This appeared last week:
A person-centric approach to digital healthcare
Australia’s public healthcare system must acknowledge the limitations of the current ‘one-size-fits all’ mentality
Ian Manovel, Accenture (Computerworld) 21 August, 2017 10:43
Following the approval of Australia’s National Digital Health Strategy for 2018-2022, the health services ecosystem now has a mandate for transformation to digital healthcare. As healthcare moves to harness the power of digital and implement digital strategies like providing easy access to My Health Record, the Government and healthcare practitioners are critical enablers to ensure new technologies will provide consumers with improved control of their own health and wellbeing.
According to Accenture’s Person-Centric: Reimagining Australian Digital Healthcare report, Australia’s public healthcare system must acknowledge the limitations of the current ‘one-size-fits all’ mentality and embrace a more ‘person-centric’ culture; enabling a more manageable, realistic and effective system.
Digital healthcare that is person-centric has been shown to decrease medication error rates, reduce length of stay in hospital and reduce re-admission to hospital. By focusing on the needs of distinct segments, policy-makers, payers and service providers can optimise resources and deliver the right services, at the right time, in the right way.
The report explores how this change in mindset begins with the definition of person-centred segments. Accenture identified seven clusters of people, differentiated by their attitudes, feelings and abilities, which are key drivers of behaviours and preferences.
While these segments are by no means the final word on how to segment Australian society for healthcare delivery; they begin to reveal the complex distribution of Australian attitudes toward the future of healthcare. In order to realise the benefits of a more person-centric, digital healthcare system, providers and payers must personalise their offerings:
Creating efficiency through technology
Australian consumers surveyed in the Person-Centric: Reimagining Australian Digital Healthcare report feel public funds should be used more effectively, with 67 percent of respondents believing the health system to be inefficient and wasteful.
An important part of being less wasteful with funding is the introduction of electronic health records: patients are recently able to view their own medical and pharmaceutical records in one place, which should reduce waste and promote collaboration and efficiency between patients and treating clinicians. Pathology and imaging reports that have been requested by a GP, need not be re-done by a specialist who could easily view those same reports securely online.
Improving the information flow
Patients need options relating to access and privacy settings, however these options cannot limit accessibility of information to time-poor clinicians trying to deliver better health outcomes, or who find themselves in emergency situations. The data kept by GPs and hospitals is typically extremely siloed, but most Australians surveyed are in favour of treating practitioners having access to full medical records, as well as allowing data to be shared automatically between treating doctors. Less fragmented communication of health information could have a major positive impact on re-admission rates, hospital-acquired complications and avoidable medical harm.
Understanding diverse attitudes to privacy
The Person-Centric: Reimagining Australian Digital Healthcare report shows that patients trust health organisations – especially public services – with their personal data far more than other organisations. Urgent action is therefore required to securely unlock access to healthcare data by authorised, trusted individuals for reasonable purposes such as treatment or medical research. The transparency and simplicity of privacy and security policy – along with proactive education of citizens about these policies – will be crucial to reassuring the public about data sharing. The healthcare system must begin to provide consumers with the tools to easily select to share, hide or remove identifiable details from their information.
Delivering more meaningful analytic insights
Behavioural traits of patients like anxiety and disengagement cannot be identified by traditional demographic analysis. When it comes to person-centric segmentation, the right questions can be narrowed down to a streamlined set of “golden questions” – a small set of variables that can correctly allocate an individual to a defined cluster with high accuracy.
From here, an in‑depth understanding of those defined groups allows us to predict attitudes and behaviours for individual patients. Multivariate techniques can identify groups of patients with similar needs and beliefs, then generate simplified algorithms that make future person centred segmentation quicker and easier. This is an essential step for the design of future health services and policies.
Services need to adapt to different types of patients
When discussing digital healthcare, there is always the stereotyped assumption that older patients avoid new technology. In recent years, Accenture research has shown this to be incorrect. The Person-Centric: Reimagining Australian Digital Healthcare research reveals a more granular picture, identifying both a group that drives the stereotype and a group of tech-confident seniors. While digital services for older patients should be increased, we cannot expect all groups to welcome them. Initially, most new digital services will need to exist in parallel with traditional services, rather than replace them.
Smarter segmentation of Australian patients will enable Australian policy-makers, payers and health service providers to embrace person-centric digital healthcare solutions. This approach equips healthcare professionals with better insights that improve the safety and quality of patient care. The person-centric approach engages with people from all walks of life and offers them services that are tailored to their needs.
Ian Manovel is a principal director within Accenture Australia’s health practice.
Here is the link to the original:
Here is a link to the original report.
Reading through this very interesting work there are two key lessons I take away.
The first is that there are a wide spectrum of views regarding what health information should be held, shared and so on. One size certainly does not fit all in this regard.
The second, that flows from the first, is that a system like the myHR is unsuited to meet the needs of many and that trying to make this one system meet the needs of all is a fool’s errand.
The paper, to me at least, argues for a more customized and granular and decentralised management of personal health information at its sharing.
This document deserves wider circulation than I believe it has had so far. Well worth a close browse!
David.
8 comments:
I've read it carefully. I cannot see how the contents of this article and the 7 patient categories provide any useful basis from which to develop a shared /person centric health record.
A really interesting paper, I does leave my wondering if the foundations in understanding and education around shred decision making have been thought through by the ADHA, even with the MyHR the aim seems to be to shift more accountability to the patient when it comes to health and wellbeing decisions. This all sounds wonderful in theory but are we preparing everyone for it?
Hopefully the human side of the equation is not to technical for some.
1. What does Patient-Centric Segmentation mean?
2. Does this survey support anything more than "there are different groups of people with different views on and requirements for privacy and healthcare?"
3. Neither this article nor the ADHA strategy mentions P4 medicine (personalised, predictive, preventive and participatory medicine), although the strategy does refer to personalised medicine without explaining exactly what it means by the term or how it can deliver such a thing. In fact nobody has explained what the MyHR will achieve over and above existing medical record systems.
Exactly Bernard. It's more a nice academic treatise to chat about. The fundamental question from my perspective is: Will it help my software engineers, system architects and clinical systems analysts develop a shared health record which an individual and their health care provider(s)and carers can rely upon as a trusted, accurate and complete source of the individual's health information? No.
Ian,
The trouble with asking people what they want and what they think (like ADHA did with its consultation) doesn't tell you much about how to deliver it.
Maybe that's why the ADHA strategy didn't have a plan. ADHA doesn't know how to create and implement what people are saying they want.
And of course, people might not know the consequences of what they are asking for (e.g. the effort required of the patient to keep the data current, the privacy risks etc) or the value of their getting it.
For example GPs are reported to have said that they might use the PCEHR if everybody had one. I'm rather suspicious of that one, it looks to me like cherry picking the evidence/feedback to re-enforce a prejudice. I don't think GPs had thought through the negative consequences of being responsible for gathering the data and updating a patient's MyHR, especially when there's so little in it for them, over and above their own medical record systems.
And it's not as though Accenture is a player without an agenda. With their involvement with PCEHR/MyHR and their role in delivering health related solutions, it would be a stretch to say it was independent. Even if the author was independent, there is the perception of a vested interest.
All,
I am not sure we are not asking too much. I saw the report as establishing on of the barriers to 'one size fits all' national systems that are handling personally sensitive data.
I thus took them to be saying such national systems are way harder (maybe even too hard) than we have been led to believe if we are to meet the full range of personal attributes and aspirations.
Solutions seemed to me to be beyond their scope - but I found the data useful for what it was!
David.
I agree with you David, is this Accenture strategically repositioning itself? An appreciation that big systems have a end of life. I found through the paper the author was clear to outline the thing and assumptions etc... either way a useful contribution and although patient centric is not new it is good to see fresh perspectives.
10:12 outlines an interesting component if I read it right, the shift toward shared decision and patient centric care is a shift in mindset and current practice. There will need to be investment in helping non medical people to get into a position where this can be a reality, I am just as certain a repositioning of the care models will require changes for medical people.
Perhaps 10:12 you could elaborate, or if anyone else has thoughts on shared decision making
Accenture is simply telling the world they know something that has escaped all others... hence the clueless mandarins may genuflect with $$$'s in hand.
Post a Comment