Numerous efforts over the past two decades have tried to lower expenditures by making health care more efficient, or less wasteful, but it’s done little to make care more productive. Even though it’s important to eliminate unnecessary care, it does nothing to lower the cost of producing the care that’s needed. After the waste is removed, it reverts back to the same phenomenon.
When Henry Ford shortened assembly time from 12 hours to 93 minutes, boosting productivity and producing reliable, less-expensive cars, not only did he create a product that was seen as cost effective, but he also revolutionized the way people live. Today, the way the U.S. health care industry operates flies in the face of the principles Ford established to boost productivity. In fact, the way health care operates today is like Ford trying to persuade the American public to make fewer, more expensive cars – with extras that people really don’t need – rather than making more vehicles at a lower cost. The issue isn’t that care is too expensive, but that people aren’t getting their money’s worth. Clearly the time has come for health care to focus on increasing productivity to lower the cost of producing units of care.
Like education, health care is a labor-based industry that depends on experts to deliver care. It’s always been based on a simple formula: One doctor must see one patient to get a desired outcome. This formula is why professional labor is the single-most-expensive component of care. As a result, health expenditures will increase faster than GDP growth because wages will rise at the same rate. At the same time, demand will grow as a result of scientific discovery and an aging population. The only way to change that trajectory is to reduce our reliance on expert labor.
Reversing the cost trend will depend on finding ways to deliver care with fewer professional resources. This means developing operating models that do three things: move work from more-expensive to less-expensive labor, shift tasks back to the patient and move work to digital technologies, such as virtual health, either as an enabler or delivery mechanism.
Various health care studies consistently show that individuals expect personalized care with compassion; technical perfection is expected but not enough. People want care on their own terms and an experience consistent with other aspects of their lives. They expect care to be simple, transparent, coordinated, personalized, secure and seamless—and these expectations don’t stop at the doctor’s office door.
How Virtual Health Can Help
As health care systems around the globe face the common challenge of balancing capacity and demand, virtual health solutions can help improve the care of both under-served patients and those already receiving sufficient care. In an American Hospital Association survey, 76 percent of consumers ranked access to care ahead of the need for human contact with providers. The take-away is that well-executed virtual care can complement in-person interactions and improve both physician capacity and the patient experience.
Much of a physician’s time during a typical in-person office visit is spent gathering and reviewing patient information, considering treatment options and interacting with the patient. Often, a patient shares information with a doctor in bits and pieces at different points of the exam, increasing the likelihood of misinterpretation on both ends.
What if part of a “typical” doctor’s visit could happen before the actual office visit? Common consumer devices, such as sensors and digital scales, could capture and send a patient’s biometric information to a clinician beforehand. Through a secure portal, a computer-generated medical assistant would guide a patient through standard intake questions, such as family medical history, and ask what issues or concerns need to be addressed during the visit. Then, using a diagnostic engine to analyze the combined data, clinical options would be suggested to the doctor prior to the appointment.
Virtual health solutions are already being used in health systems globally. One example is a pilot program in Scotland using virtual care tools in an emergency department. The pilot found nearly 85 percent of patients in urgent care could be safely assessed with remote diagnostic equipment, such as an electronic stethoscope, with similar levels of patient satisfaction. Roughly 10 percent of patients preferred virtual visits to in-person visits because they found it was more engaging to see what the doctor was seeing, such as an eardrum or heartbeat. This is similar to what happened when televised sports went from novelty to necessity. Just being at the game wasn’t enough, people wanted to see replays, statistics and other graphical information to augment the experience.
The Patient as a Resource
Surprisingly, the patient remains the most-underutilized resource in medicine. Engaging patients in their own care through virtual health models can help the industry accomplish those goals and, at the same time, produce better health outcomes.
Greater emphasis on virtual health practices across the globe is increasing the opportunity for patients and doctors to benefit from new digital technologies. For example, social portals, such as the Big White Wall, are enabling U.K. citizens to access behavioral health services and interact with peers in a clinically monitored environment. In another example, the Silver Cloud in the United Kingdom provides mental health professionals with a technology to enable patient interaction outside of visits. One-fourth of patients in the UK National Health Service who receive mental health services from a clinician do so using digital technologies.
Consumer self-care tools, such as digital solutions that interface with medical devices, are also a viable option for chronic disease management. Accenture recently completed an analysis of primary care visits and looked at the parts of a visit that can be removed when digital technology is used to supplement patient visits. We estimated that for just diabetes care, the time that can be freed up for other uses is equivalent to approximately 24,000 full-time PCPs. In other words, the physician capacity that’s unlocked can be applied to treating more patients or other value-added activities, essentially improving the productivity of the whole system.
Digital technology, in the right context, is a critical element of making care both more productive and more personalized at the same time. The technologies that exist now can deliver care in a more affordable way by optimizing the clinician’s time. And, just maybe people will feel they are really getting their money’s worth.