Sixteen stakeholders comprising health technology developers (7), national health policy makers (2), university presidents (2), hospital directors (2) and health technology company administrator (3) were interviewed between August and December 2021. Recruitment rates from invitation were 80%. All interviews were undertaken via online platform. Each round of interviews had a median length of 22 min (range 12–35 min).
Importance of Health Technology and Its Impacts on Future Healthcare
All stakeholders agreed that health technologies strongly impacted healthcare transformation. Technologies which will drive healthcare transformation included artificial intelligence, data analytics, telehealth, internet of thing (IoT), sensors, point-of-care diagnostics, and personalized/precision medicine. These technologies can be classified into three main categories.
1. Molecular technologies: The main technology in this category is high throughput technologies. These techniques enable physicians to characterize the biological markers (biomarkers), including deoxyribonucleic acid (DNA), ribonucleic acid (RNA) or protein, by massively parallel sequencing. With the increase in technological capacity and decrease in cost, routine available sequencing tests can become available and would better guide patient management, including disease predication, prevention, and treatment decisions. This will facilitate the development of personalized medicine.
2. Biomedical engineering technologies: This category includes medical sensors, surgical robots, assistive technologies, biomaterials, three-dimensional printing technologies, microdevice development, point-of-care diagnostics, etc. These technologies will increase the performance of health services. For example, surgical robots can help access organs that are difficult to approach, provide more precise and less invasive operations. Advancement in medical sensors, microdevice development and point-of-care diagnostics will enable patients to be more engaged with the healthcare system.
3. Health information technologies: Information technologies has a strong impact on healthcare in various aspects. Development of online databases is the core infrastructure of bioinformatics which enables complex genome and protein analysis. Development in medical artificial intelligence can enhance efficiencies of medical imaging technologies with accurate image analysis capabilities. It also helps in the design of personalized treatment for patients based on their medical history. Personal health data from various sources such as personal tracking devices, medical records, laboratories, etc. can be uploaded and retrieved for analyses. Blockchain technology will make personal health records more accessible with heightened security. An online health platform can link physicians with their patients. Eventually, healthcare will undergo digital transformation in which digital technology is completely integrated into all areas of health services and will fundamentally change how healthcare services are operated and delivered.
Based on the three technology categories mentioned above, healthcare will be transformed with three key aspects including delocalization, personalization, and digitalization. The center of healthcare will move from medical institutes such as hospitals to more personalized environments such as the patient’s home. Healthcare can be delivered everywhere to serve patients in remote locations as well as decrease expenditures and costs while increasing efficiency and convenience. Advances in high throughput technologies and health informatics will foster personalized medicine for more responsive healthcare management for many different levels of patients ranging from the elderly to the underserved populations. Healthcare will see a shift from the application of statistically certified paradigms (such as in evidence-based medicine) to more personalized protocols that consider the patient’s (genomic) specificity.
Necessity of Health Technology Developer and Its Role in Healthcare Transformation
All stakeholders appreciated the importance of health technology developer in the process of healthcare transformation. The Policy Makers group described a shortage of human capital in the health technology industry at the national level. They also pointed out that, in order to improve the Thai health technology industry, three main areas require development. These include: (1) establishment of national standards; (2) a market for health technology and investment for sustainable growth; and (3) eco-system for the medical device industry that includes technology and human resources. This group emphasized the necessity of an urgent upscaling of domestic expertise and technology to match that of the international level as well as long-term research funding in the development of human resources and technology related to current as well as future trends in the medical device industry.
The University Administrator group mentioned their roles in producing health technology developers. They described the programs and courses in their universities that are involved in the process. However, there is no comprehensive program that covers all skills required for being a competent health technology developer.
Health Technology Company Administrators and Health Technology Developer groups described limitations in infrastructure for health technology development. Lack of a national center for health technology certification was a main obstacle and barrier to success. This lack of a national certification center for health technology prohibits the process of launching newly developed technologies in the market. These experts also highlighted that another problem is that local health technology companies are less competitive when compared to large international companies. Since purchase decisions for health technologies depends on trust, local companies in Thailand face adversities in branding therefore, international companies with long-standing tract records are more trustworthy and have more advantage in term of market competition.
Skills required for being a health technology developer
All stakeholders described the skills required for being a health technology developer. The skills were categorized into four domains including (1) Health Science, (2) Health Technology, (3) Product Development & Design, and (4) Marketing & Entrepreneurship. After three rounds of the Delphi method, skills in each domain were ranked (Tables 2 and 3). Table 4 shows the final list of top skills required for health technology developers.
Kendall's concordance coefficient is also used to determine the level of agreement between experts. Kendall's coefficient W ranges between 0 and 1 in general; the larger the value, the better the degree of coordination among experts. Kendall's test result's statistical significance indicates agreement among experts. The expert coordination coefficients as shown in Table 5 were statistically significant (P < 0.01) in all dimensions in the third Delphi round. This indicates that all experts have a tendency to agree (Holey et. al, 2007[20]; Liu et al., 2022[21]; Mohd Noor et al., 2022[22]; Shi et al., 2022[23]).
Concerning the Health Science domain, top skills required were scientific method, precision and personalized medicine, human cognitive functions, and diagnostic laboratory techniques. The scientific method is an indispensable foundation of rigorous, systematic research that supports evidence-based treatments and enhances our understanding of disease. Precision and personalized medicine takes this concept one step further by tailoring treatments and interventions based on each patient's genetic makeup, lifestyle choices and medical history. Furthermore, cognitive functions - mental processes that support decision-making, problem solving and communication skills among others - are vital tools used by healthcare providers when diagnosing and treating their patients. Diagnostic laboratory techniques are essential in the diagnosis and monitoring of various medical conditions ranging from cancer to infectious diseases. These techniques require many skills including sample collection, analysis and interpretation - essential elements to providing timely diagnosis and effective treatment options. Noteworthy is the emphasis placed by hospital directors and administrators of health technology on diagnostic laboratory techniques, reflecting their significance in healthcare delivery as well as laboratory professionals' roles. This statement underscores the complexity of Health Science as a field requiring varied skill sets for success.
The processing of digital information has been identified by the Health Technology domain as the most important skill. The fact that the top four skills are all directly related to data processing confirms this finding. These four skills include: artificial intelligence in healthcare, data science in healthcare, bioinformatics and signal processing and analytics. Digital data processing is crucial to the Health Technology domain, as it allows for valuable insights to be extracted and more efficient and effective healthcare solutions developed. The rapid development of technology, and the availability of more data is driving the demand for digital data processing experts in the healthcare field.
The Hospital Directors Group has identified four skills as essential in the area of Product Development & Design. The skills include design thinking, clinical design & innovation, user experience and user interface, technology & ethical considerations. These skills are essential for the design and development of innovative healthcare solutions. They also ensure that products are ethically sound. It is also important to note the Hospital Directors' group expressed concern about the sociocultural aspects of innovative technologies. They are aware of the possible cultural differences that can exist when using health technology. These concerns highlight the importance of considering the sociocultural influences that can impact the development and design of healthcare products. It is important to make sure that these products are accessible and inclusive to all groups, regardless of cultural background or socioeconomic standing. Incorporating sociocultural perspectives in the product development process allows healthcare organizations to create solutions that are both effective and culturally appropriate.
There are several skills that are crucial to success in the Marketing & Business domain of the Healthcare Industry. These skills include digital health and E-market, the healthcare industry and market as well as medical device certification and approval. These skills are essential to the development and marketing of successful healthcare products and service. It is important to note, however, that the Policy Maker Group has highlighted the importance of wider areas such as the medical device business strategies. This shows the importance of a holistic approach to marketing and entrepreneurship within the healthcare industry. It involves understanding not only the specific skills needed but also the wider strategies and tactics that are necessary for success.
On the other hand, technology developers both at the administrative and developer level have shown a greater concern for practical issues such as the approval and certification of medical devices. This is due to the fact that it's important to have a thorough understanding of the processes and requirements involved in gaining approval for devices. These findings, taken together, demonstrate the multifaceted nature and complexity of the Marketing & Entrepreneurship in Healthcare domain, which requires a variety of skills and expertise. Understanding the needs and concerns specific to different stakeholder groups allows healthcare organizations to develop marketing and entrepreneurship plans that are tailored for their needs and goals.