Today’s healthcare delivery system was built in the middle of the last century. It was built as a reactive system - people who were chronically ill or had an acute disorder went to a medically trained professional. It was fundamentally not built for today’s massive rise in chronic diseases and patient expectations. Today’s patients and diseases cannot be addressed using a system that is a century old. It has to be re-imagined from its first principles. A ground up transformation is, therefore, inevitable. That technology will be at the centre of this transformation, there is little doubt.
Digital re-invention of hospitals
A digital re-invention of hospitals has already begun. Two sacrosanct principles of hospitals are bound to change. One, that hospitals are physical spaces that serve beds and patients requiring primary / secondary care; and two, that care is local. A virtual command centre will evolve that moves the care delivery closer to where the patient is. Remote care through tele-medicine, devices, healthcare kiosks, praramedics to your homes, is how hospitals are going to extend healthcare close to a patient.
If the patient requires physical intervention/admission, it is the only point in time the patient needs to get to the hospital. The outpatient care of hospitals will really become out-of-hospital experience. Core technology backbones and re-imagining care models are the first steps to this change. Digital devices close to one’s smartphones or at a kiosk in your building / office space are going to become mainstays of this change.
Newer care models
The industry has evolved to a “one size fits all” model of care management. Most clinical services centre around body parts or specialities and diseases. Hardly personal, hardly tailored for a segment. Management of polycystic ovarian syndrome or diabetes requires a deeper connect with the patient, and a very involved process of management. Today, much of these are treated and managed like an episode with potentially undesirable side effects. Tailored care models by population segments are a need for every patient and this has to be the future of care. Not episodic treatments. Each individual’s health timeline needs a specific intervention and a specific care plan.
Everything from design of such care protocols, the team that manages a patient’s care, workflows, a wider network of care providers (pharmacists, therapists, behavioural health specialists) and monitoring systems have to be built out, starting from the segment of patients. Analytics and care management efficiency research has to be, therefore, on top of a clinician’s or hospital’s mind.
Virtual health companions
Managing the health timeline of a patient would mean that we need a continuous connected mode of care. Ability to record a patient’s progress (vitals, health parameters, lifestyle) is essential for the success of this model. Core providers will also need to monitor these parameters to decide a particular care management protocol. This will give rise to the need to have digital clones of care providers and patients in the healthcare system. They will manifest as artificial intelligence, decision support tools, devices, care companions or health trackers for the patients and as virtual doctor assistants for doctors and hospitals. Primary care support will lead to “virtual care teams” being setup that become the command centre for a population, patients or otherwise. These virtual care teams need to be a clever mix of humans and machines. An idea of a health call centre that supports an annual maintenance contract of your body / health is not far-fetched.
Understanding that a digital revolution is inevitable, trust in technology is the first and most requirement of a future doctor. AI and devices are going to be in the arsenal of every doctor. Evolution of newer long-term care plans, deeper care protocols, co-designing the AI with technologists, understanding of data and its power and setting goals / validating AI will all be part of a doctor’s daily tasks. As much as it is important to treat patients, it will be inevitable that they help shape the future digital clones that would perform most of their repeatable tasks.
Behaviour of patients
Much as hospitals and doctors will lead the transformation of this industry from a healthcare providers viewpoint, it is also the patient’s behaviour and expectations that can accelerate this change. It is important to start viewing health as an asset or an investment that you build over a period of time. As the environment undergoes changes and lifestyles change, it is important to know that primary care is not just about the occasional flu, but a starting point of one’s long term health and overall wellbeing. Investing in health, engaging with the right health providers constantly through the easiest access points should, therefore, be everyone’s priority.