What’s the role of the private sector?
The UK’s Department of Health and Social Care announced in July a collaboration with Amazon to enable people to use Alexa’s voice-assisted technology to source medically verified information from the NHS website. The Secretary of State for Health and Social Care, Matt Hancock, alluded that this move was part of a broader initiative to make more digital healthcare services available over the next 10 years (for more details see the NHS Long Term Plan).
In Mr Hancock’s vision of the future of healthcare, the innovative use of technology plays a significant part. He stressed that, to enhance health services offerings, their delivery methods and clinical and administrative workflows, the collaboration with Amazon would be the first of many, saying, “I want to see us build similar relationships with Google, Apple and anyone else who is building the tech that people use and rely on every day”.
Innovating healthcare from outside
The private sector has played an ever-increasing part in bringing innovation to healthcare, highlighted by the above example of Amazon’s Alexa dispensing voice-assisted advice. Over time, the scale of these activities has grown, as has the private sector’s hunger to set up alternative healthcare delivery options of its own, outside the bricks and mortar of traditional healthcare institutions. Other examples of the NHS teaming up with private sector companies, in this case for remote video appointments with GPs, include Babylon Health, Push Doctor and Now GP.
Healthcare institutions co-innovate with industry
The industry’s work with the healthcare sector typically consists of a cooperation between a healthcare institution and an industry partner, where the former commissions the latter to innovate workflows and service delivery. Often this entails users being involved in the product development on an ongoing basis to ensure solutions perform optimally.
There are lots of examples of such joint innovation initiatives. One involves the Marienkrankenhaus, a hospital in Hamburg that’s been working with neighbouring start-up apoQlar to introduce new technology to the operating theatre. apoQlar’s Virtual Surgery Intelligence solution projects patients’ two-dimensional CT and MRI images, which are transformed into three-dimensional anatomical maps, into the space above the patient’s body part to be operated on, making the use of screens redundant. Surgeons wear mixed-reality glasses to see those 3D projections while the patient’s body remains visible, and they control the system with speech and gestures. In addition to MRI and CT images, this new technology can also display other relevant patient data such as surgical reports and lab data. Both the involved surgeons and apoQlar have been working closely together to optimize the solution so that it can allow for more-precise surgeries with lower risks.
A shot in the arm from external players
More recently, companies foreign to the healthcare sector have put a lot of effort and resources into exploring new ways to deliver healthcare. Often, these players have a background in the consumer or retail industry, offering a very different outlook on how healthcare can be administered. They also tend to take a longer-term view on their investment and so are more likely to command larger sums of cash reserves and sophisticated IT know-how than those that have been traditionally operating in the healthcare field.
A lot of innovation in Europe has focussed on telemedicine, with companies like UK-headquartered Zava offering written, asynchronous online consultations in several European countries to patients seeking medical advice. Making healthcare more convenient has been a powerful force in modernizing patient care. Retailers in the US have been especially active in this field. Walmart opened primary care facilities known as Care Clinics offering diagnoses, preventative services as well as the treatment of chronic and acute illnesses in three states. Pharmacy chain CVS expanded its medical service portfolio after buying Aetna, the third largest health insurer in the US in 2018. Alongside its well established walk-in clinic service, MinuteClinic, CVS has begun to address patients with complex needs in so-called “health hubs”, projected to be installed in 1,500 of its stores by the end of 2021. The hubs are set up to provide care for patients with chronic conditions such as obesity, high blood pressure and diabetes.
A private haven for patients
The most notable example is Haven, a non-profit joint venture created by Amazon, Berkshire Hathaway, and JPMorgan Chase. The goal is to transform the way that 1.2 million of these companies’ employees and their families have their healthcare needs met. In the process, Haven wants to come up with new forms of engagement that improve quality, cut costs and can be circulated around the healthcare system. Surgeon and author Atul Gawande assumed Haven’s helm as CEO in July 2019 and formed a leadership team. Expectations are high, but Haven’s programme remains a conundrum. In the search of disruptive reform, Haven can afford to try, fail and try again, for as long as patients’ safety isn’t compromised.
Is innovation by private sector future-proof?
Maybe there’s no clear answer to this question. Healthcare organizations around the globe have been looking into success stories in other sectors to transform ailing healthcare systems, but their sector remains a special case. Medical services are highly regulated, complex, constantly evolving field and must not put life at risk with a half-baked trial-and-error approach. In addition, the influence and resistance of established companies, governments and patients should not be underestimated.
There are also valid concerns about the long-term viability and reliability of the activities of private companies in healthcare delivery. The UK has seen some spectacular outsourcing failures, where private companies dropped contracts after failing to make profits, leaving the NHS to revive service provision. For example, Virgin walked away from its contract to provide services to frail older people in Staffordshire and Serco prematurely ended its agreement to manage Cornwall’s out-of-hours GP service on behalf of the NHS. Not only were its profit margins squeezed, Serco was also accused of having manipulated its performance figures. This has tarnished the public’s confidence and there are also fears among healthcare providers that the efforts of the private sector will add further to the fragmentation and complexity of healthcare. Bringing in new services without streamlining existing ones could add yet another layer of complexity to healthcare.
Maybe there’s a happy medium, weaving private sector’s fresh approaches into a governmental framework that ensures the well-being and safety of patients prevails short-term gains. It certainly will need a more rigorous screening of the financial soundness of private sector hopefuls.
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