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18 September 2020updated 09 Sep 2021 1:43pm

From chaos to catalyst

What are the imperatives for the future of healthcare?

By William Shea

The coronavirus pandemic will be the catalyst for lasting change throughout the global healthcare industry including the UK. Key stakeholders – government, the medical profession, patients – need to work collaboratively to plan the right strategies to reimagine the future of healthcare in a world being reshaped by the pandemic.

While no one truly knows what the long-term impact will be, we can make educated guesses, based on initial indicators. Around the world, the virus has forced healthcare organisations (of both the public and private variety) to adopt new ways of working, from wider adoption of telehealth to regulatory easing.

Meanwhile, patients are quickly adapting to new tools that support virtual and in-home care. Together, these forces are creating unparalleled opportunities for the healthcare industry, including the NHS, to address systemic inefficiencies and catch up with other industries regarding digital transformation. We recommend that healthcare organisations address the following five imperatives, adapting these to their business vision, local market conditions and financial strength.

Take out costs

The financial effects of the steep drop in elective procedures have been widely calculated and reported and it is no surprise that health industry leaders are making changes to long-term investment plans. Optimising costs will be required to ensure business continuity. The NHS must consider the following:

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-Benchmark operations, including revenue cycle, patient contact centres, and the supply chain against international peers to identify cost-savings opportunities.

-Consolidate and standardise clinical and non-clinical applications in the IT portfolio to reduce operating costs; retire or modernise legacy applications.

-Reduce costs by moving to the cloud. Cloud-based platforms put leading-edge technologies within reach with minimal infrastructure investment and volume-based operating costs.

Deliver virtual Care@Home / “Care Anywhere”

Covid-19 forced the adoption of telehealth at scale. Care@home is the next evolution of virtual care in which the NHS and private healthcare providers offer a wider range of services virtually. Patients have rapidly adapted to using virtual consults and practicing in-home care – and there is room for still greater adoption. Many chronic conditions can be monitored in remote care settings, and some outpatient procedures and follow ups can be effectively virtualised. McKinsey estimates that approximately 20 per cent of walk-in care could be virtually delivered, creating a substantial value pool in 2020 and beyond. Telehealth enables health systems to decouple care delivery from the constraints of their physical infrastructure. We recommend:

-Evaluate existing telehealth capabilities and performance; determine what additional services could be delivered remotely via virtual channels.

-Ensure telehealth workflow is integrated into clinical workflows and electronic health record (EHR) systems to capture documentation for reimbursement and care management.

-Extend virtual care beyond primary care, including chronic conditions such as congestive heart failure, COPD, diabetes and behavioural health.

-Streamline referral and prior-authorisation processes to make access to in-home care smoother.

Implement low-touch healthcare

The Covid-19 pandemic is forcing healthcare entities to reduce physical contact during care delivery and related administrative processes. A critical challenge here is delivering a personalised, human experience while still practicing social distancing and contactless processes.

Patients must be confident that medical offices, clinics and surgery centres are safe to visit. Similarly, payers must ensure that members have access to care, especially those managing chronic diseases or cancer.

The pandemic presents a new opportunity for the industry to achieve its longtime goal of paperless physician practices by redesigning office processes to digitally enable:

-Scheduling, pre-screening and check in. Enable patients to schedule appointments and check in via mobile devices.

-Check out. Enable digital delivery of visit summaries and orders and digital scheduling of follow-up appointments.

-Payments. Enable touchless payments, including Apple Pay, Google Pay, and others, before or after the visit to avoid physical handling of paper and surfaces.

Accelerate digital transformation

Shifts in consumer behaviour, combined with regulatory easing and powerful new technologies, create a perfect environment for change. Covid-19 has forced most businesses to adopt at least some virtualisation.

As a result, technologies and behaviours that were slow to catch on previously appear poised to become mainstays post-pandemic. Forrester Research estimates that worldwide video visit volume will reach a billion transactions in 2020, up from a projected 38 million transactions before the pandemic. To capitalise on this trend it will be critical to:

-Create a digital care ecosystem around existing Electronic Health Records (EHRs) that will enable care anytime, anywhere. This requires creating a scalable and agile architecture and ensuring that EHR vendors can support the same.

-Implement a “digital front-door to care” strategy that delivers a consistent set of experiences for patients regardless of their entry point into the healthcare continuum.

-Modernise data infrastructure to leverage automation and machine learning to drive better clinical and operational outcomes.

-Transform the IT operating model and move to a product-oriented consumer-focused mindset.

Build new strategies around increased and improved data flows, including greater use of longitudinal data, AI and analytics.

Improve collaboration

Healthcare stakeholders have an opportunity to work together to engage members and patients to control costs. They can create a model of joint operations to maximise operating efficiency, reduce waste and duplicated effort, maximise information delivery speed and improve stakeholders care.

Health organisations may need to revisit assumptions about the size and needs of populations that they serve.  Incentives must be aligned across the ecosystem to support new care-delivery models, including services delivered virtually or via care@home. This will require stakeholders to:

-Create a post-pandemic financial recovery roadmap to sustain operations for the new normal.

-Embrace digital transformation and build evidence to validate that virtual models of care will reduce total medical costs and improve outcomes.

-Show leadership in discussing broad technology adoption. Many are hesitant to implement new technologies because they are concerned about adoption. Many of these new technologies have tremendous promise to streamline operations, making this an appropriate time to launch these initiatives.

-Leverage interoperability to create true clinical-data-sharing agreements for clinical insights and decision-making.

-Create mechanisms to create value-based programs leveraging new care-delivery models that incentivise the provider community to invest in digital engagement with patients.

William Shea and Sashi Padarthy are vice president and associate vice president at Cognizant Healthcare Consulting.