This week Deloitte launched its report, 2018 Global health care outlook: The evolution of smart health care - which looks at the challenges health care will be facing in 2018 and the strategies that can be utilised to alleviate the pressures facing the sector globally. This week’s blog highlights some of the key findings from the report and their implications for the UK.
A sector under pressure
Many public and private health systems across the world are facing financial and workforce challenges. Deloitte’s 2018 Global health care outlook report identifies a number of key trends that are leading to these challenges:
- global health care spending is projected to increase at an annual rate of 4.3 per cent in 2017-2021, up from 1.3 per cent from 2012-2016. However, spending in the UK is expected to increase by only 1.1 per cent per year compared to four per cent in Western Europe, and 7.5 per cent in transition economies
- per person health care spending will also continue to vary widely, from $11,356 in the US to just $53 in Pakistan in 2021
- life expectancy is estimated to increase between 2016 and 2021 —from 73 to 74.1 years
- most countries have made headway in the battle against communicable diseases through improved living standards, better sanitation, and wider access to health care and vaccinations. However, urbanisation, sedentary lifestyles, and rising obesity levels are fuelling increases in chronic diseases. For example, the number of people living with diabetes globally is anticipated to grow from the current 415 million to 642 million by 2040. In the UK, the number of people living with diabetes has more than doubled since 1996, with an estimated 4.5 million people currently living with the disease, 1.1 million of which are undiagnosed1
- in 2017, an estimated 50 million people worldwide lived with dementia—a number that is predicted to double every 20 years. In the UK it is estimated that the number of people with dementia will increase to 1.14 million by 2025,2 and become a trillion dollar disease by 2018.
These trends, if left unchallenged, will place a considerable and unmanageable amount of pressure on health systems. Today, these trends are requiring health care providers across the world to work harder. However, a key question in the global health care outlook report is - are they working ’smarter’? The report identifies a number of existing and emerging challenges that health care stakeholders are likely to face in 2018 in their quest to get ‘smarter’ (Figure 1).
Figure 1. Key issues in global health care
Strategies to tackle these challenges
Having strategies to tackle the above trends and challenges can provide a firm foundation to alleviate pressures facing health care. Below we explore the strategies and considerations for stakeholders as they seek to deliver high-quality, cost-efficient, and smart health care:
- Creating a positive margin in an uncertain and changing health economy - Public and private health systems have been facing revenue pressures and declining margins for years. Spending is increasing at unprecedented levels due to: growing and ageing populations; increasing patient expectations; the need for infrastructure improvements; and advancements in therapeutics and technology. In the UK, this has manifested itself in the National Health Service (NHS) experiencing the longest slowdown in funding in its 69 year history, with the majority of English hospitals struggling to break even. Meanwhile, the provider system as a whole has recorded a consolidated deficit for the past two years. In response, health care stakeholders are pursuing new cost reduction measures, such as developing alternative staffing models, shifting patients to outpatient services, and reducing administrative and supply costs.
- Strategically moving from volume to value - Health care is continuing its transition from fee-for-service to outcomes- and value-based payment models. A successful transition to value-based care requires that market players and consumers move beyond transaction-based treatment to the holistic health of populations – from treatment to prevention and wellness, and from individual to population health. Health care providers can also look at deploying innovative care delivery models based on data and analytics. One example in England is the NHS RightCare national programme, which is committed to reducing unwarranted variation in care delivery in order to improve people’s health and outcomes. NHS RightCare aims help deliver a financially sustainable health system by aligning population value with the principles of value-for-money, thereby achieving sustainable, optimal healthcare for the whole population.3
- Responding to health policy and complex regulations – health systems worldwide face overarching health policy and regulatory goals aimed at ensuring quality care and patient safety, mitigating fraud and cyber threats. Digital health care technology solutions addressing better diagnostics and more personalised therapeutic tools are leading to the challenge of data protection. Cybersecurity and data risk management are a growing threat. Holistic approaches to investments in people, processes, and technology will be key to regulatory compliance. Care providers also need to explore strategies to build second-line defences to reduce their administrative, financial and reputational exposure.
- Investing in exponential technologies to reduce costs, increase access, and improve care – exponential technologies are driving less expensive, more efficient, and more accessible care delivery. They are reshaping health care by impacting areas such as synthetic biology, 3D printing and nanotechnology, and companion diagnostics. Hospitals of the future are being built to deploy digital and AI technologies, and enhanced talent development. At the outset, keeping pace with rapid technology developments is likely to require significant investments in electronic patient records, mHealth, interoperability, and big data. Organisations should also consider strategic investments in people, processes, and premises enabled by digital technologies.
- Engaging with consumers and improving the patient experience – health care is moving to a more personalised care model through better engagement with consumers by elevating the patient experience using digital solutions to aid omni-channel patient access, including customer apps, patient portals, personalised digital information kits, and self-check-in kiosks. It is also enhancing provider-consumer interactions by leveraging social media to improve patient experience; and deploying telehealth, telemedicine and virtual reality/augmented reality. Health care has an opportunity to learn from other industries (consumer products, financial services, and hospitality, as examples) on how to more effectively target, serve, communicate with, and retain customers and patients.
- Shaping the workforce of the future – workforce challenges such as staffing shortages in specific hospital specialties and nursing shortages are evident across the globe. Compounding the workforce shortages is the scarcity of next-generation skills to guide and support the transformation to becoming patient-centric, insight-driven, and value-focused organisations. As identified by our report, Time to care: Securing a future for the hospital workforce in Europe, the challenge of securing and maintaining a healthy medical workforce is crucial if we are to alleviate the pressures our healthcare systems are facing. Technology will play a key role in providing and facilitating the new ways of working needed for the future. Digital technology, robotics, and other automated tools have enormous potential to resolve current and future health care workforce pain points. Health care providers should embrace strategies where talent can collaborate with technology to improve efficiency instead of competing against each other.
The Global health care outlook 2018 report recognises the enormous challenges facing the financial and operational performance of healthcare across the globe. It suggests that to improve health care services and alleviate the pressures facing the system then all stakeholders should: collaborate, learn and adopt what works; understand how new technologies can improve and facilitate new ways of working; and look to secure a sustainable and empowered workforce. Without this shift, patient wellbeing will suffer, health care services will struggle to cope, and the quality of services that people have been led to expect will become unsustainable.