplace. Starting with ATMs (Automated Teller Machines) and evolving to include a slew of increasingly sophisticated e-banking products, the retail banking sector has completely transformed its approach to service delivery. Twenty-first century banking is consumer-driven, on-demand and available round-the-clock. This digital disruption is happening in every sector. Direct-to-consumer technology solutions are cutting out the middleman and driving increased convenience and lower costs. 

Though the health sector fears a looming human resource crisis, with a projected frontline health workforce gap of 18 million by 2030, it has been slow to adopt similar digital technologies to optimize the use of scarce human resources and to increase the accessibility and convenience of healthcare for clients. 

But COVID-19 has catalyzed a watershed moment for digital health adoption. Direct-to-consumer digital technologies can empower individuals to play a greater role in maintaining their own health and serve as a “digital front door” to health care. Examples of these technologies include chatbots that can answer clients’ questions about their health, telehealth platforms that connect clients to health workers regardless of distance, and remote monitoring systems that help individuals manage chronic conditions. 

These solutions have the potential to strengthen the connection between clients and health workers, but while the evidence of positive client benefit is emerging, the picture for health workers is much more ambiguous. Few research studies directly assess the impact of client-facing technologies on health workers and the health system. Those that do, paint a mixed picture: while some health workers experience increased efficiency and an ability to prioritize, others can see benefit for clients but not for themselves, or report having trouble drawing boundaries and managing their workloads.  

For digital health services to be accepted by clients and health workers alike, they need to take careful account of the needs and preferences of both sets of target audiences. Too often health workers’ perspectives and first-hand experiences are excluded from the design, implementation, and evaluation of these technologies and they fail to consider the potential impact on health workers or the importance of strong linkages to care. 

Health workers are a critical interface between digital and in-person services and need to be prepared for the new roles and responsibilities that can ensue. For example:

  • Helpdesk agents need to be trained and supported to answer questions and make referrals
  • Health workers need to be involved in the design of digital self-care services and appropriately trained on any new roles they need to perform (e.g., enrolling clients or monitoring client-submitted data or queries)
  • Client-facing digital self-care services need to be integrated with health worker-facing case management tools, electronic medical records, and health information systems

The technology, when applied well, should extend the reach of health workers and reinforce and enhance relationship-driven in-person care, not fully replace it. 

A conversation for action

The Johnson & Johnson Center for Health Worker Innovation is collaborating with a network of regional partners around the world—including ARMMAN, mothers2mothers, and Reach52 —on research, real-world implementation, and advocacy in the area of digital self-care and remote care management. We call this work Health in Your Hand.

On 17 November 2021, these partners will participate in a ‘Front Line in Focus’ event, bringing together frontline health workers, researchers, technology developers and program implementers. This conversation will highlight the urgent need for health systems to adopt digital technologies designed, implemented, and evaluated with health workers in mind so that they extend – rather than replace or undermine – the health workforce and enable clients to be active participants in their own health.  

Register here to be part of the conversation!

Credit: Center for Health Worker Innovation