How we can reinvent care delivery to expand access for all
July 7, 2022
We have reached a tipping point in healthcare. Clinician capacity has been stretched to its limits. In the United States, 500,000 nurses are expected to exit the workforce this year and by 20341, we may face a physician shortage of more than 100,000.2 In the United Kingdom, 110,000 clinical positions in the National Health System (NHS) are unfilled, contributing to 18+ week wait times for non-urgent care.3 It takes months to see a specialist. Mind you, these are countries where people have “good” access to healthcare. In some places, the situation is even more dire.
The clinician shortage is affecting the patient experience, increasing the burden on the remaining clinical staff and having a negative impact on health systems’ performance. The estimated annual cost of turnover and reduced clinical hours due to physician burnout is $4.6 billion in the US.4
We’ve been citing this shortage for years, but it is beginning to hit home for all of us. For some, the effects are devastating. It is time to stop admiring the issue and instead, explore a reinvention of care that will fundamentally fix the issue.
The human impact
The numbers paint the picture, but the message is clearest when we hear real stories about those affected by this challenge. We’ve heard such stories from many clients. To bring this situation to life for you, we will describe Leon’s journey, which represents a composite of several stories.
Leon is a middle-aged father of four. He lives in Anytown, USA and works for a manufacturing firm, which provides his health insurance. In August, Leon started feeling sharp shooting pain in his side and noticed specks of blood in his urine. Like many, he didn’t have a primary care doctor, so he waited a month for his appointment. During that appointment, the doctor sent Leon’s urine and blood for analysis and recommended a CT scan. The earliest scan he could get was in December. A week later, Leon’s primary care called to suggest he visit an oncologist. He met the oncologist in early February. By now, Leon was regularly taking over-the-counter medicines and using patches for pain relief.
During his appointment, the oncologist told Leon he had cancer in several places, including his lungs, liver and bladder. An initially localized bladder cancer had spread quickly. His oncologist discussed treatment options but told Leon it was unlikely they’d be able to cure it. After a few virtual meetings with a grief counselor, Leon and his wife decided on hospice care. Leon recently passed away. Though the outcome may have been the same, Leon’s care delays did not serve him well.
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The business impact
Nothing can compare to how this situation is affecting people, but we must also recognize what is happening to healthcare organizations. Some have recently announced aggregate quarterly losses in the billions, leading 1 in 3 to face negative margins.5
Healthcare wages have gone up in the wake of COVID. The American Hospital Association (AHA) reports that labor costs per patient jumped by 19% between 2019 and 2021.6 As healthcare workers look for higher pay or more flexible work schedules during these challenging times, some are turning to traveling positions. The AHA found that high-cost traveling nurses made up 39% of hospital nursing budgets in January 2022, up from 5% in 2019.
We can’t solve the access crisis by training and recruiting more nurses and doctors—it would take too long, and the deficit is too great. To solve this issue, we must reinvent care delivery.
Reinvention for better access, experiences and outcomes
In the past, technology has helped lower costs and optimize existing care processes. It hasn’t helped remove work, automate tasks when it is sensible and delegate administrative work to others.
Imagine a reinvention of care delivery that systematically delegates tasks, such as faxing forms, confirming prescriptions and requesting medical records to employees with the right licensure so that nurses can focus on what they were trained to do.
Imagine a reinvention of care delivery that connects patients to the right clinical service through the channel they prefer. For instance, what if we enabled patients to complete intake forms from home, before an appointment? Or, as we describe in Accenture’s 2022 Digital Health Technology Vision, what if we enabled patients to consult with their doctor in an augmented reality setting or receive physical therapy in the metaverse?
The technology to do this already exists. We simply need to stitch it together and deploy it in smarter and more meaningful ways. This will optimize clinician time, so they can focus on care and collaboration—work that is meaningful for them and the patients they serve.
For years, we’ve focused on finding technology that better diagnoses and cures disease. Now, we need to also think about how technology can make care more accessible. Let’s think back to Leon. If technology were helping to improve access, he would have received the care he needed sooner.
Change starts now
If healthcare’s mission is to help people, we cannot wait to reinvent care delivery. Doing this will allow health organizations to fulfill their promise to their communities and patients. It will allow healthcare workers to focus on doing what they were trained to do. And for the rest of us? Reinventing care will increase access for us and our loved ones. In Leon’s case, as in many others, access could be a matter of life or death—and it doesn’t need to be.
1https://www.bls.gov/ooh/healthcare/registered-nurses.htm
2https://www.aamc.org/media/54681/download
3https://www.wsws.org/en/articles/2022/03/12/axsf-m12.html
4https://www.mcpiqojournal.org/article/S2542-4548(21)00126-0/fulltext
5https://www.aha.org/system/files/media/file/2021/03/Kaufman-Hall-2021-Margins-Report-final.pdf
6https://www.aha.org/2022-04-25-new-aha-report-highlights-massive-surge-input-costs-hospitals-and-health-systems
