“When we step back and look at how the current healthcare system delivers value, we see that the system is often based on a fee-for-service approach. Within this model, the medical system is reimbursed regardless of whether the patient feels better or not. As the world changes, life expectancies increase and people all over the world will begin to live longer, potentially experiencing more illness in their lives, a new way of thinking may be required to fit the new status quo.”
Jonathan Keytel, Head: Healthcare Transformation and Sustainability a Roche Diagnostics discusses sustainable healthcare and end-to-end solutions from the patient perspective – What is the ideal and could there be more to healthcare organisations creating shared value for the patient, the healthcare system and themselves?
“When we step back and look at how the current healthcare system delivers value, we see that the system is often based on a fee-for-service approach. Within this model, the medical system is reimbursed regardless of whether the patient feels better or not.
“As the world changes, life expectancies increase and people all over the world will begin to live longer, potentially experiencing more illness in their lives, a new way of thinking may be required to fit the new status quo.
“About 10 years ago, Michael Porter, a marketing specialist, wrote about a new model for healthcare systems called ‘Value-Based Healthcare’. This approach considers value delivered through the lens of the patient. In this model, instead of going to the doctor or facility and paying regardless, the reimbursement to the healthcare providers in is based on improved patient outcome. This approach will deliver better value for the healthcare system in time and will create the more efficient use of resources.
“As most of us know, this system is not in practice yet, by a longshot. But the idea can get us thinking more about value from the patient’s perspective. This is where the idea of end-to-end solutions for the patient comes from; where we consider the patient as the heart of the healthcare system, and we map out a patient journey that considers the value offered at multiple points.
“The patient journey is not a new concept. Companies have employed the idea for years to understand where they can play a role, in terms of solving patient challenges. There are many barriers to receiving healthcare, particularly in resource-limited settings in Africa. These barriers are multi-factorial, encompassing supply chain, the physical infrastructure and clinical capacity, among other things.
“As healthcare service providers, we must work harder at understanding the patient journey. For example, there are many people who don’t even know that they have something wrong with them. Hepatitis is a major example of this. People may be infected without symptoms. And in Africa particularly, the journey has to start with education and awareness.
“This can lead to screening and then diagnosis. The next part of the journey is identifying solutions and asking the pertinent questions, ‘Can we cure you?’ and ‘Can we treat you?’ or ‘Is it a chronic condition requiring chronic medication? When you join the dots on all these answers, you come out with a clearly mapped patient journey.
“In the past, a single company may have done screening or diagnosis exclusively. But to really deliver value for the patient, organisations at different stops in the journey must join forces. One organisation on its own does not have all the answers, nor can they possibly have all the products and solutions.
“This brings us back to the concept of value-based healthcare. And this is where inter-organisational collaboration will be key. If we create partnerships that significantly create value across the patient journey and create access to healthcare in a non-competitive environment through cooperation, as the number of partners in the chain expand, the opportunities for competitors to overlap and collaborate increase. It is simply a case of identifying where exactly companies can cooperate.
“To make this new cooperation work requires us all stepping into a new space known as ‘coopetition’. The idea is that industry players that may usually be considered as competitors can collaborate as long as they identify areas where there is no direct competition. This approach could be considered a form of strategic alliance, however by specifically focusing the approach towards creating increased value for patients allows us to unlock new sources of shared value for the industry while better serving our patients.
“Within the identified value chain, everyone plays a critical role in understanding their relative impact to overall value creation and assigning proportionate value-share based on input. It’s not about marginalisation for anyone involved in terms of getting paid. It’s about cooperation driving more value for the patient and healthcare system in the bigger picture.
“With the country moving towards national health insurance, we are going to have to become more efficient in how we spend the money we have for healthcare. Ultimately, our goal is to make people well and prevention will play an increasingly important role. The best value for the patients is for them not to get sick at all. It’s about early detection and awareness. This represents a shift in how the healthcare system is reimbursed for the value they create.
“This adds value to the whole system as there are fewer people to look after and it is more manageable. We are living in a different world due to COVID. We have had to revaluate how we operate at so many levels. An ideal way to do it is through a renewed focus on patients, end-to-end integrated solutions and new styles of partnerships between healthcare players”.