• Dr. Anna van Poucke, Leadership |

Many healthcare systems are showing signs of extreme vulnerability and some may be at risk of collapse in various parts of the world. People are struggling to access the right care, at the right time. There’s a need for a new approach to healthcare systems that strikes a balance between having a future-ready workforce and utilizing innovative technologies to get there.

While many people believe COVID-19 was responsible for the cracks in healthcare systems around the globe, the reality is that systems were struggling long before the pandemic brought these issues to the fore.

The Partnership for Health System Sustainability and Resilience, a global collaboration between the World Economic Forum, the London School of Economics, Philips, KPMG, the Center for Asia-Pacific Resilience and Innovation, and the WHO Foundation released research examining healthcare systems in 13 countries in phase one, 1 with data on eight additional countries to come in phase two. The results from phase one should ring alarms for systems worldwide, showing they are underfunded, workforces are stretched, stressed and inequitably distributed, and that coordinated and proactive care remains a challenge.

The pandemic is the first in a wave of circumstances — verging on crises — that could batter the healthcare sector. The old ways of trying to improve systems, such as increased funding and hiring additional support staff, are unlikely to be effective in responding to the magnitude of current and future challenges.

Through conversations with healthcare leaders around the world, there’s widespread agreement that systems transformation is imminent. In the 2021 Healthcare CEO Future Pulse, KPMG professionals surveyed 200 health leaders from around the world. Seventy-nine percent of them agreed that all aspects of care delivery will be transformed by 2024. The road to transformation is long – only small steps have been taken so far, increasing the urgency for change every day.

Healthcare Horizons, KPMG’s report on inclusive care and transforming healthcare systems, provides insights to help navigate towards a much-needed new horizon for healthcare, where organizations and communities can thrive and provide equitable and accessible healthcare.

Decision making that leverages data will be critical to equitable transformation moving forward and must include solutions that combine technology, engage and support engage workforces and empower communities. To prevent further disruption and possible collapse the sector will need to reimagine and rebuild, while taking these matters into account:

Address worker burnout and build an empowered workforce

Workforce shortages and the wellbeing of healthcare workers have been long-time issues, without much being done to improve them. In recent years these issues have worsened to a point where they are affecting clinical operations in many systems.

Here are a few suggestions to start addressing these challenges:

  1. Shift from short-term rostering to long-term strategic planning.

  2. Invest in AI and technology to take over administrative and routine tasks and ensure frontline staff can take a lead role in complex tasks that need human interaction and highly professional skills.

  3. Implement micro credentials to enable focused skill development within more flexible workforces, so everyone performs tasks based on their specific skills and training.

  4. Enable a more agile and flexible workforce by adapting contracting, training and renumeration across organizational settings and at the regional level.

  5. Once implemented, use the micro credentials system and platforms to leverage both formal and informal workers, tapping into health and social services.

Ensure technology is accessible

Technology can be part of an answer to the healthcare crisis, but still requires a multifaceted approach. Studies show a strong connection between having internet access and vaccine uptake— meaning those without the internet were at a disadvantage both when it came to getting the COVID vaccine and throughout much of the pandemic when a lot of healthcare went virtual.

Technology has many benefits, including when it is used to support and empower workforces and adapted to meet the needs of diverse populations. However, it cannot be the entire solution. Adopting technology-heavy models is likely to deepen the divide between those who are digitally literate and have internet access and those who do not, such as the elderly and those in rural communities.3

Make decisions based on data

Access to reliable data is crucial to improve health and healthcare delivery, yet it is lacking in many regions.4 Gathering data on factors including gender, race and socioeconomic status can aid in developing targeted policies to reduce inequalities in access to care and the overall health of individuals. Strategically investing in easy-to-understand, broad-ranging data systems and analytical capabilities can help support insight-informed decision making.

Widespread social issues

Social care is health care. Without strong, integrated systems in place to support the most vulnerable, healthcare and hospitals will remain strained.

When Montefiore Medical Center in New York City analyzed 4,000 high-risk patients,5 it found that social factors are closely tied to higher healthcare costs:

  • Patients with a history of substance abuse had 89 percent higher costs than the average patient
  • Those with a mental health diagnosis and a medical condition, such as congestive heart failure, had healthcare costs that were 38 percent higher than average
  • Patients with unstable housing environments had 16 to 20 percent higher healthcare costs on average

Issues related to poverty can lead directly to health troubles and end up costing communities more. Treating these issues at the source — not the symptoms — benefits everyone and can help remedy the healthcare crisis.

Where do we go from here?

As demand for healthcare grows, it gets more expensive — highlighting the need for sustainable transformation. Technology will be an important base for transformation within the sector, but it cannot stand on its own.

Societies must use technology and data to strengthen community care, empower workforces, take the burden off hospitals and use informed findings before making substantial changes to the current system. It may seem like a daunting task, but by collaborating, involving local communities in decision making, strengthening workforces and putting equitable access at the heart of everything we do, it’s possible to build better, more resilient systems for the future.


1 Partnership for Health System Sustainability and Resilience - 2022 PHSSR Global Summit Recap: https://www.phssr.org/recap_2022phssrglobalsummit

2 Lack of internet risks COVID-19 vaccines for the vulnerable | World Economic Forum (weforum.org): https://www.weforum.org/agenda/2021/07/digital-divide-internet-vaccine-affordable/

3 Digital Health Tool Survey | Morehouse School of Medicine: https://www.msm.edu/Research/research_centersandinstitutes/NCPC/DigitalTechnologySurvey/index.php

4 Partnership for Health System Sustainability and Resilience - 2022 PHSSR Global Summit Recap: https://www.phssr.org/recap_2022phssrglobalsummit

5 Montefiore Targets the Social Factors That Drive Up Healthcare Costs (hfma.org): https://www.hfma.org/topics/article/55128.html