Introduction
Healthcare is among the sectors that have actively tapped into the potential of digitalisation. A range of digital health technologies has emerged and become ubiquitous over the past two decades.
The most frequently adopted technologies include artificial intelligence, telehealth, wearable patient devices, electronic medical records, electronic health records, and mobile health applications (Senbekov et al., 2020). These technologies have been rated as beneficial for providers and users alike. FDA, other regulatory authorities, and healthcare organisations have expressed optimism about their growing convergence with the healthcare system (Senbekov et al., 2020).
Even though these technologies are generally poised to deliver sustainable care, their downside in this context is overwhelming and open to debate. Aside from certain inconsistencies relevant to sustainability, this digital revolution in healthcare has also engendered a few ethical and legal concerns. This paper is aimed to analyse digital and tech-assisted healthcare in the light of generally recognised criteria of sustainable healthcare along with ethical and legal dimensions.
Tech-Driven Healthcare and Sustainability
Artificial Intelligence for Service Providers
As mentioned, the digital drive within healthcare is in full swing. Healthcare service providers are increasingly eager to capitalise on the potential of artificial intelligence that enables them to make informed decisions by relying on sizable datasets (Bohr & Memarzadeh, 2020). The classification of data concerning demographics also facilitates customised and personalised service delivery.
Other than the improved intelligence to support decision-making, a potential benefit of using AI is the reduced speed of delivery and, thereby, improved satisfaction rate and cost.
While seen from the triple-bottom-line perspective of sustainability, the use of AI by service providers appears to be a potential solution to its contributions towards efficiency.
One of the important requisites of sustainability is ensuring that the depletion of resources is slowed down to the degree that their ample reservoir is left out for the coming generations (UN Department of Economic and Social Affairs, 2021). The cost-effectiveness attached to AI is based on austerity-oriented use. Therefore, this aspect is perfectly aligned with the global understanding of sustainability.
Mobile Applications and Patient Information Management System
A wide range of technologies is being used to manage the patients’ data and use it to improve health outcomes. For example, some apps contain information about a huge sample of patients with shared characteristics, such as the type of disease, symptoms, and others (Sandhu, 2020). Healthcare practitioners can use this information to bring precision to their decisions.
At the same time, the patients can take benefit of such easy-to-use apps by identifying the symptoms at early stages and, thereby, avoiding the extreme consequences of diagnostic delays.
This technology also incorporates the social aspects of sustainable development, where improving health outcomes is among the key considerations (UN Department of Economic and Social Affairs, 2021). Patients’ ability to be aware of the symptoms and corresponding outcomes will help them be more cautious.
At the same time, it also holds reciprocal value for the practitioners’ strategies to expedite diagnostic procedures and spread awareness about unhealthy habits and practices. In this way, it is a sustainability-oriented contribution at the collective level.
Another noticeable benefit of information management and storage technologies is that they reduce the reliance on paperwork by allowing for the electronic storage of records. This feature also has its potential concerning sustainability as think tanks worldwide are mulling ways to reduce waste (UN Department of Economic and Social Affairs, 2021). Since papers account for the major part of global waste, any consideration similar to electronic healthcare information management must be deemed valuable.
While considering sustainability, it is important to apply a holistic approach that encompasses all sustainable development goals as laid out by the United Nations in its vision. Data management and information processing technologies are in harmony with certain social needs; they have their flip side. For example, a key aspect of sustainable development focusing on its social aspect is to promote equity.
The question of the use of information management software is if they are equitably applicable (O’Rourke et al., 2020). This question remains unaddressed and open to debate because it is understood that such technologies and software are confined to the tech-literate population. In this way, the practitioners and patients in underprivileged areas where such services are barely accessible are unlikely to be part of this trend. Even though the tools and technologies are easy to use, their application and the ability of a patient to take advantage depends on a certain amount of tech literacy.
Since not all individuals are equally tech-savvy, it is questionable if this approach accommodates the need for equitability or rather deters the same.
Telehealth
Telehealth is among the rising technological trends in healthcare. There is a broad range of technologies and artefacts used to facilitate telehealth, including but not limited to remote monitoring setups, communication tools and devices, and video storage options.
These technologies enable practitioners to deliver their services remotely, such as performing diagnoses, educating patients, and monitoring their condition (Gajarawala & Pelkowski, 2021). The growing use of such tools has reduced the need to commute the physical servicescape (such as hospitals and clinics). It is beneficial for practitioners and patients alike.
From practitioners’ perspective, it is a cost-efficient alternative as it facilitates the faster provision of services aside from reducing the need for physical space. The same benefit is cherished among the patients as they can avoid the hassle and cost of travelling. Besides, they can avoid being admitted to the hospital and continue to be watched and monitored while engaged in their routine activities.
This offshoot of tech integration within healthcare outperforms the developments mentioned earlier in many aspects. For example, within the sustainable development vision, a key focus is to reduce carbon emissions. Much of the emission of harmful gases and pollution is attributable to transportation (Wang et al., 2020). Therefore, the alternatives to traditional methods that reduce reliance on transportation are deemed environmentally sustainable. As mentioned, the provision of telehealth has reduced the need for travel. In this way, it contributes to the alleviation of pollution.
Telehealth can be deemed beneficial also in how it improves the accessibility of healthcare services. It is particularly beneficial for people in remote areas who have to cover long distances to access quality healthcare service centres located in urban parts (Wang et al., 2020). With this facility, the service is at the doorstep and fingertips of everyone, which is an important stride towards ‘inclusive’ healthcare service delivery. However, the issue of inequitable service application, as discussed in the previous case, remains intact in this context, too.
Ethical and Legal Issues
Whereas the digitalisation of healthcare has its ups and downsides in terms of sustainability, it has also instigated debates surrounding ethical and legal concerns. For example, the methods applied to accumulate, store, and use the information have been subject to criticism because of certain ethical issues inherent to its application. For example, the critics are concerned about the non-voluntary participation of the patients in the process.
They argue that the confidentiality of patients’ information is among the pillars of healthcare ethics. The information system requires patients to publicise their information, thus against such consideration (Iakovleva et al., 2019). It is also susceptible to legal complications in parts of the world where patient confidentiality has a legislative cover (Kisekka & Giboney, 2018). At the same time, the patients who agree to participate are mostly unaware of what it means for them and their information users because of their presumed illiteracy of health and medicine as a subject (Kisekka & Giboney, 2018). Therefore, the ethical status of data management software is open to question.
Besides, there are certain standards in different parts of the world regarding an organisation’s criteria for using patients’ data. For example, in the United Kingdom, an organisation has to meet GDPR standards, which involve cybersecurity mechanisms, data protection facilities, and proof of legally permissible use of data (Kaplan, 2020). Since most of these requirements are hard to meet and any single loophole may result in reputational loss, the application of data management technologies has considerable legal hurdles.
Then, there is Haight Act 2008 and other hurdles requiring the physicians to examine the patient in person before prescribing the medicine. This obligation limits the otherwise potential of telemedicine or telehealth (Gajarawala & Pelkowski, 2021). The most prominent ethical issue is the ongoing threat of privacy breaches (Gajarawala & Pelkowski, 2021). Therefore, physicians are required to be hyper-cautious while carrying out online diagnosis or monitoring.
Similarly, as with any other domain, automation in healthcare is subject to criticism due to reduced reliance on human input. This perspective makes it appear antagonist to labour protection.
Conclusion
The digital revolution in healthcare has opened the doors of endless opportunities for healthcare practitioners, patients, and all stakeholders. Aside from bringing more convenience, these technologies deserve credit for positive contributions to the triple bottom line and vision for sustainable development.
However, there is a need to improve inclusiveness that will come with improved tech literacy and awareness about the potential positive outcomes of digital health within the currently disadvantaged population. At the same time, legal considerations need to be simplified to unleash the full capacity of digital healthcare. Even though challenges are immense, the future of healthcare lies in digital integration, as evident from the current outlook of its growth and ubiquity.
Reference List
Bohr, A., & Memarzadeh, K. 2020. The rise of artificial intelligence in healthcare applications. Artificial Intelligence in Healthcare, pp. 25-60. https://doi.org/10.1016/b978-0-12-818438-7.00002-2
Gajarawala, S. N., & Pelkowski, J. N. 2021. Telehealth benefits and barriers. The Journal for Nurse Practitioners, 17(2), pp. 218-221. https://doi.org/10.1016/j.nurpra.2020.09.013
Iakovleva, T., Oftedal, E. M., & Bessant, J. 2019. Responsible innovation in digital health: Empowering the patient. Edward Elgar Publishing.
Kaplan, B. (2020). Revisiting health information technology ethical, legal, and social issues and evaluation: Telehealth/Telemedicine and COVID-19. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3662787
Kisekka, V., & Giboney, J. S. 2018. The effectiveness of health care information technologies: Evaluation of trust, security beliefs, and privacy as determinants of health care outcomes. Journal of Medical Internet Research, 20(4), e107. https://doi.org/10.2196/jmir.9014
O’Rourke, B., Oortwijn, W., & Schuller, T. 2020. The new definition of health technology assessment: A milestone in international collaboration. International Journal of Technology Assessment in Health Care, 36(3), pp. 187-190. https://doi.org/10.1017/s0266462320000215
Sandhu, K. (2020). Opportunities and challenges in digital healthcare innovation. IGI Global.
Senbekov, M., Saliev, T., Bukeyeva, Z., Almabayeva, A., Zhanaliyeva, M., Aitenova, N., Toishibekov, Y., & Fakhradiyev, I. (2020). The recent progress and applications of digital technologies in healthcare: A review. International Journal of Telemedicine and Applications, 2020, pp. 1-18. https://doi.org/10.1155/2020/8830200
UN Department of Economic and Social Affairs. 2021. UN Sustainable Development Goals. Available from https://sdgs.un.org/goals [Accessed 22nd November, 2021]
Wang, C. J., Liu, T. T., Car, J., & Zuckerman, B. 2020. Design, adoption, implementation, scalability, and sustainability of Telehealth programs. Pediatric Clinics of North America, 67(4), pp. 675-682. https://doi.org/10.1016/j.pcl.2020.04.011
