Driven by a more conducive policy environment, enabling technologies, novel business models and more ubiquitous info-structures, the Canadian healthcare system is undergoing transformation. As captured in the infographic below, the transformation of healthcare can be summarized with five major shifts.
Traditionally, healthcare has been reactive, focused on responding to an individual’s needs once a symptom, event or illness has occurred. Proactive care stratifies at-risk individuals based on known algorithms and ensures that preventive actions are taken to intervene well before the onset of symptoms, let alone illness. This approach has long been recognized as vital to maintaining population health and protecting healthcare (or sick care) system resources so they are available only for the most acute needs.
The emergence of cutting-edge technologies and sophisticated machine-learning data algorithms is taking this shift to the next level, paving a way to not only stratify risk, but also to predict risk and intervene further upstream. This is called predictive care.
For far too long, healthcare has employed the one-size-fits-all approach for any given problem (whether it is an illness, condition or side effect). While a single solution may work for some patients, it often does not work for all. Personalized care takes the individual into consideration, tailoring treatment to his or her needs. Many factors can be incorporated when personalizing care, from the patient’s biological context (genome or proteome) to his or her sociological context (access to care, ethnicity or literacy level) to his or her own values (preferences, expectations or philosophies).
Healthcare delivery has traditionally been designed around the provider, located in institutions such as hospitals, clinics or doctors’ offices. Decentralized healthcare involves moving care out of resource-intensive institutions like hospitals and into new models of care delivery such as the home, community, school or workplace, or even into retail settings.
For centuries, the physician-patient relationship has been largely paternalistic. The doctor held the information and therefore led the conversation, made the decisions and dictated the actions to be taken, while the patient’s role in his or her own health was essentially passive. Increasingly, patients are demanding a more participatory role—and even a leading role—in their own healthcare. With the advent of the Internet, wearables, wellness apps and other technologies, patients are becoming more empowered and informed about their own health and this is resulting in a movement toward patient-centred healthcare.
Healthcare providers, like other professionals, require compensation for their services. This is typically done using a fee-for-service method, where doctors (or other providers) are compensated each time they provide a service to a patient (such as giving a consultation, writing a prescription, requesting tests or performing a procedure). With this traditional model, compensation is volume based, effectively incentivizing providers to try to maximize the number of patients served in any given timeframe. The alternative, value-based care, compensates providers based on outcomes. For example, if the goal is to reduce an individual’s risk of having a heart attack, compensation may be tied to the individual achieving smoking cessation, reducing his or her blood pressure or improving control over his or her blood sugar levels. The shift to value-based care incentivizes the desired outcomes, ensuring that providers strive to achieve them while also minimizing costs.