Industry View: What’s in store for 2020?

Regular column by Scott Arrol, NZHIT CEO

Another spell of crystal-ball gazing has produced some predictions for this year around virtual healthcare, artificial intelligence and sector and political factors.

Welcome to 2020 and the new decade. The past 10 years seem to have flown by and it’s a strange feeling to have been in this role for half of them.

When I reflect on the past decade there is a lot to like in terms of the progress made, but also a great deal to be concerned about when it comes to how much more could have been achieved.

However, there now seems to be a momentum that has built over the past couple of years to provide confidence that the next five years will deliver on the promise of technology being able to fully enable the delivery of health and disability services.

This time last year I did some crystal ball gazing about digital health-related factors that would gain pace and attention during 2019. For those of you who read my final article of the year there were some things that had progressed well, while some predictions, such as a major security breach, disappointingly came true.

So, putting my neck on the line again, here are my picks for the first year of this new decade.

Providing more care in a virtual way

Virtual healthcare fully enabled by technology must make rapid progress. Put simply, virtual healthcare refers to the range of health and care services delivered in situations where the care provider (or team) is not in the same physical location as the receiver of that care. By its very nature, virtual healthcare services can only be provided where technology enables the link between carer and patient.

The commonly used term of telehealth is a component of virtual healthcare, but it is only one of many ways that care can be provided in a virtual manner. By its very definition, virtual healthcare is fully patient directed as they determine how, where and when their care is delivered.

Why is virtual healthcare important? It’s because of the ‘headcount paradigm’ that our health system has failed to come to grips with over the past 20 years and that must not be allowed to continue for the next 20.

This refers to the ongoing problem definition that we have of “more people requiring ever increasing levels of care” which we’ve continued trying to solve by “getting more people to deliver more care”.

We know there will never be enough people available to meet the current and future health demands of our health and disability sector. Technology in this context doesn’t put healthcare workers out of work because we just don’t have enough of them to start with.

Additionally, we cannot continue to increase the spend on public health services at the levels seen over the past five years without major cracks appearing (we’re already seeing this happen).

So, the problem is still the same but the solution has to be different. The answer is to use technology in a far more effective way to support and enable healthcare providers to do their jobs, meet the increasing healthcare demands and do this more cost effectively.

2020 has to be the year when we move from talking about the huge potential of virtual healthcare to making the required changes that will see it become embedded over the coming decade.

The emergence of AI and its related challenges

Just as the internet of things and blockchain have been touted as the saviour to many of our woes, artificial intelligence has gained traction in recent times. Unlike the first two examples I think that AI will be a game changer but only if used in the context of enabling the delivery of healthcare provided by clinicians and carers.

Working in combination with virtual healthcare, for example, AI is another factor that will help to solve our headcount paradigm, but it doesn’t replace the need for humans to care for each other. Empathy when caring for people who are at a vulnerable time of their lives cannot be replaced by technology, not in my lifetime at least, and the power of touch cannot be understated.

We need to be careful about the hype surrounding AI and its use in the health sector. There is no doubt that it will be a powerful and positive contributor, although 2020 will be a period for identifying associated risks (such as security, privacy and bias) and working through these to reach a level of comfort for wider acceptance to occur.

Sector and political factors

The National Health Information Platform is obviously going to grab a lot of our attention this year, as is the Health and Disability System Review report. There’s also a general election in September that may influence what happens over the coming three years at least.

Like most of us, my crystal ball gets somewhat cloudy when it comes to these areas, although nHIP must gain its required approvals and funding otherwise our sector will be stalled for the next 10 years, if not slip even further backwards. The alternative to nHIP is the status quo – do we really want that?

The consumer of the future has a lot to contribute now

Again, the headcount paradigm forces us to be in firefighting mode for most of the time especially when it comes to the relatively small percentage of people who require a disproportionately large share of healthcare resources.

This is important but there has to be a strategic shift towards looking at the requirements of the next 10 or more years. For example, 20 years ago we knew that diabetes was going to become a big problem but we didn’t get ahead of it and put solutions in place to minimise its impact.

The 20- and 30-year-old New Zealanders of today will have different needs and expect different ways for their healthcare to be provided (i.e., virtually). So let’s make sure we don’t repeat the mistakes of the past and inflict them on the generations of the future.

Scott Arrol is the CEO of New Zealand Health NZHIT.

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Anna Arrol

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