The blockbuster of consumer power in health
It has taken a while but something comparable to the impact consumer power has exerted in areas like banking and retail is now emerging in health care.
Consumer influence over the future shape of health services was a repeated theme at the Australian Financial Review’s Healthcare Summit last week.
Health care systems, already strained by growing cost and demand are experiencing the forces of change driven by IT and the internet that are demanding more patient-focused services.
Digital health records, self-care monitoring devices and telehealth services are compelling systemic changes in our health system resulting in a health care novelty: the provider, doctor or hospital is having to take more account of the consumer.
As NSW Health Secretary, Elizabeth Koff told the Summit, patient expectation and demand will drive transformation in health care given the change in people’s expectations driven by things like the smart phone and the way the technology is placing the focus on the consumer in areas like telehealth.
Another speaker, Dr Anna Lavelle, Chair of Medicines Australia, put it more starkly: “The next blockbuster drug will be the empowered patient…”, aided by technology.
Taken literally such a trend raises big questions about the future and role of the doctor-patient relationship in mediating medical care but it does underline the changing dynamic in health care.
The Consumers Health Forum is asking whether health care in Australia is delivering best on the potential offered by the 21st Century’s vast store of knowledge now available in terms of medical science, health system research and consumer experience.
If we are to drive more responsive, personalised and convenient services, and technologies to sustain the health outcomes we expect and deserve, as well as propel our system forward to meet achievable outcomes, our challenge is to both innovate and improve – and to do so with insight from consumers.
And that requires CHANGE.
Recently the Consumers Health Forum identified ten reform priorities in health care. These include a much stronger national preventative health program, shifting our focus from hospital to much more integrated care in the community care and supporting stronger, more effective consumer involvement.
These are capable of being introduced or developed in 2019. All have a strong evidence base, all offer economic benefits and would yield a happier and healthier Australia.
Too often the default position is to resist longer-term changes which do not offer immediate benefits.
Despite the great potential for a more economic, efficient, precise and consumer-friendly system, for a variety of reasons over nearly two decades, the My Health Record and predecessor digital health programs have had a testing introduction to universal national application, formally commenced at the beginning of this month.
Of course there are sensitivities and security issues posed by personally-controlled electronic health records. You would have thought these could be overcome given we have had personally-controlled electronic bank records for near on two decades.
Consider primary health care reform. Australia has world standard medical and hospital services yet too often those patients most in need, who have chronic and complex conditions, have difficulties accessing the most effective and appropriate services.
But the Australian system of funding, including fee for service, does not routinely encourage an integrated, patient focused regimen. The result raises the risk of patients being admitted for more expensive hospital care when their clear preference is to have care at home.
The Federal Government is trialling Health Care Homes arrangements to promote integrated, team-based care, but its scope and the response from GPs overall has been indifferent.
There are many who believe the blockage to change is beyond cure until some form of federal constitutional change enables single source financing of health. Experience tells us we are not going to see that any time soon.
We must exploit the consumer-driven dynamic so our politicians and health institutions identify patient-centred approaches as a priority that supplants jurisdictional borders.
Our recent white paper, Shifting Gears – Consumers Transforming Health concluded that changes to health care are going to accelerate at an unprecedented pace, driven by digitalisation, consumer expectation and advances including genomics and precision, personalised medicine.
The time to reimagine health care is now. To do that we need to harness consumer experience to shape the services of the future and give ourselves permission to embrace disruption in health care, not fear it or pretend it won’t happen. Shifting Gears identified eight key roles for consumers, including support for consumers as leaders and advisers, as co-designers in shaping health systems, as expert patients to promote patient-focused care and as collaborators in health research.
These roles demand a change in thinking by many of our political and government leaders if Australia’s health care is to reflect and capitalise on the potential of 21st Century health care.