From cure to care
It is stunning to see that society still invests so little in sickness prevention. For example, in Belgium, a mere 2% of the healthcare budget is spent on preventive action while everybody agrees that funding wellness rather than sickness is the way to ensure a better quality of life and for healthcare systems to remain affordable. It’s easy to see why: empowered and encouraged patients, willing to bear ever more responsibility for their own health, can be kept out of the more expensive phases of treatment, hospitalisation and surgery.
Professor Leo Neels
For this to happen, however, the healthcare system will have to become more patient-centric. The system will have to break down its silos, and provide patients with guidance, information and education. It’ll also have to bring in the right set of healthcare providers at the right time on the ‘continuum of care’, starting from prediction and prevention, over curing to assuring therapy adherence.
Yet still, many further steps are needed to achieve a fully patient-centred healthcare system, one that is truly multidisciplinary and which maximizes clinical, service and operational quality, not only within an organisation but specifically between organisations to guarantee the continuity of care. The challenge will be to organise primary care as the main guardian of society’s wellbeing, directing the focus to wellness rather than sickness. This will be possible by making the GP the unique entry point for patients to a network of centralised specialized curing resources and a set of decentralised healthcare services treating chronic diseases. Also, the GP should be the reference guardian of the Electronic Patient Record.
|READY TO BE COACHED BY YOUR DOCTOR
If we are to care more than cure, prevent more than treat, then society will need doctors who can listen more - and be given the time to do so - and who are able to coach their patients into changing their lifestyles above and beyond just taking another pill. New technology will surely be able to help, but what’s really needed is a change of attitude both within the medical profession and amongst society as a whole.
Ironically though, even as the technology for electronic patient medical records is acknowledged to be ‘the’ enabler of this future healthcare provision, today it is still a barrier to realise effective communication between different healthcare players. On the curing side as well, hospitals are under pressure. It is said that we now may have too many hospitals, and that up to 15% of patient hospitalisations could be avoided. Meanwhile, incentivised by the empowered patient and the increased expectations in quality of care and performance outcome, care providers are shifting from a resource efficient oriented organisation towards one with a more effective flow efficiency. This requires a different multidisciplinary policy and governance, one that breaks down the traditional silos and calls for engineering skills to steer the complex operational planning.
|THE LACK OF A CENTRAL AND SHARED ELECTRONIC PATIENT RECORD IS A MAJOR BRAKE TO THE SYSTEM
In a recent Vlerick Health Management Centre white paper , focussing on the positioning and role of hospital pharmacies in the chain of care, the lack of a shared national electronic medical record and in many cases not even having an electronic patient record within a single hospital, were raised as serious issues. Highly requested though apparently still a pipedream, the lack of one electronic file per patient continues to be a source of potential patient safety problems. [Read the full article]
Care providers understand that patients have different needs and levels of complexity, therefore bringing to the fore both standardisation, manifest in many ways, from outpatient surgery in freestanding ambulatory centres to dose banding in chemotherapy preparation, and personalised treatment. This shift from resource efficiency to flow efficiency will go hand in hand with a shift in maximizing ‘value added’ from the organisation and hence optimize the ‘value received’ time for the patient and customer. It is also clear that the search for value is no longer the sole responsibility of care providers, as product suppliers too are on the look out on how to foster value, away from their traditional focus, mainly through healthcare services.