Facilitated Panel

Topic: Taking us towards tomorrow – envisioning the 21st century when e-health is embedded across the health sector

Shane Solomon, KPMG
John Wilson, Monash University
Mukesh Haikerwal
Omid Moghadam, Harvard Medical School
Ivan Pedersen, Connected Digital Health, Denmark
Steven Murvey, Consumer Health Forum
Mike Bainbridge, NHS

Q: What will patient-centred healthcare look like in 2025?

  • This is a generational change ie Gen Xers will be in the late 40s and 50s and everyone younger than that would have been born into an age where technology is pervasive
  • New models of care that are home and community based and include the family and the personal care network.  ‘First responder’ doesn’t need to be the clinician.
  • We have seen enormous changes in the past 15 years so what we will have in 2025 will be vastly different than today.  The role of clinicians will be vastly different.  Medical technology will be pervasive and in the home.
  • Lots of technology, yes but clinical skills will remain important.  The ‘personal’ touch will always be needed.  Marry the ‘new’ with the personal to create a more complete and affordable healthcare system.
  • Reduced fiscal budget to finance healthcare.  Who will have access and where will the $ come from?
  • We will want 21st century, evidence based healthcare served up in a martini – immediate, easy.
  • Workforce challenge – who is going to do this work, provide the care?
  • Managing healthcare will be a community effort.  Consumer at the centre who will decide who and in what circumstances their information is shared.  They will have choices of shared care, a wider network of who they may choose to be involved in their care.  Consumer will take the directing role.
  • Won’t need the ‘bricks and mortar’ – will need the technology to link up to and receive care

Q: What advantages will the 15 year olds have that the 65 year olds won’t have?

  • Better health literacy
  • Ubiquitous choice.  Wider variety of choice, even in rural and remote areas.  Will be able to consult and connect more widely.
  • Healthcare will be more ubiquitous, part of daily life instead of the episodic care we now focus on.

Q: How much control will patients have over the management of their own healthcare?

  • Will depend on the individual.
  • With power comes responsibility.
  • Perhaps the role for intermediaries will arise (government or privately funded intermediaries).  Eg to collect, critique, analyse, share and translate medical information becomes a service consumers can subscribe to.

Q: Challenges:

  • Healthcare organisations tend to be conservative and difficult to change.
  • Data stored in islands that are not communicated.
  • How do you increase the health literacy of consumers?  High levels of literacy are important and what will happen to those who aren’t?
  • Investment in e-health literacy is needed.

The NHHRC blueprint stated healthcare should revolve around patient and described a self-improving, agile system.  See report at http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report

Q: Multi-disciplinary healthcare teams

  • We are on that path now.  Legislative changes have supported it and we are seeing it in practice.
  • Necessity is the mother of invention – we are working on how to leverage the limited resources we have now.
  • It will be more acceptable in the future.  Coordination of working together will happen because we will have the tools to
  • Active participants, delegation and coordination is key.
  • Transparency allows better communication within the team and also permits collection and analysis of data to prove outcomes.
  • We already have a multidisciplinary team, they just don’t have the tools to communicate.  Totally uncoordinated and totally relies on the patient to facilitate information exchange.

Q: To what extent will I be monitoring myself?

  • Labs on chips will be prevalent
  • The more you can monitor yourself, the cheaper it will be.  There will thus be a financial incentive to self-manage and self-monitor.

Q: What will be the new models of care in 2025?

  • Model has to focus on health literacy and be ‘a darn sight better than call waiting’
  • Hospital in the home – it is there already but will be better because it has access to the record.
  • Ageing at home will provide most advantage to a cohort that needs much better care and who need to and want to stay at home.
  • The future is already here, it just isn’t evenly distributed, William Gibson (sci-fi writer)
  • Technology needs to spread further and be more accessible to everyone who needs it.
  • Medical technology will continue to become part of a consumer market and will make medical care at home more feasible.

Round of applause from 51% of the audience when Ivan from Denmark noted that there should be women and younger people on a panel talking about the future!!!  (my only comment in this blog – well done Ivan!)

Q: What factors will make PCEHR a success?

  • How well it fits my needs as a consumer and as a healthcare professional
  • Perceptions of  consumer risk to opt in
  • What makes it worthwhile me signing up?  Eg a GP says he won’t be ready to exchange info electronically until 2 years, then perhaps I change GPs?
  • Perceptions and delivery of benefits to consumers.
  • 3 major barriers – 1) have to have adequate funding; 2) skills and knowledge to use it; 3) utility – easy to use, straight forward interface
  • Persuading the current gatekeepers and controllers of information to ‘hand it over’ will be critical.
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