My mother has been an inpatient of the public and private healthcare system for most of the past few months.  It’s been a difficult and emotional time for our family.  This personal experience has intensified my sense of urgency for provider reform, and the extent of work required in the sector.  From a global perspective Australia has a good health system, but it is inefficient, and we have a long way to go to meet consumer expectations.   

The systemic inefficiency issues and root causes are well known, and our family experiences have highlighted the issues I’ve encountered during more than 20 years of healthcare reform work.  Key issues include difficulty in navigating the system, avoidable delays, significant waste, incredibly poor information sharing, and “things falling between the cracks” which can lead to life-threatening consequences. Frequently there is insufficient focus on delivering a reasonable service experience, with the system not delivering on the true “moments that matter” to patients, their families, and our clinical workforce. My recent experience is that our Health system is neither clinician- nor consumer-centric. 

The solutions are also well known, and already proven to increase access to care, care quality and safety, and cost sustainability.  So why aren’t we making more progress? 

Stronger leadership is required. Leaders must be bolder, move faster, and be smarter about how reforms are delivered. 

Friction in the provider system 
Two important lenses include: 

  • Consumers: they don’t want to wait or feel like their time is being wasted, but avoidable waste and delay is common.  Examples include unnecessarily repeating basic information to multiple clinicians and traveling up to 300 kilometres for a face-to-face follow up appointment when telehealth should be a “business as usual” offering.    
  • Health Workforce: there are many challenges – particularly in continuity of care and collaborative care modelsIn many cases, clinicians still do not have the enabling tools (technologyinformation, analytics) to make them efficient and effective, and improved the patient and family/carer experience. 

All stakeholders expect less friction in the health provider. The cost of inaction is significant. For instance, lack of reform by private provider organisations could lead to (a) poor customer feedback, (b) specialists departing to join competitor organisations if they believe the value proposition is stronger, and (c) significant financial challenges. 

Illustrative Solutions 

Reforms should be driven by new clinical models of care and a well-defined service experience, including the key “moments that matter” for important stakeholders. Technology is a vital enabler. 

For the provider market, mature and proven technology is readily available. For example, there are mature digital solutions for digital health records, omni-channel access to information, virtual care, data and analytics platforms, and digitisation of the back office (where AI and Robotic Process Automation is relatively mature).  The business case for digital reform is strong in terms of both quantitative and qualitative benefits. There is simply no more excuse for providers to avoid digital reform.   

Digital is the new normal 

Digital health is no longer a differentiator. It’s a basic necessity for provider organisations – as described in Accenture’s Digital Health Tech Vision 2019: “People expect healthcare on their own terms, and they expect digital to be the enabler. From using data to understand meal preferences of a patient in hospital, and delivering those meals exactly when they want them, to delivering information through the right channel based on selected preferences—digital can support delivery of healthcare when, where and how people want it.”   

Australians are increasingly open to non-traditional services and channels and want digital capabilities. Evolving Australian consumer preferences are outlined in the Accenture 2019 Digital Health Consumer Survey,  which found that more than a fifth (21 percent) of respondents in Australia said they’d used some form of virtual care (up from 12 percent in 2018). The survey concluded that “the model for treating the sick will not only be about bringing patient and caregiver together, in person, but about combining digital services, self-service and virtual care to address new demands.”  

Removing Friction from the Provider Organisation 

The plan for reform must consider change across the entire business and operating model – as opposed to a narrow focus on select topics (e.g. digital front end). The customer interface is crucial, but effective reform involves the core of the business and the back office as well.  Some illustrative key actions include: 

  1. Align leaders on the need for change, the vision and operating model, and the commitment to fund and support a reform agenda 
  2. Ensure the right leaders and delivery capabilities are in place. This step-change takes skilled and focused leadership and the right capability (internal and external) to deliver expected outcomes.   
  3. Work with clinicians and consumers to help define evolved models of care (including homecare and virtual care), service experience and the “moments that matter”.   
  4. Ensure you have a practical target state architecture to guide the digital reform.  It must be modular, with a clear view on the interaction with other clinical providers, providing consumer access to information, and removing inefficiency from the back office.  
  5. Develop a practical business case. The case for change and outcomes required must be clearly defined, and employees must understand where value must be delivered.   
  6. Define where core business begins and ends. Strategic partnerships with ecosystem partners are crucial.  
  7. Stage the roadmap carefully– crawl, then walk, then run when it comes to complex reform. First focus on the most important use cases and patient journeys and deliver early benefits. Agile delivery, and adaptation during delivery can help optimise success.  Resilience and determination are required during execution. 

Reform is challenging.  However, providers must evolve to better meet the needs of patients, carers/family, and clinicians, and capture the value of digital reform.  The time is now.  It will be fascinating to see which leaders step up over the next few years and make such a significant difference to the lives of Australians. 

If you have further thoughts on reducing friction in Australian healthcare, I’d value your inputs, so feel free to get in touch. 

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Dr. Travis Grant

Managing Director – Health, Client Lead, Australia and New Zealand

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