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Changing realm of healthcare

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Dr Sweta Choudhury, Head – Medical Product & Services, Nightingales Home Health Services talks about the growing consumerism in healthcare and how it impacts healthcare services, systems and approaches to care giving

A Doctor uses his knowledge, experience and judgement to diagnose the patient’s condition and prescribes a treatment plan. The patient  adheres to the advice given to him. If the condition improves, well and fine, if not the patient reaches out to the doctor again. The doctor evaluates how the disease has responded to the treatment plan and prescribes an alternate plan to treat the condition. There are two important things to note here – the patient goes to the doctor to avail the ‘service’ and the doctor treats the ‘disease’. These two aspects are undergoing a major change.

Consumerism in Healthcare

Historically, the doctor and the patient have communicated unidirectionally wherein the patient is passive and excluded from making choices. Healthcare is a complex system and patients has often been secluded from information about the disease, treatment options and clinical quality parameters.

Today’s patient is the new healthcare consumer. The patient has a lot of expectations from the doctor other than mere treatment of the disease. Dr Google has already educated the new consumer on the difference between hemodialysis and peritoneal dialysis. The diabetes patient knows the optimal levels of HbA1c. The healthcare consumer is eager to know more about his condition. Internet has already opened the floodgates of information to him. Plethora of symptom checkers are helping him play around with the correlation between symptoms and disease. The patient approaches the doctor with a lot of questions and expectations. A patient is eager to know why a particular test was prescribed to him. Why should he consume less salt if he is hypertensive?

Service on demand

The patient does not expect only the service. The consumer also expects timely service, service at his convenience and a good packaging of the service too. Few common examples include birthing suites during pregnancy, refraction test at home, quick laboratory tests with newer PoC diagnostics devices, medical records at his tips with electronic health records, nurses at home and if required, even the dental clinic can come home.

Healthcare organisations are also studying the consumer behaviour and trying to understand their needs. What is convenient for them? How can healthcare services be made more accessible to them? How can the discharge process be made quicker and smoother in hospitals? How to decrease their wait time at the OPD?

Customer feedback is equally important in healthcare. Organisations are investing more and more in getting to know the patient, his family and their preferences. Merely providing healthcare services are not important, quality and convenience are equally important.

With many services and offerings available online, the consumer has full access to information. The consumer has multiple options for a service. Online reviews further aid the consumer in making a choice.

Consumerism in the long run…

An educated patient is an empowered patient. The patient is eager to know about his problem and understand it. The moment a Doctor makes the patient a part of the treatment journey, half the battle is won. Now the patient is in-charge of his health. A diabetic patient now knows that he should not be eating more sugary foods because his insulin production is not high enough to combat the sugar. Regular walks will help him in improving his metabolism. A push from the doctor is not required anymore.

Systems approach to chronic disease treatment

We have been observing the epidemic of chronic diseases taking over a large percentage of the population. Doctors have been treating Diabetes type II, hypertension, etc. It is no longer so. The chronic disease is affected by a multitude of factors. The patient’s genetic makeup, health condition, family history, habits and environmental factors affect its progression. Frequently, there exists many co-morbid conditions in a patient with chronic diseases. This makes every patient unique. A patient with hypertension and diabetes in an affluent family needs to be tackled differently than a hypertensive patient who is a labourer, both being in overall interests of respective patients. The focus has shifted from ‘treating the disease’ to ‘treating the person as a system’. Hence, patient profiling in chronic diseases is very helpful. Patient profiling and predictive analytics can help in planning better treatment in the future. As we gather more and more data for the population of a country, we help in fine-tuning the algorithm which is running the analytics on the data.

Technology aiding consumerism

IoT has played a major role in the birth of the enlightened patient as a consumer. Wearables and fitness trackers are commonly used. The new consumer knows the importance of exercise, keeps monitoring his daily steps on a pedometer and knows what his optimal blood pressure values are.

Organisations know that they cannot exist in silos. Fitness trackers are being integrated with other systems. A seamless experience to the consumer is the key. The glucometer must capture the data and show-up in patient’s EHR. The weighing machine is helpful if the weight is captured and BMI trend can be shown on patient’s electronic health records. Medication tracker should throw up reminders for daily consumption and refill. And all of this should be present at one place. Multiple apps and multiple logins for different health data is not acceptable to the new-age consumer.

Patient-centric approach enabled by technology convergence including connected devices and digital health help in early adoption of preventive measures and quicker intervention, as and when required. The patient has taken a new avatar in the form of a healthcare consumer. Demand is for personalised care as per his convenience with high clinical quality and in a holistic way. After all, the doctor’s aim is to see people lead healthier lives and consumerism is aiding it!

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