Trends in healthcare: personalization of services

Soon, healthcare services will become more personalized and patient-centered, in order to encourage people to take responsibility for their health. At the same time, new tools, technologies and information resources of healthcare will open up more and more opportunities for consumers in this area. 

Such conclusions are contained in the new report on trends in the healthcare system "Forecast of healthcare development: personalization of diagnostic, care and treatment services" (HealthCast: The Customization of diagnosis, care and cure), published by the PricewaterhouseCoopers Institute for Health Research (PwC). This trend will be reflected in a significant change in the business models used in healthcare, in the reform of the legal regulation of healthcare and the revision of the financial incentive system over the next five years.

The PwC report was the result of an annual study of healthcare systems in 25 countries around the world. The study revealed a new phenomenon that is characteristic of both developed and developing countries. In the context of the global economic downturn and the need to reduce the growing costs of national health care in connection with the treatment of chronic diseases, governments and health authorities recognize that people need to play a more significant role in managing their health and spending on medical services in general.

In the course of the PricewaterhouseCoopers study, 590 heads of government agencies and leading companies in the healthcare industry were interviewed. Below are some of the survey results:

• 86% of respondents believe that in their countries the state will retain a dominant role in the provision of basic health services.
• At the same time, there was a consensus that, ultimately, people themselves will play a key role in maintaining health.
• 97% of the survey participants agreed that patients should bear some responsibility for maintaining their condition with chronic diseases such as obesity, asthma, diabetes and heart disease, while 57% insisted that patients should bear more responsibility.
• The lack of willpower in patients was noted as the main obstacle to their active management of their health, however, 74% of respondents believe that unhealthy habits will cause increasing rejection in their countries.

It is widely believed that chronic diseases are associated with behavioral, socio-economic and genetic factors that are not controlled by the modern healthcare system. The PwC study showed the presence of social, political, economic and legislative barriers that prevent people from participating more actively in the process of managing their own health.

In order to attract consumers and fight for them in the international market of medical services, health authorities are trying to understand the needs of consumers and their individual preferences and plan their services in accordance with the needs of consumers, as is the case in other industries that have undergone significant changes as a result of the development of consumerism.  

A survey of world leaders in the field of healthcare conducted by PwC showed the following:

• 76% of respondents agreed that the lack of knowledge and access to medical information does not allow people to manage their health. 74% believe that patients do not understand medical information and the options available to them. The development of the Internet, social media, mobile communications and the use of information technologies in the field of healthcare should open up new, unprecedented opportunities for consumers to access the range of services offered and to obtain relevant knowledge.
• In order to interest healthcare providers in changing the stereotypes of their patients' behavior, 84% of health authorities agreed that the allocation of funds to hospitals, remuneration to doctors and other service providers should be based on the qualitative results of health protection measures.
• About three-quarters of health authorities expect that healthcare financing in their countries will be reoriented from allocating funds for the treatment of patients with various diseases in medical institutions to maintaining the health of people outside hospitals, private clinics and doctors' offices.
• 45% of the heads of health authorities and companies operating in the medical services market expect that personalized medicine will be one of the important factors of health protection. New methods of diagnostics and pharmacogenomics will provide an opportunity to adjust diagnoses and treatment taking into account the individual characteristics of patients.
• Almost half of the world's healthcare leaders expect medical tourism to grow by 2015 as competition for consumers between healthcare systems increases in offering individualized services, access to medical innovations and greater value of services for consumers.
• Although many healthcare institutions claim to provide patient-centered care, PwC research has shown that only a few regions in the world are actually working in this direction. The greatest progress is observed where public authorities are increasing the pace of innovative solutions and creating public-private partnerships to provide end-result-based medical care.

The healthcare industry is an extensive, highly regulated and inert infrastructure that took decades to build. We found out that medical organizations still focus on their own problems, which do not always reflect the interests of the patient. There is a growing awareness that if the interests of the patient are not represented in this "equation", then proper management of service, consumption and expenses is impossible. A comprehensive challenge for existing healthcare systems will be the transition from an isolated bureaucratic healthcare infrastructure to a patient-oriented system that provides for his active participation as an interested party in maintaining his own health and the healthcare system.

The PricewaterhouseCoopers study indicates that it is difficult for consumers to understand or influence existing healthcare systems. Typically, such systems are based on an emergency care model and focus on the treatment of diseases after a patient has become ill or injured. At the same time, the service is traditionally carried out in hospitals or polyclinics. This model largely depends on the availability of hospital infrastructure and proper medical personnel. Moreover, the treatment of patients is often associated with their transition from consulting doctors to medical organizations and back, as well as with limited availability of medical services; at the same time, the presence of separate payment and regulatory systems has led to a skew in the incentive system, which does not facilitate the exchange of information and coordination of medical services. These factors lead to inefficiency, loss of funds allocated to healthcare, poor results, long waiting times and dissatisfaction of patients.

Most health authorities consider the introduction of an electronic system for maintaining medical records and information technologies in the healthcare system to be an important stage in the development of cooperation, expanding patient opportunities and individualization of care. 42% of world leaders in the field of healthcare said that electronic medical records will be introduced in their countries within five years, and 71% noted that providing patients with access to their medical records will increase the effectiveness of their health protection due to self-government opportunities.

Many of the world's largest countries are implementing significant regulatory and payment reforms that will change the ratio of behavioral, genetic and medical components in the structure of a patient's personal health expenses. According to a PricewaterhouseCoopers study, healthcare industry leaders can collaborate to develop solutions in the field of personalization of diagnosis, care and treatment using the following measures:

• developing incentives to form partnerships;
• preparation of regulatory reforms aimed at promoting competition and innovation;
• planning for the reorientation of healthcare financing – from the treatment of illness to the maintenance of good health;
• providing people with more information so that they are aware of their right to choose and participate in decision-making together with service providers;
• the study of resource allocation models such as telemedicine and the expansion of the functions of nurses, which will increase the flexibility and efficiency of service;
• preparing for the complexities of working in a mobile IT environment based on the interoperability of technologies, in an interactive, consumer-oriented market.

A change of emphasis within the healthcare system will mean the restructuring of almost all components of its infrastructure – communication systems, doctor-patient relations and the distribution of responsibilities, as well as, perhaps, the most difficult aspect of service – ingrained habits and traditions.

Tools for changing the consumer experience
 
In its study, PwC identifies five areas in which healthcare systems can personalize care and involve people in managing their health.

1. Coordination of medical care: Consumers want treatment to be coordinated. Integrated health care networks that have access to information, participate in the service and share responsibility for the results of treatment will become an urgent need.
2. Knowledgeable consultants: people lack the knowledge and skills necessary to navigate the healthcare system and realize their choice. In the personalized healthcare system, there will be an increasing need for consultants outside the circle of friends and family of patients. PwC experts believe that pharmacists and local community groups can play the role of knowledgeable consultants in the field of healthcare. It is also possible to create a new field of professional activity, following the example of financial planners who appeared with the development of consumer-oriented investment.
3. Patient experience benchmarks: In a patient-centered healthcare system, more attention will be paid to understanding and meeting consumer expectations. Many healthcare systems already monitor and publish indicators of the level of patient care, such as cleanliness, waiting time and satisfaction with the doctor's qualifications, which allows patients to make more informed decisions.
4. Ubiquitous care networks: The definition of "accessibility" has been revised due to the advent of wireless mobile communications, remote monitoring and new models of care, thanks to which medical services are moving from hospitals, private clinics and polyclinics to patients' homes, increasingly equipped with various network devices.
5. Medical research centers: By developing cooperation and attracting investments, some regions are positioning themselves as medical research centers, or centers of advanced technologies, because in the era of new, personalized medicine and services, this helps attract patients, researchers and service providers looking for the shortest path to access and innovation. Governments wishing to benefit from this process should encourage drug development with the same enthusiasm as other innovations, such as finding energy sources and expanding the use of renewable energy. 

The full version of the report can be downloaded on the PWC website.

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22.04.2010