The emergence of digital technologies has brought about major transformations in the field of health. Changes in relation to communications between the main agents involved in a healthcare service, in clinical care, in the competences of professionals, as well as the appearance of new non-specialised actors in this market.

For this reason, at RocaSalvatella we have identified the 8 main areas of transformation in the healthcare sector in relation to digital impact:

1. Empowerment of citizens and patients: new ways of self-managing health.

Digital realities mean that patients have increasing access to health-related information, they know more and, consequently, they tend to become more involved in their healing process. According to a report by the National Observatory of Telecommunications and the Information Society, based in Madrid, 48.3% of Spanish internet users consult health information on the Internet, a figure that represents 29.9% of the population.

However, to make good use of the information obtained online, citizens must acquire the necessary knowledge and skills to apply criteria that determine the reliability and quality of this content, that is, they must be digitally competent in the field of health.

On the other hand, digitalisation allows patients to access their personal health records, a tool that encourages citizens to follow their own files and the treatments that have been prescribed to them.

Patients inform themselves and record their data, but they can also easily organise themselves around interests and affinities, creating virtual communities in which users share experiences about their disease. This is a highly useful resource in the case of those affected by rare diseases. PatientsLike Me, the virtual community created in the United Kingdom, Health Unlocked or Forumclinic, an initiative of the Catalan hospital centre Hospital Clínic, based in Barcelona, are good examples.

Changes, in short, that lead us to a healthcare service management that is increasingly participatory and patient-oriented.

2. The impact on the healthcare professional–patient relationship.

Patient empowerment represents a change in their relationship with the healthcare professional, which may cause the latter to feel questioned and distrustful of how patients use the information obtained online. Therefore, it is essential that professionals in the sector address this new reality and reflect, for example, on the management they have to carry out regarding the ratings that patients give to medical services on the Internet.

In addition, professionals and patients now have new digital communication spaces such as social media and email. This is a reality that raises the need to establish procedures and define the function and use of these new channels. On the one hand, in relation to the security of these communications, as social networks are in the public domain, and on the other, regarding the possibilities they offer in relation to the dissemination of healthy habits and health promotion.

3. New areas of communication and relationship between healthcare professionals.

Digital tools also offer new communication and relationship opportunities between healthcare professionals: from videoconferencing and email, which can help reduce diagnostic times, to communities of practice or virtual communities of professionals such as Sermo, where they can share information about patients and/or ask for second opinions. Ultimately, these are tools that facilitate the dissemination of knowledge among professionals and the adoption of new practices.

4. Efficiency in the administrative management of healthcare centres.

Online booking, electronic prescriptions or the management and requesting of tests via the Internet are just some examples of the administrative tasks that the digital environment enables. There are also very useful services linked to open data, such as the publication of waiting times in Emergency Departments.

5. New clinical care mechanisms: diagnosis and treatment development.

Clinical care is being drastically transformed due to the incorporation of new procedures for making diagnoses or treating diseases. Today, remote diagnoses can be made by sending dermatological images, phobias can be treated through augmented reality, treatment adherence can be improved using communication tools, vital signs can be constantly monitored, and healthcare professionals can be alerted thanks to ubiquitous connectivity. Telecare and telemedicine, therefore, offer a range of new and beneficial possibilities for clinical care.

6. Data analysis for decision-making.

The healthcare sector has, for a long time, had large amounts of patient data, but today, more than ever, technology offers very powerful tools to analyse and process this data. The combination of these two circumstances has led to interesting initiatives such as the British project National Health Service Trust, which applies data analysis on patient mortality rates to study the effectiveness of treatments.

Similarly, the publication of health data on the Internet by citizens or the analysis of health searches on search engines can be highly useful sources of study for cases related, for example, to epidemics.

Regarding the internal processes of health centres, data analysis can contribute to improving the management of available resources.

7. New methods of training and acquiring knowledge.

The emergence of new technologies and new content formats implies new ways of transmitting knowledge and requires new training methodologies. Broadcasting an operation with Google Glass or using video games to learn surgical checklist verification are some of the most illustrative cases of these emerging scenarios.

In relation to the skills of healthcare professionals, the large amount of available information makes a review of information management professional competence necessary. The changes in the healthcare professional-patient relationship, in turn, require an update of patient-oriented competences and those relating to digital communication.

Finally, as far as digital knowledge competence is concerned, it becomes essential to understand the involvement of information and communication technologies and the digital aspect in the healthcare field.

8. New agents and alliances in the healthcare market.

New business models and new agents are joining the healthcare sector, offering new products and services to citizens. Large technology companies like Google or Microsoft have offered or offer personal health data registries, companies dedicated to creating health content or applications have emerged, agents that certify this content such as Health on the Net Foundation, or communication agencies specialised in the digital field. In this context, citizens, with the publication of their health data in public environments, patient communities and the use of data from sensors that measure environmental parameters, play an increasingly central role in the healthcare sector.

Furthermore, collaboration between traditional agents and new actors in the healthcare field promotes innovation and the appearance of new commercial projects such as the contact lens that measures the user's glucose, the result of the alliance between Google and Novartis, or Mi vida sin ti, an initiative to combat smoking among citizens.

To enable the transition of the 8 points of digital transformation discussed throughout this article, four issues must be addressed. Firstly, the interoperability of technological tools in order to avoid data dispersion and facilitate the efficiency and safety of communications. Secondly and thirdly, the work on a legal framework that is increasingly shared between countries and/or regions, to facilitate its deployment, and the need to consider the relationship between socioeconomic factors, health, and access and use of ICT so that these transformations benefit the largest number of patients. Finally, it will be necessary to evaluate the dimension and impact of all the changes made on the path to digitalisation with specific indicators of the health sector, such as the treatment adherence rate, the number of referrals from Primary Care to specialists, the reduction in the number of visits to Primary Care, or the reduction in missed appointments by patients or prescription costs.

Transformation is simply inevitable. Seizing all the opportunities offered by this new landscape and doing so with the aim of ensuring better service to citizens is in the hands of the major players in the healthcare sector.

This article was originally published in the digital economic information newspaper Via Empresa, 18 January 2015.