CHA’S HEALTH TEAM CHART FUTURE TRENDS IN HEALTH CARE

By CHA Health Policy Director Caitlin O’Dea and Manager – Health Policy Alex Lynch

The COVID-19 pandemic has seen the acceleration of relatively new trends in health care, some of which will have a disruptive impact on how patients expect to have their health needs met. Increasingly patients have and will seek access to information about quality, service availability and price in a manner that is more transparent and accessible than has previously been typical for the health sector. We’ve listed a few of the trends heath care providers will need to contend with in the coming years in order to meet the needs of their patients.

Telehealth

Telehealth is not new. Forms of digital access to health services have existed for decades. However, services were expanded dramatically throughout the COVID-19 pandemic out of necessity – it was often not safe to receive healthcare in person that might risk transmission of the virus. The Commonwealth Government greatly expanded access to Medicare-supported GP, specialist, nursing and allied-health services via telehealth soon after lockdowns were implemented across Australia. Recognising the ongoing expectation from Australians that Telehealth services would be offered, both the Commonwealth and state governments as well as private providers are expanding the range and type of Telehealth services available on a permanent basis.

Virtual care

COVID-19 saw existing health services ranging from tertiary hospitals to small clinics stand up ‘virtual hospitals’ – entire service units dedicated to treating patients remotely. Both public and private providers are using virtual hospitals to manage COVID-19 patients at home, in many instances providing 24/7 access to a health team. However, the option is in no way limited to patients with infectious diseases, with increasing access for palliative care patients, oncology patients, and routine GP appointments. Internationally, entire hospitals are being set up purely to provide virtual care as part of a broader care network.

Primary care and prevention

It has long been understood that effective preventative health, with a focus on primary care delivery, is preferable to a higher volume and severity of acute episodes requiring expensive hospital treatment, generally with worse health outcomes. While governments recognise this reality, it is often poorly reflected in the design of health systems, which focus on acute treatment.
This shows in the structure of the private health sector, which to a large extent limits private providers ability to engage in preventative health, particularly primary care (privately-owned GP clinics being the main exception). Both insurers and large health service providers are increasingly focused on how to improve the overall health of their patients and limit their acute admissions – to the benefit of both the patients’ health and budgets. However, this is challenging in a system that was not set up to prioritise funding for preventative health care and is leading to more persistent calls for reform.

Wearables (and swallowables!!!)

Health service providers have begun using patient-owned devices to help monitor health. This ranges from heart rate sensors on smart watches to diet tracking in apps and even swallowable capsules to monitor and diagnose issues with gut health. Patients are increasingly able to monitor elements of their own health with widely available technology, and are looking for their health service providers to incorporate this information into their care. While apps to track diet, periods and alcohol consumption are not new, their incorporation into routine care is increasing. They are also beginning to play a role in how health is funded, with insurers in Australia and internationally showing a willingness to offer incentives to patients who can prove they are leading a healthy lifestyle.

Price and quality transparency

Quality measures are increasingly baked into funding arrangements for both public and private hospitals. Working together, the Australian Commission on Safety and Quality in Health Care and the Independent Hospital Pricing Authority are implementing a suite of incentives for improved quality in health service delivery. Examples include funding implications for hospital acquired complications and avoidable readmissions. Similar programs will be featured in contractual arrangements between private health funders and providers at higher rates in coming years.
There are also calls for improved transparency in pricing structures offered by insurers, hospitals and doctors. The Commonwealth Government recently launched a (voluntary, for now) price transparency website for specialists to show their prices for a given procedure or service. It is not difficult to imagine a ‘Yelp! for doctors/hospitals’ emerging in the near future – it may become broadly accepted that patients can rate their experiences. This in turn leads to…

PROMs and PREMs

Patient-reported outcomes and experience measures are finding a place in measuring the quality of health service delivery, for both improvement and funding purposes. PROMs and PREMs can include measures like self-assessed short and long term clinical outcomes – a patient’s perception of their own health, as well as how they felt their health service provider treated them, what their experience was like. It is important that patient experiences are a focus for health service delivery, though using these experiences as a performance metric will present a challenge for health services going forward.