Healthcare needs radical reimagining

The best way to treat people is to identify the potential benefits and challenges of each new technological breakthrough

The future of health that we envision is only about 20 years off, but health in 2040 will be worlds apart from what we have now.

Based on emerging technology, we can be reasonably certain that digital transformation – enabled by radically interoperable data, artificial intelligence and open, secure platforms – will drive much of this change.

Unlike today, we believe care will be organised around the consumer, rather than around the institutions that drive our existing healthcare system.

Why does the future of health matter? Nothing is more important than our health.

All of us interact with the healthcare system to varying degrees, and we will continue to do so throughout our lives.

The cost of healthcare affects individuals, families and employers, as well as local, provincial and state budgets.

Humankind has reached a turning point in its continuing journey to preserve and improve our quality of life.

We are at the forefront of these continuous advances, allowing us to watch over ourselves as part of an interconnected ecosystem.

The evaluation report of the pilot phase of the National Health Insurance (NHI) shows serious deficiencies and a need to change the mind-set.

It is clear, at least to me, that the NHI seeks not to revolutionise healthcare delivery but to sustain the age-old system that fails to appreciate the advances the changing population needs.

While it does, in some areas, make progressive suggestions on the way forward, these are buttressed on the same old, same old.

There is an urgent need for the current public health leadership to realise that the NHI must be aimed at reimagining and redesigning healthcare for the future as a primary basis.

Also, the future of health won’t just be defined by the innovations we set out to create; it will equally be shaped by how we respond to – and anticipate – the challenges and consequences of each great advancement.

The more we know, the more “known unknowns” are revealed.

The boundaries of areas left for researchers to explore constantly expand, while possible applications of new technologies proliferate.

Therefore, mapping out new healthcare, we must make sure each route leads back to the intended beneficiaries.

Large-scale changes driven by technological innovation are only as valuable as their impact on individual people’s lives; lives we are constantly striving to improve and extend.

I believe the best way to protect and treat the people we all serve is to identify the potential benefits and the potential challenges of each new breakthrough.

Leveraging innovation wisely will let us help more patients than ever before.

Another realisation is that healthcare is an ecosystem. So are the externalities disrupting it.

Every player across the healthcare ecosystem has an opportunity to transform themselves and, in turn, positively impact on the broader system.

There is no need for creating a gulf between private and public healthcare. Nor is there a need to see citizens as patients and not active participants in reimagining and redesigning the care they want.

The process of reimagining healthcare needs to start with thinking about new ways to deliver care.

The traditional, one-size-fits-all, office-visit model of medicine has reigned for decades.

Clinicians are locked into a system that requires them to see another patient in their offices every 30 minutes, and alternatives like email consultations have been slow to catch on.

With a very young population, isn’t it time we designed healthcare services around the needs of particular populations?

For example, opening walk-in health posts where a person could get more than a health screening.

Or opening clinics near tertiary institutions and taxi ranks so as to make it convenient for the people and reduce the cost of access.

Very important is the need to think about redefining the core competencies of the health executives of the future.

As healthcare has evolved we have not adapted the competence of those needed to manage it.

We still require people with clinical backgrounds and it has been shown that this does not yield positive results.

The most important skill for the healthcare executive of the future is leadership.

Leadership of the facility, leadership of ancillary providers, and physician leadership is essential to the new models.

The healthcare executive of the future needs to develop the leadership skills to be able to navigate new complex environments, while providing optimal performance at every facet of the vertically integrated organisations.

Anticipating future skills needs for health professionals is crucial for meeting the new demands of healthcare – for example: the shift from care in hospitals to the provision of care closer to home, to cope with elderly patients with multiple chronic conditions, such as heart disease and diabetes; the growth of new technologies, new medical appliances and diagnostic techniques, which requires technical knowledge in addition to clinical knowledge; and the expansion of e-health, which enables distant diagnostics services – and requires new ways of working.

What does the future look like? It is one where, for instance, a GP uses their tablet ultrasound to make a movie of a patient’s beating heart.

When irregularities are noted, the GP shares this immediately with a cardiologist who diagnoses the patient’s condition and sets up a care plan there and then.

There’s no need to make an appointment for weeks or months ahead – the issue can be dealt with immediately.

This is what we have become accustomed to when booking flights, doing our finances or shopping online.

It’s a world where someone with a chronic condition has all their vital data streamed to their care team that will probably know before the patient does that someone needs to step in to provide support or treatment.

Patients will still need specialists with expert knowledge, but the patient and specialist don’t need to be in the same space at the same time.

A network of connected care means several experts can look at the case simultaneously.

This would enable the early diagnosis of health issues by constant monitoring before they become more serious.

This will be normal practice within 10 years. The idea of maintaining people’s wellbeing rather than reacting to an episode of illness makes sense.

It will be difficult to change a system that is conditioned to be more reactive, but that’s how it will be in the future.

We can choose to start now or play catch up later at high cost!

Maxon is a public servant and social commentator

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August 2020

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