Senior Director, Head of Philips Hospital to Home in Asia Pacific
In Asia, the share of population above 65 years old is rapidly increasing and the region will be home to half of the world’s elderly1 and bear half the global burden of chronic conditions by 2030. Compounding this demandside challenge, growth in working-age population is not keeping pace. In China alone, by 2050, the working-age population will drop by 170 million while the elderly will increase by 190 million2. Today’s already stretched healthcare systems will face increasing constraints in labour supply. Also, patients’ demands as consumers of medicine will change drastically.
To expand current care models, Asian nations will need to double or even triple healthcare spend as percentage of GDP just to match OECD spend levels. The scale of such change (in many countries already underway) is massive. Against this forecast, Philips foresees smarter and more efficient care models to avert Asian challenges to sustainable healthcare delivery. Tomorrow’s healthcare should be population-based (weighing cost and outcomes) but individually tailored, thoroughly coordinated around patients.It must also leverage the world’s largest workforce of healthcare workers (today largely untapped): patients and their families. Technology is the fundamental enabler that makes this vision of healthcare possible.
Economic growth in Asia is changing lifestyles. Affluence allows greater standards of living, while improving healthcare systems help extend average life spans. In the 1950s, Asia’s life expectancy was less than 45 years whilst today it surpasses 74 years3. With an ever larger percentage of elderly (8 per cent of total population today, 19 per cent by 20504) and growing middle class living sedentary and indulgent lifestyles, increase in chronic diseases is unavoidable. In South East Asia, cardiovascular diseases alone cause over 25 per cent of all deaths.
Additionally, there is a shortage of healthcare professionals. One key challenge is that many of the locally trained clinicians are leaving local systems to pursue opportunities abroad and those remaining are usually overworked. Under such pressure, it is neither sufficient nor sustainable to keep building healthcare infrastructure and adding more hospital beds. Rather, health systems must innovate to escape the predictable path of development. Transformative integrated-care models will help maximise impact of existing and future resources.
Complex, multi-morbid patients will see more and more specialists. Moreover, general practitioners (family medicine), allied health professionals, such as rehabilitation or physical therapists, plus hospital nursing teams and homevisitation teams, will be involved. Today, each one of these providers operates in their respective care setting, typically independently from each other. Poor coordination leads to repeated doctor visits, prolonged hospital stays, and spiraling healthcare costs. The current payment system does not help either, as it rewards providers for volume of services rendered instead of better patient outcomes. Financial incentives today are not aligned with patient's best interests. The role of patients (and their families) in their own healthcare is usually limited to that of passive recipients of care.
Coordinating efforts across the healthcare continuum (with information sharing and efficient care transitions) is not new – it’s been piloted before and is applied today. However, the challenge is to scale-up such efforts aggressively to reach all patients who stand to benefit from tailored cost-effective care integration programs. With technology, workflow planning solutions and patient engagement tools, Philips is building the platform to scale-up care coordination efforts from site level (few hundred patients) to national-level (thousands of patients).
Ultimately, such collaboration and teaming will not be optional. Asia can avoid the pitfalls along the foreseeable path of developed-country systems where improvement in quality and outcomes no longer keeps pace with costs that spiral out of control (leading example is the USA, where annual healthcare spend approximates one-fifth of GDP already5). Asia can leapfrog the typical evolution seen in the West by decisively adopting care integration, deploying scalable care coordination models that marry technology and team-based, integrative patient care.
Healthcare lags other industries in adoption of digital technology. But it is precisely digital technology that will help us achieve care coordination at national scale. Specifically, connected technologies will enable care models that efficiently coordinate individualised,
tailored care for entire population cohorts – while shifting focus from institutional to home-based care settings. Health systems of the future will excel at four core components of scalable integrated care:
• In-depth understanding of target population’s needs
• Integral workflows that include patients in the care team
• Technology foundation for scalable deployment
• Seamless care bound by data,analytics and decision support
Deep understanding and identification of target population cohorts are the first step towards integrated care delivery. There is no one-size-fits-all program. Health systems must understand in detail the population they serve to create tailored clinical programs with differentiated service levels. By leveraging clinical and psychosocial insights, providers can design interventions that fit specific needs. With clearly identified population cohorts health systems can focus on patient recruitment for targeted programs, iterate improvements to
scale-up and achieve organizational learning and network effects.
Health systems must transform current clinical workflows to include effective multi-disciplinary care teaming. This leverages expertise across health specialties and allows all clinicians involved to practice at the top of their licenses. Health systems must also welcome greater involvement of patients through education and selfmanagement.
Putting patients and their families in the cockpit will give them more control of their health status and reduce the need for repeated visits to specialists and eventual re-hospitalisations. With better understanding of their disease and how to best manage it, patients identify signs of imbalance and alert care providers earlier with the right information to allow for timely adjustments.