By SPECIAL TO THE NATION
As millennials, Generation X, and baby boomers will enter new life stages at the same time, there will be simultaneous demands for three things – lower cost, convenient care delivery and better management of chronic illness and outcomes.
Concurrent with these population changes are market factors that will also have a significant impact. The concept of “value” is now being defined and assessed by consumers. And, there are a number of technology disrupters poised to enter the healthcare arena in areas with significant consumer impact – from distributing drugs and lowering the cost of health insurance, to serving as centralised, more transparent platforms for decision-making.
Faced with these demographic and market challenges, today’s healthcare organisations should transition to a consumer-centric delivery model. In doing so, a consumer-centric healthcare industry should follow the lead of other consumer industries by taking an omni-channel approach to connecting with healthcare consumers and meeting their needs, according to KPMG’s study, “Healthcare 2030: The Consumer at the Center”.
First, there is the need to keep pace with consumers’ evolving demands. To truly understand consumer behaviour, there must be a free flow of consumer data, regardless of the care setting. Consumers are largely on board, with a number of recent studies indicating that individuals are more than willing to share their medical data if it leads to the most appropriate care in the most appropriate settings, as well as improved customer experiences and better outcomes. Across all consumer industries, more than 75 per cent of individuals say they are generally happy to part with some level of personal information in exchange for greater personalisation, better products and services, improved security and more value, according to a recent KPMG survey, KPMG 2018 CEO Outlook by KPMG International.
In fact, availability, mobility and interoperability of clinical data help create the empowered customers that are so critical to a consumer-focused healthcare industry. Armed with a navigable picture of their medical histories, patients will be more in control of their own health and wellness needs and more apt to use digital instead of physical engagement when it improves their experience or outcomes. They will embrace new technologies to enable better chronic condition management, and opt for different types of care for different types of health events.
For their part, health systems need to start understanding and relating to individuals as people rather than as patients. This requires reframing how customers are approached. Healthcare organisations need to make larger investments in multi-channel approaches to patient motivation, bearing in mind the age-based needs and access preferences.
Second, organisations need to commit to true value for outcomes. In a consumer-centric healthcare system, the focus on customer experience should be underpinned by an equal commitment to improving clinical outcomes. Health systems must make more significant investments in advanced technologies that can impact outcomes – e.g., genetics tools, risk stratification calculators, rare disease detection algorithms, machine learning, natural language processing and predictive analytics. Such investments are critical to caring for patients with early warning signs of chronic illness, as well as the shift to a healthcare paradigm less focused on treating illness than on prevention.
Further, care management solutions can be used in the clinical setting to ensure that patients move through the healthcare enterprise safely and with appropriate care; enable two-way communication between patients and providers to better manage chronic conditions; and provide accurate measurement of care-team performance so that all procedures, tests and treatments are warranted and not duplicative.
Partnerships with technologists will be central to building advanced analytics capabilities that allow providers to blend historical medical data with personal preferences, thus providing a holistic approach to better outcomes and experiences across the lifespan.
Third, providers should foster care continuity through layered delivery models. As traditional settings decline in number, there will be a simultaneous expansion of alternative sites of care. Patients will be able to receive care where and when they prefer across a variety of flexible formats, much the way many retail brands offer products through a variety of channels ranging from brick-and-mortar to online stores. Movement between care settings would be seamless and patients would be known no matter where they sought treatment.
Such a model would likely require a mechanism for directing patients to the right site of care at the right time. Patients of all ages would benefit from having focal points – or aggregators – that knit healthcare services together, allowing more complex decision-making to occur. Aggregators would house and parse the data that patients need to make medical decisions – from the best care centre for a particular procedure, and physician recommendations, to comparative pricing and how treatment for one condition might exacerbate another. These are critical components to the layered approach for consumer-centric healthcare:
l Retail Clinics. It is likely that retail clinics will evolve to a greater role in helping patients manage chronic illness with the ownership of their own medical data that allows them to seek healthcare anywhere suitable. Since health systems will not excel at all aspects of customer experience delivery, it is not critical that they own all aspects of layered care or develop new retail care capabilities themselves. The best approach will likely be to partner with entities that already have a retail presence and permission, while co-branding on health to create value for both enterprises.
l Virtual Care. Services that transcend geography like telemedicine and other forms of virtual care are critical to the layered approach. Used strategically, these technologies allow providers to meet the needs of remote or homebound patients from one centralised hub and provide guidance to physicians in other locations who may be struggling with complicated cases.
Perhaps most critically, telemedicine can be used to preserve the lifetime value of the customer. Right now, healthcare is local, fragmented. If patients relocate for job changes or retirement, their relationships with local healthcare providers will likely end. Instead, healthcare organisations should develop virtual care capabilities to meet patients where they are through a diverse set of services and then evolve those offerings over time according to changing patient needs.
l Critical Care in the Home. Increasingly, providing hospital-level care in the home will also be an integral part of a layered approach. Over time, a number of critical care procedures currently performed in hospitals – such as treatment for pneumonia, skin infections or even post-surgery recuperation – could be provided for 30 to 50 per cent less in the home, according to research from the Johns Hopkins University School of Medicine. Of course, to make this possible, delivery and payment reforms must continue to progress so that providers will be incentivised to prescribe in-home services for the post-acute phase of a patient’s care.
In summary, this layered approach to healthcare delivery requires reciprocal relationships between health systems, retail clinics, telemedicine providers and home care providers, and by extension same-day surgery centres and rehabilitation centres. Specifically, retail care may involve some aspects of virtual care that patients can access on site. By the same token, care in the home will likely rely on virtual technologies when it comes to monitoring post-surgery patients and the chronically ill.
Finally, providers that utilise virtual care must work closely with health systems and specialist physicians to ensure that there is two-way communication if patients should require higher-acuity care than they can provide.
Contributed by TANATE KASEMSARN, head of infrastructure, government, healthcare and hotel, for KPMG in Thailand
Source: “Healthcare 2030: The consumer at the center”, KPMG LLP, 2019.