Rapid advances in digital tech are revolutionising healthcare and creating opportunities for efficiency and access – but also leave co-ops in the sector needing the maintain their people-centred ethos in a new operating environment.
These issues came under discussion at the Global Cooperative Conference, with a workshop led by the International Health Cooperative Organisation (IHCO).
The session looked at how co-ops can use digital mechanisms to connect with patients and practitioners, streamline work and provide and efficient and effective service – while still being underpinned by co-operative values and principles.
Moderating the session was Jose Pérez Arias, deputy director of Fundación Espriu and IHCO secretary general, who described how digitisation can improve access, enhance patient engagement, increase efficiency and convenience, and provide tools for remote monitoring and chronic disease management.
But there are challenges, he warned, including data security and privacy concerns, inoperability and standardisation, and regulatory and legal hurdles. “There are also issues around the digital divide and accessibility, healthcare adoption and training, user experience and design, cost and return on investment, and, particularly for co-ops, ethical implications.”
Related: ICA Global Cooperative Conference round-up
Susan Thomas shared experiences from the Self Employed Women’s Association (Sewa) Shakti Kendra in India, where a digital scheme gives informal women workers access to medical data using blockchain technology and a mobile app. Sewa, which started 50 years ago and now serves 3 million women across 18 states, set up a health co-op in 1990, and established India’s first women-run pharmacy in 1992.
The challenge, Thomas said, was that data was managed manually, and people didn’t know where their documents were – or they were held by (male) heads of households. Sewa looked into using blockchain to create secure digital identities for informal women workers to allow them to verify eligibility for different schemes, making sure they get the benefits they’re entitled to, while maintaining data privacy.
“We partnered with a tech company in the US to develop an app and are now piloting the scheme in Gujarat and Ahmedabad,” she said. Blockchain secures the women’s digital identity, enabling them to access their documents whenever they want, take independent decisions and manage their entitlements and rights in a timely manner, making them self-reliant.
“The app was co-created with the women who would be using it, in their own language, in a way that would be intuitive to them,” added Thomas. “There is some initial training needed, but it gives women control over their own data. It’s fast, secure and low-cost – and scalable.”
Related: 2024 End of Year Q&A: Dr Carlos Zarco
Lyman Manzanares from Cooperative Health Management Federation (CHMF) in the Philippines agreed that digital healthcare delivery “hands patients empowerment” – but said it works best when integrated into traditional healthcare systems, to streamline processes and reduce costs.
While the government and private companies run some healthcare tech initiatives, CHMF’s member-driven approach addresses some of the challenges, including the cost of healthcare and access to beds; in the Philippines, rural areas have fewer than one bed per 1,000 people (compared with 3.4 per 1,000 in urban areas).
CHMF is involved in a broad range of technologies, said Manzanares, including hospitals, health clinics, banking, insurance, rural outreach and disaster response. They are particularly proud of Coop Pay, a payments system that eliminates transaction fees and prompts financial inclusion.
Giuseppe Milanese, president of Confcooperatives Sanita, shared his experiences of people-centred digital health in Italy, which is aiming to help vulnerable people who are facing challenges in accessing healthcare.
“Lombardia in the north of Italy was one of the areas hit hardest by Covid-19, but here co-ops demonstrated the ability to respond swiftly in times of crisis,” he said. During the pandemic, the MedinRete network – four co-ops comprising 500 GPs – was established to track Covid patients at home via digital monitoring.
He also shared the examples of Kaleidos, a social co-op working in mental health which includes an innovative co-housing facility, and Vivi Calasci – a community-based care co-op which carries out daily monitoring of five vital parameters (temperature, blood pressure, oxygen saturation, respiratory rate and heart rate) and “has been so successful, it has been expanded to 30 more municipalities”.
But, said Milanese, tech is the tip of the iceberg. “The digital transformation of healthcare is a multidimensional process that is far more than just the adoption technology. It requires motivated and trained professionals, supported by an organised system.”
“In Spain we don’t have a national health service, we have an NHS in each region – but they don’t share data,” said IHCO president Carlos Zarco, who shared his experiences as director of Fundación Espriu, a Barcelona-based organisation dedicated to supporting the social economy, with a focus on co-op healthcare.
To address this, a co-op network of hospitals in Spain is using the Green Cube Healthcare Management System, which uses a cloud system to connect doctors, patients and other healthcare professionals within its network. It stores a single clinical record database which oversees the management and registration of any health centre or network. This makes day-to-day work easier for the professionals, said Zarco. “Green cube allows patients to book and manage appointments. It empowers patients to become the custodians of their own clinical history.”
The technology has reduced no-shows from 40% to 20%, he added. “The system also has a professional app and portal that allows doctors to access information from any location within the hospital, as well as business intelligence tools and manager systems.”
Coop Profesionales in Panama uses cloud technology to store a great quantity of data, which allows easy computation and efficient information-sharing at lower cost, said Marison Ng de Lee – but here education is key, too.
She highlighted the importance of principle six – co-operation among co-operatives – to overcome challenges such as governance, digitisation and the need for specific skills.
There was also the need to deliberately use different strategies to engage with all generations, she said. “Older people love the co-operative but there is still resistance to using new technologies. But digitalisation is not just an option, it is a must for co-operatives.”
