October 19, 2018
By: Ian Manovel

Clinicians and health service managers are focused on increasing the safety and quality of patient care in the Australian healthcare system. However, I think the challenge of healthcare sustainability should simultaneously be addressed from the other side of the care relationship. Self-care may have an even greater impact on care quality and sustainability than traditional, health system-provided care services.

The arrival of technologies like AI, access to home digital testing for chronic conditions and a rebalancing of the historic medical information asymmetry, mean that consumers are increasingly empowered to care for themselves. Growth in self-care should reduce the burden on public care facilities and increase the adoption of predictive analytics tools that pre-emptively address preventable acute episodes, especially in patients with typically stable chronic conditions.

Greater patient empowerment

Inevitably the information asymmetry between patients and clinicians is changing in favour of the consumer. More information in patient hands will mean greater capacity for self-care. The traditional asymmetry has been part of the reason healthcare is the only industry to become more labour intensive over time. Healthcare really must go as digital as possible – there simply isn’t enough funding to sustain the kind of in-person care we have given the population, especially the aged population, in the past.

The Accenture Doctors Survey of 2015 indicated that significant numbers of doctors felt that patients updating their own medical records hurt accuracy of records, that they found their organisations’ electronic health record systems hard to use and that healthcare IT had decreased time with patients. Notwithstanding those results, subsequent consumer surveys have indicated that consumers are using wearables in rapidly increasing numbers and are adopting them faster than ever. The paradigm has shifted.

Armed with digital mobile devices, consumers are clearly interested in self-care, which has become the new normal. Engagement with clinicians has increased strongly and wearables are no longer regarded as a fad. In fact, even from the clinician’s perspective, our surveys of Australians indicate that wearables are turning out to be very useful in getting patients to follow their treatment plans, attend scheduled return consultations and generally follow through with therapy.

Direct feedback loop

The Accenture 2018 Consumer Survey on Digital Health confirms that consumers are readier to take the plunge than ever. Usage of health apps and wearables has rapidly increased in popularity in the last four years.

Graph showing increase use of health apps and wearable devise from over 2014 to 2018

The direct feedback loop provided by apps and wearables means consumers are more motivated to reach their goals. Instead of catching the bus, they might walk to work to make up their quota of steps for the day when they notice they are below their personal target. The reality is that broad swathes of consumers are empowered to be informed about healthcare conditions in ways they never were before. It’s no longer necessary to be clinically trained to get that kind of continuous feedback. We can all become our own clinicians – all we need is a mobile phone.

Don’t resist the wave, ride it

Much as the incoming waves invariably demolish our sandcastle, doctors have now realised that the wearable tide is irresistible. Doctors have stopped thinking wearable digital devices and IoT are a trend and are now thinking of them as remote vital signs monitors. They can provide patients with personal direction on which information sources and apps are most reliable and useful. Pharmaceutical companies can create medication adherence programs and allied health professionals are enrolling patients into support groups that facilitate selfcare while providing trusted advice. Chances are, whatever condition you have, there’s a digital channel for you, whether it’s a meetup group, blog, social media channel – you can consult and get access to treatment information anywhere, any time.

Self-care isn’t about removing responsibility from clinicians; it’s about getting high quality health information in a timely way, predicting acute episodes and managing our health optimally. As healthcare consumers, we previously waited until we were experiencing symptoms before we sought professional healthcare. Now, a proactive culture of self-care could reduce costs to consumers, governments and health insurers alike and make for a more sustainable Australian healthcare system.

Do consumers have the right digital tools to enable self-care? Are healthcare providers riding the digital wave? I would love to hear your thoughts.

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