It is widely accepted by clinicians, academics, policy makers and patient representatives that empowerment in healthcare is desirable and can result in many advantages, such as improved health outcomes, quality of life, patient wellbeing, professional satisfaction and system efficiencies.
However, despite these agreed objectives, and rapid technical advancements to facilitate progress, frustratingly little progress has been made in recent years.
Until 2020, when Covid-19, acting as a transformation catalyst, accelerated the implementation and adoption of changes in healthcare delivery at an unprecedented scale. The rising infection rate due to the new strain of the virus has further highlighted the desire for change. Currently, our health system is under severe strain, with over 30,000 Covid-19 patients now in hospital (as of 6 January 2021) and the press reporting that we are only a week away from system breakdown, if infection rates continue to spread. Health care needs to be delivered in a new way, using remote methods as far as possible, to alleviate the burden on hospitals and care providers.
New models of healthcare delivery, based on remote healthcare solutions, are emerging across the care continuum, with an increased emphasis on preventive measures, rapid diagnosis, virtual care, an increase in self-management, and personalised, adaptable treatments. Not only do these bring numerous benefits in terms of cost, speed and efficiencies, they are also leading to greater empowerment for patients, clinicians and healthcare professionals.
What does empowerment mean in the context of healthcare?
In general terms, empowered individuals can prioritise their own needs and take the necessary action to suit their unique situation. Empowerment is situation-specific and, usually, highly individualistic.
In the context of healthcare, however, empowerment has been difficult to achieve. This is due to the breadth of needs across a wide range of stakeholder groups, the diverse needs of caregivers and care recipients, and the presence of national infrastructures and centralised management of resources. There has always been a balancing act between what may work best at an individual level versus what is feasible within the larger system.
One of the outcomes of the Covid-19 pandemic has been wide-ranging transformation across the healthcare system, and notably the adoption of remote solutions. For example, according to the Royal College of General Practitioners, 71 per cent of routine consultations were remote in the four weeks leading up to 12 April, compared to 25 per cent in the same period last year. This is a tremendous shift. The adoption of remote healthcare solutions is enabling personalised care and empowerment for both caregivers and care recipients. Patients, clinicians and healthcare professionals are benefitting in a variety of ways.
Remote healthcare solutions are enabling personalised patient-centric solutions
At first glance, remote solutions may appear impersonal, given the lack of face-to-care interaction. However, remote solutions, such as virtual health, digital health and telehealth, enable a greater range of possibilities, both in clinician terms and engagement terms, increasing touchpoints and interactions, with many associated patient benefits.
For instance, telehealth solutions give the patient access to a wide range of clinical specialists and care providers, in a rapid and time efficient manner, from the comfort of their home. It also removes the need to enter a hospital, which reduces the possibility of infection. Patients can discuss their diagnostic information, review it in conjunction with a range of health care specialists, discuss and review their treatment and prescription needs and manage their care provision through online portals. They can also ensure their care records are made available to a wide range of clinical stakeholders, whose interaction determines the appropriate treatment path and best outcome.
Remote monitoring enables personalisation and adjustment of treatment plans at an individual level. Treatment is moving away from one-size-fits-all to highly customised and regularly adapted treatment protocols. This is made possible through digitally connected remote monitoring devices, such as digital inhalers, wearable cardiac monitors, biosensors, pulse oximeters, weight and exercise tracking devices, and connected glucose monitors. Moreover, the developers of connected medical devices now recognise that patients are fast becoming consumers and administrators of their own care in remote care situations and are incorporating consumer-centric product design principles from the outset.
Advancements such as these are enabling the personalised treatment of chronic conditions where there has been great variation in care standards and outcomes. Connected medical devices can help patients proactively predict and identify episodes, manage their own care, avoid hospital stays and access healthcare professionals when required. Improving the management and outcomes of chronic conditions has the potential to greatly impact the health of the nation and the total healthcare budget. 26 million people in the UK have at least one long term chronic condition and 10 million people suffer from two or more. According to NHSE, long-term conditions account for 70 per cent of total health and care spend.
Remote healthcare solutions are providing patients with a host of benefits which extend beyond improved health outcomes. Patients now have better and speedier access to healthcare, improved quality of care, greater engagement and participation in formulating and modifying personal health plans, regular timely feedback, peace of mind and daily assurance for condition management, support to self-manage, less travel to specialised centres, notification of timely interventions and improved education and support. New patient-centric care models, enabled by remote solutions, are delivering patient empowerment on a large scale, across a wide range of clinical conditions.
How remote healthcare solutions are empowering clinicians and healthcare professionals
Clinicians and healthcare professionals wish to both save and improve the lives of their patients by bringing their expertise and knowledge to bear in a timely manner. In short, they wish to be able to diagnose accurately and speedily, and treat precisely and personally, to deliver the best health outcomes.
Remote healthcare solutions are enabling clinical decision-making across the care pathway from preventive care, to diagnosis, treatment, maintenance and prevention of recurrence. Connected health solutions can feed information back to both frontline healthcare professionals and expert clinicians, enabling treatments to be adjusted as necessary, and providing tailored and personalised treatment plans. For example, by remotely monitoring a patient’s use of an asthma inhaler, the respiratory specialist can see how frequently the inhaler is being used and whether it is being used correctly. Feedback can be provided to the patient to improve compliance and outcomes, avoiding acute attacks, hospital admissions and condition deterioration.
In addition, remote healthcare solutions can help healthcare systems become more efficient and assist healthcare staff manage increasing demand without over-stretching already strained clinic and staff resources. They reduce footfall to healthcare facilities, allowing resources to be focused on where they are needed most.
Remote health solutions also have the potential to greatly improve the day to day working experience of healthcare professionals, enabling them to focus their time and expertise where the need is greatest, and improve overall work satisfaction. According to a survey undertaken by BMA in April 2020, 44 per cent of doctors said that they were currently suffering from depression, anxiety, stress, burnout or other mental health conditions relating to or made worse by their work. These factors in turn make the profession less attractive and cause many to leave, due to undue stress and dissatisfaction. A Nuffield survey, published in 2019, stated that there were around 100,000 full-time equivalent advertised vacancies in NHS hospital and community services, equating to an estimated shortfall of 8.1 per cent (around one in 12 posts). Remote healthcare solutions can greatly contribute to alleviating causes of low morale, high attrition and burnout in the medical workforce by reducing the burden of administrative and basic clinical tasks, enabling medical professionals to focus on patients’ needs.
What is the future for remote healthcare solutions and stakeholder empowerment?
Given the system-wide adoption of remote healthcare solutions, propelled by the imperative of the Covid-19 pandemic, we are unlikely to see a return to old ways of delivering care in person. There is motivation from all stakeholders to embrace digital-first care models, built on remote care solutions. NHS Digital estimates that half of the 102 million GP appointments from March to July 2020 were by video or phone call. Virtual consultations are now being rolled out to other community care practitioners including optometrists, pharmacists and dentists.
Technology will continue to deliver new possibilities for remote healthcare delivery, with MarketsandMarkets forecasting that the IoT medical devices market will grow to USD 63.43 billion by 2023 from USD 20.59 billion in 2018, at a CAGR of 25.2 per cent. The connected medical device market is expanding with the evolution of high speed networking technologies and increasing penetration of smartphones, tablets, and other mobile platforms in healthcare. As with other areas in life, patients are increasingly embracing technology to manage their health; they are accepting the remote delivery of care and are becoming more engaged with their health management.
As a result of these combined factors, the ability to analyse vast amounts of health data will continuously inform and develop the system, support the development of new remote care models and further advance benefits and empowerment for all stakeholders. A rich pattern of behaviours and insights can be gathered via data analytics and AI tools. This informs clinicians on rapid diagnoses, case triage, personalised treatment protocols, and informs frontline healthcare professionals on the appropriate, most effective care. It also helps drug and device companies innovate more effectively. Data sharing will continue to enable innovation across the care continuum and efficient skill and knowledge transfer.
The adoption of remote healthcare solutions is finally realising the delivery of healthcare on an individual basis, on a global scale, leading to greater empowerment for both patients and medical professionals. As we navigate such turbulent times, this shift has arguably never been more imperative.