Kevin McGowan, IBM’s thought leader for change and transformation in healthcare, outlines the key challenges facing the sector and how Smarter Care technology can improve quality and help social entrepreneurs to deliver new services.
The fundamental issue facing healthcare is its sustainability. While Ireland has a younger demographic than other European countries, a tsunami of negative health trends is approaching in the near future. It’s a question of whether society should wait for these problems to arrive or to manage and prevent them in advance.
As these challenges impact the acute and primary sector, care co-ordination becomes vital for managing them in a sustainable way. That’s the key challenge alongside getting in front of the demographic curve in terms of prevention and population health. Without this approach, healthcare becomes completely unsustainable and we face only two choices: cutting back on services or raising taxes to an unsustainable level.
Prevention and wellness are critical and core components of the Government’s Future Health strategy for reforming services (DoH, November 2012).
We have also seen in Ireland good non-governmental examples of effective policy such as the Fit Kids programme and RTÉ’s Operation Transformation series – which only involves six people but reaches a considerable audience. The ability of people to start taking control of their own lifestyles and behaviour is a key determinant of improved health alongside a person’s genetics and their social environment.
ICT has a clear role in delivering the care co-ordination and early intervention which is needed to respond to the challenges. Electronic medical records provide a foundation for this work and, subject to consent, can be shared with clinicians and other care-givers such as families and NGOs.
The clinical community is ‘at the coalface’ of resolving ill-health but the wellness and population policy agenda takes in a much broader range of stakeholders. Patient portals engage those receiving care about their condition and therefore help to prevent admissions to more expensive acute care services.
Policy-makers increasingly recognise the integration of health and social care as a priority, especially as it can benefit the most vulnerable people in society. This cohort also tends to have high requirements for healthcare, often incorporating mental health and chronic conditions.
IBM has a clear approach to healthcare transformation and the integration of social care. Three years ago, it acquired Cúram – one of Ireland’s largest indigenous software companies – and it has since developed and launched its global Smarter Care solution from its Dublin base.
We’ve been able to take that technology – which allows providers to deliver a differential response to meet the social and health needs of the individual and consider the vulnerabilities of the individuals – and integrate that into our technology stack.
Analytics is essential for identifying and enabling integration so it can be implemented at scale. Smarter Care has been tested and deployed globally but the real challenge is in getting the local care teams to work together and move beyond their traditionally distinct silos and funding streams. There are clear examples of how teams can be integrated at a local level and the process really has to be outcome-driven: both for the patient and for the State and its finances. A clear example of this is in Catalonia.
In terms of efficiency, it’s well-known that at least 30 per cent of a clinician’s time is spent looking for information. A digitised healthcare system would therefore deliver an obvious return and many identifiable cohorts of people could be assisted by better co-ordination of care.
Numerous surveys show that when integrated care teams are put in place around people, patient satisfaction goes up, the costs go down and the quality improves. Initial returns are usually seen within three to six months and in turn reduce the workload on accident and emergency departments.
The medium-term and long-term returns are delivered by EMRs and predictive analytics that can manage illnesses and ensure wellness through care co-ordination. This is Smarter Care.
To take one group, Ireland has around 60,000 frail elderly people aged over 85 – a number expected to double over the next 10 years – and this group prefers to receive its care in the community. In practical terms, this means making sure that basic daily tasks such as gardening and shopping are still carried out on their behalf.
Social enterprises, making best use of the latest technology, could be built around those people, giving them respect in their homes and ultimately the care that they need in a setting where they want to receive care it.
Individuals will be served by collaborative, co-ordinated health systems.
Address the current lack of sustainability by providing leadership and political willpower, removing obstacles, encouraging innovation and guiding countries to sustainable solutions.
Make realistic, rational decisions regarding lifestyle expectations, acceptable behaviours, and healthcare rights and economies.
Pharmaceuticals and Device Manufacturers
Work collaboratively with care delivery organisations, clinicians and individuals to create products that improve outcomes and lower costs.
Care Delivery Organisations
Expand the current focus on episodic acute care to encompass the enhanced management of chronic diseases and the life-long prediction and preventation of illness.
Doctors and Other Caregivers
Develop partnerships with individuals, payers/health plans and other stakeholders, collaborating to promote and deliver more evidence-based and more personalised healthcare.
Payers and Health Plans
Help individuals remain healthy and get more value from the healthcare system while assisting care delivery organisations and clinicians in delivering higher-value healthcare.
Profile: Kevin McGowan
Kevin has been a Senior Client Representative with IBM for seven years and provides thought leadership on healthcare transformation. His background was in using IT to improve business outcomes.
As a highly experienced and successful executive, he understands how to apply technology to drive business value based on over 25 years of experience. He holds a Diploma in Local Government Management from the Institute of Public Administration and a Master of Business Studies degree in international marketing from University College Dublin.
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