How an inclusive approach to healthcare may evolve future healthcare systems
Predicting how individuals, communities, healthcare workers, hospitals, global players, payors, planners and policymakers will support transformation
Why interoperable data will be key to supporting transformational efforts
As seismic as the future trends that are expected to profoundly impact every industry over the next decade and their predicted applications to healthcare are, none of them will be effective on their own in moving towards inclusive health systems. To achieve this goal, they will need to happen in harmony – to be driven, or at least directed, by local health leaders working to bridge global and community actors into a coherent model of their future health ecosystem. This will require integration at two levels.
First, the integration of local communities with health systems and global platforms. Engaging communities in health promotion, prevention and care is the single most important factor enabling the inclusive vision described in Healthcare Horizons. At a global level, technology will be key to unlocking this, but it will require planning, investment and coordination from health leaders to ensure that the global players entering this space do not fragment and cherry pick patients. At the system level, the energy of local communities will need to be harnessed and to ensure equity their needs fully understood. But to make this happen integration must be accompanied with empowerment, entrusting communities with influence in the evolution of health systems.
Second, integration of health services themselves – physical and virtual, primary and secondary – so that patients can seamlessly move between different tiers of support with continuity of care and interoperable data acting as an engine for predictive and proactive healthcare. This is where changes to the health workforce and to information flows become most vital.
What kind of health system could this create? The diagram that follows is one that may, at first, be familiar in its core, but has several layers and key distinctions from the reality of most healthcare systems today.
Roles and responsibilities
The predictions below have been developed based on KPMG professionals’ healthcare industry expertise and experience working with healthcare payors and provider organizations around the world.
Individuals: Service users will be empowered to undertake many activities that would traditionally be the realm of health professionals, enabled by an explosion of smart devices, opportunities in decentralized data governance and new virtual environments. This means that much of the activity that may have taken place in hospitals or primary care settings now takes place in the comfort of peoples’ homes, including consultations via virtual reality (VR) or augmented reality (AR). As healthcare becomes more deeply personal, individuals will be empowered to take on a greater role in their own health and overall wellbeing.
Communities: Local citizens, community groups and civil society organizations will be more actively engaged in population health management, health prevention and local health promotion activities. They will have a far greater level of decision-making power – both in priority setting and, crucially, by how the data generated by local health and community organizations are used. Patients and community members may even be given a direct stake in their health systems, such that they themselves benefit from improvements to efficiency and sustainability. Local communities – individually and/or collectively organized – will also be an essential resource to help vulnerable patients navigate the rollout of new health technologies.
Healthcare workers: More staff will be employed at the system-level rather than individual organizations to support integrated care delivery. Artificial intelligence and machine learning will provide staff with more capacity (time) and greater support in decision-making. These technologies will create new roles such as behavioral health specialists, health coaches and patient activators that will be essential to ensuring equitable access for all community members. Micro-credentialing will widen the array of available healthcare workers, bringing in not only formal, but also informal, but credentialed, workforces.
Hospitals: Hospitals will be focused on 24/7 specialist and emergency care provided by multidisciplinary teams. Hospitals will also provide services at home to community members through remote monitoring, virtual wards, and VR or AR consultations. Hospitals will support community and primary care in providing consultations and specialist knowledge and setting up and supporting health data centers (through which interoperable data is shared and artificial intelligence and predictive analytics tools are used to orchestrate care across the ecosystem and make insight-informed decisions). Hospitals will also need to set their capabilities for use by not only individual patients but also supporting communities in their new roles.
Global players: After regulatory challenges are addressed, global providers will play a key role in care delivery largely based on platform and Web 3.0 technology. Services from global providers will be offered directly to individuals and also to local hospitals based on cognitive technologies. Local care systems will interface and manage these relationships, while also collaborating with other systems and global players on platform development and research.
Payors, planners and policymakers: At the whole system level, the architecture of healthcare payment, planning and regulation will shift to enable the seismic changes described above. Local healthcare decision makers will put health data centers at the epicenter as they work towards their vision of an ‘integrated community healthcare system,’ with key performance indicators being patient and community activation scores, as well as more traditional clinical indicators. Among payers and policy makers there will need to be radical change, most importantly in payment models, which will need to be more bundled but also significantly reward improvements in health among patients at the most risk. Next to that payment models will need to adapt to new organizational setups and entities, from global services to community-based organizations to individual micro-credentialed health workers.
Tying it all together
At the foundation of all of these layers will be interoperable data, which each layer both contributes to and uses, but with ultimate ownership and control residing at the individual and community levels. The ultimate outcome is a technology-powered, ‘glo-cal’ (global-local) system that achieves inclusive healthcare that is predictive, proactive, preventative and personalized.
The health system of the future capable of delivering ‘inclusive’ healthcare scenarios will likely look very different from today, with seamless interaction between local, national and global organizations with their personal data and communities. Health leaders should think hard about how their organizations fit into this picture – those who fail to define their role may have it defined for them.