The future of healthcare in five words!

At yesterday’s Washington Post Live Transformers:Health event, I was pleased to briefly reflect on five themes I believe citizens, patients, healthcare providers, industry watchers and companies must wrestle with if we are to fully realize the potential of digitization, connectivity and data.

Each summed up by one word!

Here’s a highlights reel from a great event. And here follows the transcript of my full presentation:

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How often is it that we hear about the jaw-dropping costs of healthcare?

In the US alone, we’re talking about over $3.3 trillion annually – more than $10,000 per person or, put another way, 18% of GDP. With more than four billion annual prescriptions dispensed along the way. That’s just the story in the United States…

There’s no escaping the huge figures involved but, to paraphrase Oscar Wilde, we must not be guilty of knowing the price of everything and the value of nothing because, of course, these costs are merely the consequence of the way we currently work.

As I reflect on “the future of healthcare in five words,” my “first word” refers to the single most important measure for our industry.

Not cost, but outcomes.

If you’re in healthcare, outcomes are the reason you get up in the morning. The move to value based care is unstoppable. Achieving the “Quadruple Aim” is critical -- driving better outcomes at a lower cost while enhancing the patient and staff experience. It’s all about better ways to deliver the right care in the right place, at the right time.

As an industry, we are not sufficiently geared up to measure ourselves against outcomes. Too often we reward activity, not output. There is little or no reward for prevention. We put too little emphasis on patient-centered personalized care, first-time right diagnoses and precision medicine. Get it wrong and we simply try again.

We need a change of focus to outcomes: shift our focus and we shift the patient experience. Technology, of course, is better than ever at helping to measure outcomes and we’re working harder than ever to make data actionable to help achieve better results.

Second word, inclusion.

We’re not going to fix issues like access to healthcare overnight. Nor can we expect to transplant high cost solutions to remote communities or the developing world. But to look beyond the US for a moment, in Africa we’ve developed Community Life Centers in some of the most disadvantaged areas in an attempt to rewrite the rules for inclusion. We bundle infrastructure with technology and services in modern, well-designed clinics. These provide vital primary care as well as being important drivers for economy, education and safety.

The technology package includes health care equipment (to enable patient monitoring, diagnosis and triage), laboratory equipment (especially for antenatal care tests), refrigeration (preventing spoiling of vaccines), IT (for patient data storage) and water supply and purification (preventing waterborne diseases) and efficient and durable solar-powered LED-lighting (enabling extended opening hours and providing security). By the way, in Mandera County, supplies are now starting to be delivered in drones to these Community Life Centers: truly a new way of providing primary care.

The possibilities for inclusion apply to mature economies too. More than 15% of the US population lives in rural areas where millions of Americans face pressing health needs amidst a physician shortage and high rate of hospital closure. In fact, according to population health experts, your zip-code is the single most important factor in determining your lifespan. And that’s why Lost Rivers hospital in Idaho is using cloud based technologies to help the community achieve a higher quality of life at a lower cost through system-wide integration, data-sharing, expedited billing and streamlined referrals.

Technology can increasingly close the gap between the haves and the have-nots – telehealth is changing the way we engage with our patients – but it requires new ways of working as well as new models of reimbursement.

Third word: productivity. You may think this is a dry term beloved only by industrialists, but I want to share a broader perspective.

As Warren Buffett has noted, productivity lies at the heart of American prosperity and its role is largely underappreciated. In 1900, America’s civilian work force was 28 million. Of these, 11 million, or 40% of the total, worked in farming. The leading crop then, as now, was corn. About 90 million acres were devoted to its production and the yield per acre was 30 bushels. That gave a total annual output of 2.7 billion bushels.

Then came mechanization and other innovations in planting, irrigation, fertilization, and so on.

Today, the US devotes almost the same area to corn as in 1900 (in fact, a little less). But productivity has improved yields more than fivefold, all while the labor force has fallen from 40% to 2% of the total!

I contend that the Digital Age has as much to offer as the Industrial Age in enabling the way we transform healthcare through productivity.

One example is the introduction of techniques like Lean, Six Sigma and variance analysis to drive tremendous efficiencies. Intermountain Healthcare has transformed its Supply Chain to achieve a radically lower cost structure. The result has been significantly lower costs for our patients and communities—as much as $2 billion in savings over the last five years. In 2016 alone, the amount Intermountain billed was $700 million less than they would have billed had they not transformed the way they provide care.

Another example: designing scalable, repeatable processes and workflows that optimize care delivery: half of Kaiser Permanente’s outpatient contact is now “remote.”

Or pioneering new advances like Artificial Intelligence and Machine Learning to augment human expertise.

Imagine how the kind of productivity achieved in the last century could improve today’s care experiences! This is why we put emphasis on clinical information to improve workflows and apply Artificial Intelligence to help make doctors more productive.

And when you think of the care experience, it’s fair to say that, generally speaking, health systems can be rather “silo’d” with each component of the system striving for excellence before “handing over” the patient to the next part, leaving the integral care process less than optimal for patients.

Sound familiar?

This is a crying shame because digitization has enabled the standardization and optimization of the building blocks of health systems, so it’s possible to drive more complete integration of health systems.

Which brings me to my fourth word: – seamless.

Seamless care totally changes the patient experience by “joining up the dots.”

Quick example: Karolinska University hospital in Sweden is redesigning the entire stroke care pathway so it is seamless. Triaging takes place in the ambulance rather than the hospital so that the emergency room can be bypassed, and data availability is continuous.

At this stage, precision diagnosis and best outcome predictive analytics are applied and the patient moves straight to the hybrid operating room for treatment. Hence a massive reduction in ‘call to needle’ time.

Afterwards, following an initial spell of post-operative care in hospital, recovery in the community begins and – to complete the story – treatment effectiveness measured using continuous monitoring, with built-in feedback loops, so that any treatment can be fine-tuned and patients coached back to healthy lifestyles.

I know we are seeing equally exciting work here in the US. Through better, more seamless connections involving telehealth, remote oversight in the e-ICU and home monitoring, Banner Health has reduced cost by 34%, lowered hospitalizations 45% and realized 26% fewer deaths.

And Westchester Medical is using tele-psychiatry to knock down barriers to care and make it easier for patients to keep their appointments – resulting in a fourfold reduction in cancellations and $1M in savings.

Seamless describes what the care experience should be like. It’s why Philips is moving beyond being a transactional seller of technological piece parts, to one which helps build “solutions” for our customers, which take into account a more holistic view of the patient care journey.

My final word, is one of the most overused in our industry and others but nevertheless remains paramount: innovation.

Philips has been an innovation company for more than 125 years and I’m proud of the work our Research Labs continues to produce, not least in areas like software and Artifical Intelligence. We lead in diagnosis, image-guided therapy, patient monitoring, and clinical IT solutions applied to cardiology, oncology and other disease areas.

But no one can innovate in isolation any longer.

Today we partner with customers, especially University hospitals, with academia like MIT, Stanford and Texas A&M University System and also with start-ups – in a process of co-creation and open innovation.

In fact, every word I’ve described today: outcomes, inclusion, productivity and seamless [care] depend on innovation.

And innovation, of course, involves people. Creative, committed, talented people innovating not only new technologies but new ways of working, workflows, funding… new ways of thinking.

I hope this excellent event inspires new ways of thinking – allowing us to break down the barriers that confront healthcare and drive a new future!