Diagnosing Australia's healthcare system.

Could disruptive digital technologies be the answer to the 'broken' healthcare industry's biggest ailments?

As part of our quest to pick out the challenges facing modern businesses—and discover innovative and disruptive solutions to them - we came up with our Yolk series of events. The idea is simple: we gather together a panel of key leaders and thinkers over breakfast by the Swan River and ask them to debate the big questions facing their industry today.

The first time around we bit into the state of the transport industry, chewing over everything from the imminent autonomous vehicles to drone delivery (alongside the bagels). Yolk #2 saw key health industry figures - from start ups and large corporations alike—debating just some of the topics that follow.

Newspapers are decrying our ‘systematically broken’ healthcare system, and a high percentage of Australians are apparently considering dropping private healthcare altogether. It’s a similar story in the USA, with people looking to disruptive digital technologies to turn things around. Globally speaking, healthcare systems are large, complex and comprised of multiple players; the fragmentation leading to inefficiency as health insurers communicate ineffectively with providers, and providers lack the incentives to reduce costs for the patient.

Fast, quality and affordable care is what the industry should be aiming for, and for the first time the stars seem to be slowly aligning in the continuum of digital health that can make it happen.

The price of good health.

Australia spends around $160 billion a year on healthcare, which is approximately 10% of our GDP; some states contribute so much to healthcare that they are already struggling to sustain the load. It’s the same in the US: the country spent 17.8% of its GDP on health provisions in 2016, with that predicted to rise to 37% by the year 2050.

With doctors and surgeons charging thousands of dollars an hour for their services, and aging populations seeing a rise of patients with complex comorbidities, the reality is that the cost of servicing Australia’s community isn’t likely to drop in the long term unless things change. It’s an all-too obvious consequence of the leaps that medicine has taken over the last century: people living longer get sick more frequently, and therefore need more care.

But while the costs are high and the infrastructure is shaky, the medical outcomes are outstanding. Australia rates 6th for life expectancy in the OECD, while one of our panel told us their US counterparts often marvel at Australian healthcare. The key is retaining this same level of outcome with increased efficiency and reduced costs.

Prevention is better than a cure.

Some health insurers have an idea of how to work on this challenge: they want to move from a ‘payer’ model to a ‘partner’ model, improving the wellbeing of their members and reducing the large percentage of payouts that go to a very small percentage of members who suffer from chronic diseases. They’re taking a preventative stance in the hope that by helping members manage their chronic illnesses or avoid them altogether, they’ll reduce necessary appointment time and the overall costs of health insurance policies to customers should come down.

They’re counting on everyone playing a part, and digital technology being the factor that helps them do so. Health monitoring and maintenance apps are on a constant stream of evolution: from the iOS-standard health app on every new iPhone, to those that can monitor blood pressure, explain your medication and when you should be taking it, or platforms that track glucose levels for diabetes sufferers.

The rise of telehealth.

Even more vital than patient-managed apps is the rise of telehealth as a viable option for medical consultation and diagnosis. A remote medical workforce accessed via telehealth services allows a patient to see a doctor on the internet within minutes and offers a number of practical benefits to patients as well as a reduced cost. Patients can be anywhere with a web connection for their appointment and can have a resulting script sent directly to the pharmacy nearest to them - it’s popular with employers who see that their employees then don’t need to take lengthy breaks from their day to travel to their GP.

There are some limitations, though. The doctor in question needs to be comfortable that they can make a diagnosis solely on the basis of a video call - you can’t use a stethoscope over an internet connection, after all, so some patients may simply be referred back to their nearest GP. Plus, Medicare rebates are immitted for telehealth and only provided under very specific circumstances, for example based on the distance a patient life from a specialist.

Remote diagnostic tools are also being gradually added into the mix, with one technology being developed to allow a doctor to diagnose respiratory disease from the sounds of a patient coughing into a phone, an incredibly useful bit of kit that has far-reaching potential in the developing world, too.

And telehealth is growing according to Deloitte there were 100 million telehealth consultations in the last year in the US, and that’s expected to double in the next few years. Australia sees over a million GP appointments made each year, and according to some sources about 50% of them could be carried out via telehealth, with 30% of the population happy with the concept.

But is ‘sexy’ tech always the answer?

Some say that the problems the healthcare industry is trying to solve need fundamental thinking and service design before the really futuristic technology will improve things. The lack of data transparency is one of the true barriers to efficiency, as medical and patient information languishes in silos. The trade of doctors and health providers is in the information asymmetry that exists between them and patients - it comes from them knowing more than the patient, which means many aren’t keen to change that.

So while there is vast amounts of data being collected, it’s these information silos that prevent patients from making informed decisions and comparisons. Simple tech, like the internet itself, can prove to be the root of the disruption the industry needs - for example, it’s the basis of the Commonwealth’s massive investment in pushing the cloud-based ‘My Health Record’ initiative, an electronic record which aims to put patients in control by giving them a ‘360 view’ of their healthcare in one place. It’s proven successful so far on an opt-in model, and usage is predicted to increase exponentially when an opt-out model comes into play.

The healthcare industry knows that it needs to tackle three major areas to move forward - increase efficiency and reduce costs, improve patient outcomes and improve the patient experience - but it’s historically a slow and conservative beast thanks to its highly complex nature. It’s likely that it will be late to adopt AI, robotics and drones, along with many other forward-thinking technologies, too. One diagnosis is certain: the healthcare system is ripe to be ripped up and rebuilt, but for now we’ll need to keep it under observation.