Digital health — reimagining reform
In June, Federal Health Minister Mark Butler requested a review into the $22 billion private hospital system, with pundits arguing that the system was sick and facing substantial viability issues thanks to rising labour and input costs.
In addition, there are widespread reports of severe financial distress across our public hospitals with both Northern & Western Health in Victoria reporting likely layoffs, ward closures and other measures to adapt to the recent Victorian Budget.
The inarguable reality is that our public and private healthcare systems, including primary health, allied care and aged care, are under enormous strain and it will take widespread, significant reform, to secure our health and care systems for the future.
Harnessing the power of technology to change health and care
According to Oscar Boldt-Christmas, Rebecca Kannourakis and Madeline Maud, a shift to more accessible, cost-effective virtual-care models could mitigate increases in healthcare service demand, expenditures and patient dissatisfaction (McKinsey, 2023).
They argue that shifting acute care to the home, and the creation of so-called ‘virtual hospitals’, could deliver three key benefits over traditional brick-and-mortar models of care: expanded bed capacity, improved patient satisfaction and outcomes, and cost savings.
In Australia, the COVID pandemic saw one of the most rapid shifts in care delivery in history; however, it is becoming increasingly evident that there is a slow, inexorable return to pre-COVID behaviours across the healthcare landscape.
Evidence-based digital healthcare solutions have been proven to achieve significantly improved economic and patient outcomes across a wide range of areas, including chronic disease management, medication adherence, preventative health, diagnosis and rehabilitation, and yet they are still rarely deployed at scale in Australia.
Digital health solutions also have the potential to significantly improve healthcare access and affordability for patients, especially for those in regional and remote areas, where timely access to the appropriate clinician can require costly transport and long waiting times.
Within the ANDHealth pipeline of 950+ operating digital health companies, 20% identify hospitals as their primary end-user setting, whilst a further 19% identify GP and allied health and 8% identify community and subacute care. In short, 50% of innovative Australian companies are primarily trying to disrupt and improve the delivery of care at the coalface.
Patient engagement: the blockbuster of the century
In 2012, Leonard Kish coined the phrase that “the engaged patient was the blockbuster drug of the century” (Kish, 2012), a tenet that has been backed up by significant healthcare leaders around the world many times since.
A combined approach of virtual digital health services and engaged patients through the deployment of new digital health technologies is, without doubt, part of the answer to the relentless demands of healthcare systems on national budgets.
Of the 950+ companies in the ANDHealth pipeline, 29% of digital health companies are currently deploying technologies with a primary focus on self-management of disease, patient behaviour change and medication management, whilst a further 20% listed clinical decision support as their primary purpose.
These types of technologies allow patients, and their care teams (professional and personal), to be informed and engaged in their patient journey. From demonstrating sustained improved HbA1c levels in type 2 diabetes patients to early identification of cancer and coronary heart disease, reduced hospitalisations for those with chronic respiratory conditions, making hearing tests for children accessible from anywhere or delivering best-in-class cardiac rehabilitation virtually, digital products and services across the spectrum of health care have continually proven, through robust clinical trials, that they can deliver outcomes more accessibly, more efficiently and more impactfully than traditional care alone.
Creating an environment for reform
We’ve heard for years the chant that we need to shift to ‘value-based care’ and incentivise those interventions which drive patient outcomes in a more cost-effective way, but little has really changed. The unfortunate reality is that for new models to emerge, existing models of delivering care need to evolve. Every component of healthcare delivery has an economic model behind it, whether it is the GP practice leveraging MBS codes or the realities of delivering care through public or private hospitals or private health insurance in an environment where costs only ever go up.
To drive change, we need to shift the economic incentives and reward those that drive the uptake of new technologies. Regulation, reimbursement, procurement and performance structures all need to evolve to embrace a new way of delivering care — this is not for the fainthearted and will likely be politically unpopular. However, significant reform is the only way that future generations will enjoy the world-class healthcare system that we have all benefited from our entire lives.
Digital health is certainly not the only silver bullet to our healthcare budget crisis — but it clearly has a big part to play in delivering clinically significant, accessible and affordable health solutions for Australians. And that is something we all need to get behind.
*Bronwyn Le Grice founded ANDHealth — Australia’s only digital health commercialisation organisation — with a specific focus on digital medicine and digital therapeutics in 2017, in collaboration with a consortium of industry partners.
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