The future of our healthcare industry isn’t sitting in a waiting room

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Debajyoti Das, Client Partner, Healthcare at Tata Consultancy Services Australia and New Zealand answers key questions senior leaders are asking about the big questions in healthcare.

Posted: December 2020
Healthcare leaders are busy diagnosing new operating conditions for their industry.

Many are seeking a second opinion on what the future may hold for their organisations, with questions starting with the obvious: “How will healthcare change in a post-pandemic world?”.

Debajyoti Das, Client Partner, TCS ANZ, based in Sydney, is responsible for leading all TCS healthcare accounts in Australia and New Zealand and is engaging with healthcare providers and insurance companies within this vital ecosystem. After 16 years with TCS, working in the healthcare industries in multiple geographies and now Australia, Debajyoti says the spotlight on the healthcare industry has never been brighter.

“Healthcare as an industry has been around for a long time, but it has rarely been the centre of attention globally as it has been in the eight months since the pandemic hit,” he says.

“Healthcare is all about trust, and this trust has most commonly been established over the years in the form of visiting a GP or a doctor in person.

“The pandemic has changed this dramatically, and a question being asked by everyone in healthcare is whether this change towards telehealth stays or does it revert to the way it was?”

Debajyoti gives the context, observations, and commentary that he is currently sharing with ANZ leaders about the big questions in healthcare.

Telehealth is here to stay

Telehealth has been an emerging part of the healthcare industry, but the pandemic fast-tracked its acceptance more in six months than in the past 10 years. Even though telehealth has been around since 2010-11, it had never fully taken hold because of the comfort people felt with in-person visits to their GPs. But the rise of telehealth due to necessity in the past six-to-eight months has created a unique ecosystem.

Many healthcare companies and health insurers are trying to grapple with this new ecosystem, which includes the geographical challenges of serving remote communities. The Healthcare ecosystem has seen new technologies and new platform solutions in telehealth that deliver healthcare remotely, whether it be in outback Australia or in undeveloped regions such as Africa and Asia. The combination of telehealth along with remote care enabled by smart devices like smartwatches combined with the power of IoT has started redefining the healthcare ecosystem. The healthcare of the future will be a tectonic shift from the current model that we all are very comfortable with.

Millennials driving future change

The adoption of telehealth is strongest among younger generations, which is not surprising. However remote care or care-at-home is also becoming a viable option for all age groups as certain medications and procedures (for ex. dialysis, chemotherapy) are administered at the comfort of their homes which is a huge shift from the current operating model.

Millennials do not prefer to wait for an appointment or be kept in a waiting room to see a doctor. This younger generation’s desire for “healthcare on-demand” is why I believe telehealth is here to stay. For now, it looks like there will be a different mix of telehealth acceptance among the various demographics within societies.

People in the age group between 40 and 60 will likely be satisfied by a mix of telehealth services and in-person visits with a preference for face-to-face when they have the time. It’s the age group of 60 and above where there is most lack of trust in a telehealth system, plus the fact that this demographic is most comfortable with the bond and personal interaction of visiting a doctor for any reason.  

It’s always been a matter of trust

Governments and healthcare organisations will jointly need to address the biggest issues in telehealth and remote care around privacy and confidentiality as the new trend continues.

All citizens need to see trust and transparency in these areas that have highly sensitive information. This could lead to new legislation that requires companies to demonstrate how they are enabling trust and transparency and ensuring the details a person is communicating to a doctor is private and confidential and won’t be stolen or hacked.

It raises multiple challenges within the healthcare industry, starting with how do organisations continue to foster the adoption of telehealth, remote care, and deliver trust to those people who choose this path for their health needs?

Governments, health departments, healthcare company executives, and customers are all trying to understand what the healthcare ecosystem will look like in the post-pandemic world and everyone is trying to find the right balance that will enable the next generation of healthcare across the world.

Australia’s system is healthy at its core

Australia has one of the best healthcare systems in the world. The private-public partnership model is a good one that drives excellence across the board. In terms of healthcare spending, Australia has one of the highest and ranks ninth in countries across the world. And it delivers results.

It provides quality safe and affordable healthcare for Australians and their families and is a reason why Australia has one of the longest life expectancies in the world.

This has been possible due to Australia’s very unique ecosystem of private and public investment, supported by academia, which has fueled innovation in the sector and delivered life-changing treatments and thus helped the overall healthcare ecosystem.

Importantly, this system has helped significantly during the COVID-19 era, one that has seen Australia record one of the lowest death rates amongst COVID-19 patients in the world.

In the time of a global health crisis, the numbers in Australia tell a story about how good the country’s healthcare system is and how all parts of the ecosystem have stood up to deal with the unforeseen challenge.

Fixes that might help solve a headache for health insurers

One of the key challenges for the healthcare industry in Australia today is the limited participation of people through private health insurance organisations.

Within the private health insurance industry in Australia there are five major players as well as smaller health funds, but the combined overall coverage of the population is not as good as it could be.

There is pressure on health insurance companies to remain sustainable. We see a worrying trend across the private health insurance business – margins diminishing, revenue not going up which will make them unsustainable in the long run. Even though health insurance companies saw a higher level of member enrollment in the past few months, the situation is not optimistic. If you drill down into the age bracket of new sign-ups they are mostly aged above 40, which is not helping future business models.

There may be ways – possibly including through new legislation to encourage the younger generation to participate actively in the healthcare insurance model, bring in new business models to move towards Health Orchestrators, tap into new markets etc. For example, more rebates and tax credits could be offered to people who enroll early.

Another interesting discussion point is about employer-based health care, something that happens in some countries, which would also most likely require legislation if considered in Australia which can ease the burden on Medicare. This could translate to taxpayers saving money, which in the current economic climate is going to be a strong consideration.

To understand the context, we must remember that Australia has been on an economic growth trajectory for the past few decades, but now for the first time in a long while the economy is contracting.

Australia has spent approximately 10% of its GDP on healthcare in the last few years. With the economy contracting, probably the spend on Healthcare has to be between 12% - 14% of GDP over the next few years just to maintain the current level of spending, which is not desirable.

The bigger picture trend is integrated healthcare

The new trend that we are seeing is that every health insurance organisation is trying to be a healthcare organisation. I see Health Insurers changing themselves to become Orchestrators of Health with members being at the core of the ecosystem. This will drive better outcomes, establish a value-based care model, improve efficiency and foster trust and partnership across the various entities of the Healthcare ecosystem.

The health insurers need the young generation – especially the 25- to-35-year-old age bracket – to be enrolling in health care so that it gives them a cushion, but it hasn’t happened to the extent the health insurance companies would like. As a Health Orchestrator, health insurance companies are trying to improve the health of their members by partnering with gyms and wellness centres, providing incentives to buy smartwatches etc. All these are targeted at making the insured population healthier which will drive down the healthcare cost.

As such, integrated healthcare is in focus because it crosses boundaries between primary community allied health hospital care and aged care. This is the model that every healthcare insurer is looking at, which is good because providing integrated care as part of the health system across the entire country is a good outcome for patients, providers, and the private health insurance system.

Better products, value-based care and making it personal

Another aspect for health insurance companies to consider in a rethink of their business models is how they can provide better products to customers. This includes how they can cater to the different age groups and individuals with varying criteria across a vast geographical landscape.

Health insurers currently have four major types of products with few permutations, but they are broad-based and do not meet everyone’s needs. So there is a need for personalised health insurance products to be brought into the market, and this can attract a new audience to participate in the health insurance ecosystem.

Evidence-based personalised wellbeing will allow a health insurance product to be based on a member’s preferences, which is becoming increasingly important. Health insurers should consider their investment around value-based care. Additionally, they should tap into the data and analytics to provide better outcome for their patients as well as mine the historical data combined with market sentiments to come up with new products and offerings.

The pandemic has taken a toll on the mental wellness of the population and the health insurers can have a huge role to play to alleviate this situation. Though few health insurance companies are providing some support to their members on mental wellness, there is a huge vacuum that needs to be filled. All health insurers should venture into mental wellness and see how they can better support their members (for example offer new products for mental wellness).

Interoperability of platforms, where a person can seamlessly switch from one insurer to another at any point of time at their own choice can help bring value and trust for the insurer and allow them to better drive market penetration and growth across the market.