Healthcare has never been more specialised — or more fragmented — and the experience of care for many people is becoming increasingly disjointed. No one sees the whole picture or is responsible for the whole person.
So, how can we do better?
That was the challenge I set for myself as I prepared to speak at the international e-Mental Health Conference (eMHIC) in Toronto last November.
How do you inspire a room full of dedicated but overstretched health professionals to rethink how we are delivering care — not incrementally, but fundamentally?
I’ve spent my career challenging the status quo and redesigning health and government services to deliver better public outcomes. This time, I had just 10 minutes to outline the pivotal — and critical — opportunity facing us to rethink how we provide care.
The idea was bold but achievable: a radical evolution of integrated care, made possible only now because of advances in AI. This wasn’t about the technology. In fact, I knew that even mentioning AI could be a turn-off for some. The real challenge was whether we were prepared to design for people rather than organisations.
Most health professionals can see the gap. As specialisation deepens and the value and resources available in general practice continue to decline, the fragmentation of the patient experience widens. No one is caring for the whole person. Nowhere is this more visible or more damaging than in mental health, the one area of care that is inseparable from every other aspect of wellbeing.
At the conference, I shared stories of people I’d met while researching better approaches. People like Kate. Kate survived breast cancer. Clinically, she was a success story. But the trauma of her illness, combined with anxiety, depression and financial stress, slowly dismantled her life. She lost her job. Her relationships collapsed. She spiralled — not because help didn’t exist, but because no one was responsible for helping her put the pieces back together.
Her GP did what he could, but the challenge was bigger than the time he had, the funding model he worked under, or the reach of his professional remit.
Kate’s experience isn’t unique. The problem was that every system around her was designed to work in isolation, not together.
Health doesn’t operate in isolation. What’s happening in a person’s life — housing insecurity, unemployment, family breakdown or financial stress — directly impacts their health, and poor health in turn erodes a person’s ability to manage those life challenges.
The OECD has been highlighting this connection for years. Evidence shows that once someone begins to decline mentally, their capacity to address challenges in other aspects of life diminishes, reinforcing a vicious cycle.
Breaking that cycle takes coordination. Trials of integrated care have consistently shown better outcomes: improved wellbeing, reduced hospitalisation and stronger participation in work and community life. The problem is that these models rely on extraordinary effort. They depend on individuals navigating funding silos, professional boundaries, legal complexities and fragmented data systems on their own.
Bringing together a package of care, services and support is no one’s job. Professional and jurisdictional boundaries are deeply entrenched, and breaking through them can take decades.
Instead, what if we recognised and kept the value of specialisation while adding a new relational layer around the person?
In this model, clinicians and service providers continue doing what they do best, using their existing systems and expertise. Technology takes on the role of contextual connector to coordinate care around the individual rather than the institution. And by supporting the whole person, we reduce long term demand on the health system.
This is where “life hub” comes in: the concept I presented at the conference.
A life hub isn’t another system layered on top of many other systems. It’s digital infrastructure that brings together healthcare, mental health, social services, employment and community supports around the individual — reflecting the reality that people don’t live in silos.
The technology to do this now exists. AI can help manage complexity, personalise support and surface insights across health and non-health domains while respecting consent, privacy and professional autonomy.
So, the question is no longer whether whole-person care is achievable. It’s whether we are willing to design for it.
We know how to do this, but too often we build the wrong things. Digital health solutions still optimise for organisations, funding models and reporting requirements rather than the needs of people managing illness, work, family and recovery at the same time. Every system that keeps services separate makes whole-person care harder, not easier.
The next generation of digital health infrastructure should be judged not by how well it supports a service or a workflow, but by how effectively it helps a person rebuild their life.
That’s the real test of whether we’re ready to look after the whole person.
Fiona Armstrong, CEO, Liquid
Fiona has over 25 years expertise leading the transformation of social outcomes internationally. With 20 years leading whole of government reform, her speciality is transforming complex eco-systems and sensitive issues, including mental health and ageing. She has championed the adoption of a human centred digitally enabled approach across Government and is passionate about realising better outcomes for everyone. Fiona is currently CEO of Liquid, a strategic design & digital transformation consultancy where she inspires and delivers the best possible futures for clients and their customers.
Fiona Armstrong wrote: “No one sees the whole picture or is responsible for the whole person.”
I have some good news. GPs see the whole picture and are responsible for the whole person.
I have met GPs who do not want to be responsible for the ‘whole person’ so choose not to see the whole picture.
The foundation of General Practice is whole person care, this is what we do all day everyday, however, sadly the government and the community do not value this and it is being eroded by the current government.
Yes, and we should continue to build health systems for organisations, and interoperability between these organisations’ systems. It is the organisations spending millions to improve their processes. However these systems should be able to deliver an international patient summary to an authorised third-party on demand. With the current vogue for the medicalisation of the human condition, their will be just too much unworkable data collected/shared if we design health systems for patients rather than orgaisations.
Yes. Unfortunately the obsession with “digital health” is out of control.
I completely agree that GPs play a critical role in supporting whole of person healthcare, but in this opinion piece I was calling out that recent advances in tech mean that we could move towards integrating support across issues such as housing, employment and poverty, that often create a vicious cycle of negative impact on someone’s health and wellbeing. For example, there are some great integrated care pilots that combine mental health and employment support. But until now, these haven’t been scalable. If you’d like to collaborate to solve some of these entrenched social issues please reach out.