Challenges in healthcare create opportunities for innovators.
How to drive change in an industry that is traditionally averse to change? How to fix a broken care and delivery model that does not manage people well in the continuum of care? How to cope with razor thins margins at a time when the expense of delivering care is outpacing reimbursement?
These are just some of the challenges identified at the North American Healthcare Forum, a major international event hosted by Enterprise Ireland, and attended by senior leaders from US and Canadian healthcare systems, as well as some of Ireland’s most successful and innovative healthcare solutions providers.
One of the biggest areas of opportunity for the latter was identified as the ongoing shift in focus from the acute setting to the social care setting, with a growing emphasis on the social determinants of health, such as lifestyles and behaviours.
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Budget is a major healthcare challenge
But working within constrained budgets was a recurring theme. For Arden Krystal, CEO of Southlake Regional Health Centre in Canada, where a socialised, single-payer care model exists, one of the biggest challenges is capital.
“We depend very heavily on foundations to fund our capital. Governments take a very limited role in that and it creates a lot of challenges for us in terms of keeping up with things like information technology and newer technologies. We’re always behind (the curve) just replacing things that are literally broken,” she said.
Hospitals in growing communities fare better than those whose communities are performing less well.
Michelle Conger is Chief Strategy Officer at OSF Healthcare in Illinois. Aside from Chicago, the region is not a growing market, she said. Much of its focus, as a result, is on the integration of social services agencies, through a digital platform. One current initiative involves a community of 22,000 people, whose local hospital has closed, leaving residents without access to acute care facilities.
The aim is to improve health outcomes by providing access to OSF hospitals using technology and making better use of community-based programmes.
“In the US, social service agencies and healthcare operate in silos. A lot of times we are all working with the same people but not able to improve their health outcomes because we don’t realise it. Just creating that kind of transparency has had a big effect,” said Conger.
Opportunities for innovation in healthcare
Another challenge is transitions of care, said Brian Donley, CEO of the Cleveland Clinic UK. “Whether it is transitions from hospital to home, from one hospital to another, or from the operating room up to the floor, we see that as a big cost opportunity. Transitions of care costs a lot of money,” he said, pointing out they also lead to concerns about quality and safety. “How we achieve transitions of care better represents an opportunity for innovation,” he said.
Advances in electronic medical records software is a complicated topic, said Michelle Conger. “It gave us access to the data we need – and we built a separate data warehouse that helped us – but I think work has to be done to really help providers work differently because I’m not sure the system has made it more efficient.”
The challenge of highly constrained funding over the past seven years was highlighted by Rob MacIsaac, CEO and President of Hamilton Health Sciences in Canada. “Our strategy is to constrain funding in healthcare and expand capacity in communities,” he said.
“What that has meant for many providers is that we are being challenged to transform the system without having the resources to do that transformation. Innovation is very challenging if you can’t invest in it.”
There are however great sparks of innovation happening, he said, including R&D work around remote monitoring, to try and help patients into their home more quickly after treatment and surgery.
“We’ve also done early work in stratification of patient populations, trying to gain insights so we can start to better predict people before they crash, in a way that helps to prevent that. We are starting to do work around understanding what the potential is for us as a learning health system, and the role metrics and analytics can play in that,” he said.
Southlake Regional Health Centre is in a growing region, and so is the recipient of more funding. This has enabled it to invest in its own innovation centre. It has successfully partnered with a number of tech companies and entrepreneurs to develop products and services, which it has gone on to procure.
The aim is to have innovators come in at an earlier stage, “rather than with a fully baked product that may or may not work in a healthcare environment,” said CEO Arden Krystal. “We hope to do our call outs sooner, saying, here’s a couple of big chunky problems we have – companies, come to us and tell us how you think you can work with us and co-design a product that can help us.”
As with many healthcare systems, particularly those with ageing populations, “a lot of our big problems are around the fact that we have way too many patients and not enough space, so we have to find a way to continue to reduce stays, to help people back into the community. So remote monitors are big, but also some process tools to help us communicate faster and move people through our system hospitals. It’s all those kind of non-sexy processes that we sometimes don’t do very well in healthcare. We’re open to all of those as well.”
Any innovation that enables medical professionals to work “at top of licence” will be welcomed, said David Longworth, interim CEO of Lahey Hospital and Medical Centre in Massachusetts.
Ensuring doctors and nurses are not bogged down in routine tasks or paperwork, for example, will ease problems of burn out.
“If I had a blank canvas in relation to solutions in healthcare I would look at the way patients move through the system and at who is delivering the care, having people operate at the top of their licence,” said Lahey’s Longworth.
“I would also invest in transitions of care, leveraging technologies and applications to help foster seamless transitions of care, care giver engagement and patient engagement. I think we have just scratched the surface in how we can apply technology to not just individual patients, but populations of patients.”