In the report “Crossing the Global Quality Chasm: Improving Health Care Worldwide,” a committee of the National Academies of Sciences, Engineering, and Medicine calls for urgent, comprehensive efforts to transform the design of healthcare globally.
The committee believes that the care systems of the future will differ radically from those of the past.
Digital health technologies are key enablers to optimize health systems and improve the quality of care for individuals and populations, yet they are double-edged.
With the explosion of new digital tools over the coming years, new players will join the healthcare field. In particular, patients will become ever more active in consuming information about prevention and diagnosis; researching options for treatment; and communicating with care providers using a wide range of media, not just in-person visits.
The new health care system will focus more on prevention, risk factor management, and personalized care, using precision medicine and predictive models and with the patient at the center shaping the demand for and the design and delivery of care.
These changes will be disruptive, even threatening, to legacy structures, jobs, and beliefs, but they are inevitable. The committee believes that health systems need to embrace new digital care technologies, guided by a vision of patient care that is anticipatory rather than reactive; thoroughly integrated across time and space; and wholly centered on continually improving the experiences—the “journeys”—of patients, families, and communities.
The committee envisions these new designs delivering care directly to people wherever they are—in schools, in homes, or in market stalls—and relying far more on community resources and far less on formal health care facilities. This shift will require new skills, attitudes, and culture among healthcare providers and new, more active roles for patients and families in shaping, evaluating, and delivering the care they need.
Payers, academics, patient groups, health care networks, and medical product development and technology companies in the private sector will need to develop multi-sector governance mechanisms appropriate for these new models of healthcare delivery to maximize their benefits and minimize their risks. Co-design and coproduction of health care between providers and patients, as well as consideration of human factors in the design and use of technology, will become the norm, with benefits to both.
These changes will necessitate attention at multiple levels. The question of whether the technology will be, overall, a disruptor that improves or worsens quality remains unanswered.
Currently, many countries exercise little regulatory oversight of care and little use of care guidelines to ensure quality. That will not suffice in the future healthcare world or in the era of UHC.
Ministries of health will need to accept a dual role: identifying and applying policy, financing, and regulatory frameworks to accelerate the growth of new, digitally assisted health care, while also remaining mindful of quality and mitigating the risks of these new care models.
They will need assistance in taking on these roles. Global partners, including private companies within both the healthcare and information communication sectors, have new opportunities to join ministers of health, health care leaders, and other stakeholders in pursuing a joint path forward that will benefit all parties as technology advances.
Health systems within each country will need to embrace this transformation in partnership with one another, while anticipating and mitigating the risks that such changes will bring.
National Academies of Sciences . Engineering . Medicine
Crossing the Global Quality Chasm, Improving Health Care Worldwide, Report, Aug 2018