SPECIAL REPORT: Advances in technology are changing the interaction between healthcare providers and consumers, providing greater competition and choice.
SPECIAL REPORT: Advances in technology are changing the interaction between healthcare providers and consumers, providing greater competition and choice.
Technological disruption is changing the playing field for the healthcare sector in Western Australia, delivering greater choice to customers and the possibility of lower costs for cash-strapped governments.
From startups adopting mobile phones for health checks to corporate giants such as Telstra seeking to leverage the advantages of more sophisticated IT systems, existing healthcare providers are now faced with a wide range of threats and opportunities, at the same time as governments increasingly hand decision making over to patients.
The more adroit players are manoeuvring to expand market share in this competitive and fast-moving environment, while those who can’t keep pace could come under threat.
While the federal government’s National Disability Insurance Scheme is turning that industry on its head – putting the consumer front and centre in terms of choice – the broader healthcare market is encountering such changes in a more piecemeal fashion.
In tandem with that change is the growing rise in costs, due to a transition from a healthcare system that dispensed cures to one increasingly focused on prevention of maladies such as obesity and mental illness.
WA Primary Health Alliance (WAPHA) chief executive Learne Durrington said the shift to preventative medicine reflected the growth in patients presenting with chronic conditions, as opposed to one-off communicable diseases, during the past decade.
“The overarching challenge for the whole healthcare system is the growing number of people with chronic diseases increasingly attending hospital,” Ms Durrington told Business News.
“With the change in the health status of the community, we haven’t really adapted the system of care to respond to that, so how care is delivered needs to change.”
This includes increased uptake of digital or telehealth services, and more services delivered at patients’ homes. Both offer reduced costs and reflect changes in consumer demand, she said.
Care delivery
This year’s Rising Star winner, Chemo@home, is an example of a business exploiting this change. It is a pioneer in delivering chemotherapy and other infusions at a patient’s home.
Chemo@home co-founder Lorna Cook said the business was founded in response to the consumer movement opting for in-home treatments.
“The medical model has reflected the way the world has operated; the doctor is the centre and everything revolves around them; the hospital, the nurses, the patients,” Ms Cook said.
“But that’s changing and patients are voting with their feet.”
During its first year, 2013, Chemo@home administered 500 treatments. Ms Cook said that number was predicted to reach 5,000 this year.
“We are at least half the cost and we can actually save them on a number of readmissions,” she said.
The home provider has also expanded its services into other illness areas, including multiple sclerosis and rheumatoid arthritis, and Ms Cook hopes the government will consider funding public sector patients in the near future.
“It’s a worldwide trend in consumerism to move treatment closer to home,” she said.
HBF managing director Rob Bransby backs the move towards greater consumer input into treatment options, and said service users would ultimately drive what happened next in healthcare.
“The way health has been delivered historically will never be delivered again into the future,” Mr Bransby said.
HBF has already assessed its delivery model and introduced its health partner strategy five years ago.
This enabled the insurer to more personally interact with its consumers beyond bill payment, offering services including fitness in the park sessions, weight loss programs and free flu vaccinations, encouraging users to engage more with their health on a regular basis.
Mr Bransby hopes the integration of technology will further increase HBF’s user interaction level.
“What’s interesting is that 98 per cent of Australians have a smart phone and a majority of those use their phone to live their life,” Mr Bransby said.
“If you get a text message, you look at it; if there are reminders, you do it. We’ve got to embrace that to help manage our health.”
Perth-based ResApp Health has taken the usage of mobile phones in health a step further, with its technology allowing a cough recorded by a mobile device to be analysed, testing the user for respiratory diseases.
Digital era
Mobile phones are only part of the technological revolution overtaking traditional models.
WA startup and 2014 Rising Stars winner HealthEngine has created a central data portal on a smaller scale, offering consumers an online booking service as well as the ability to compare information on choice of provider.
HealthEngine chief executive and 40under40 winner Marcus Tan said the ability to navigate the health system was complex and offered the potential to adapt a self-serve model similar to booking flights or hotels.
“We created HealthEngine because the health system, unlike many other industries, hasn’t really caught up when it comes to being able to offer transparency around where, what, when, all the usual things most other industries have visibility on,” Mr Tan told Business News.
“What we were doing was trying to create a central place where people could actually find all of that information.”
Since it was launched in 2012 and went national in 2013, the online booking platform now attracts about 10,000 practitioners and 1 million users across the country to the site each month.
In the past 12 months, a new type of functionality has been introduced, which Mr Tan compares to TripAdvisor.
It operates as a consumer comparison-oriented site, with patients able to locate bulk bill practitioners, view when they are available and what they do, as well as consider other patient’s recommendations.
“People can actually see where the good practices are,” he said.
“When being rated and reviewed, to some extent you can’t rely on just doing the run of the mill, you actually have to continue to impress; what that does is lift the game of the entire industry.”
Mr Tan believes this shake-up could assist in driving efficiency across the sector, but also encourage people to engage more with their health.
“Any time you have patients who are able to make better care choices for themselves and can actually navigate the system better, you’ll get efficiencies and you’ll also remove the duplication of services,” Mr Tan said.
Also offering what they promote as a TripAdvisor-like model are major health insurers HBF and Bupa, which last week announced they would invest in the development of fellow insurer nib’s existing platform, Whitecoat.
The digital platform currently carries around 35,000 registered providers, with the majority of those ancillary suppliers such as dentists and optometrists.
The new joint venture plans to expand this base into medical specialists and surgeons and increase usage of the site by leveraging the private health insurers’ combined membership pool of 6 million Australians.
Community engagement
In July this year, HBF launched HBF Activate, an entrepreneurial initiative that encourages the WA community to come up with digital ideas that could enhance different areas of health.
This month, participants will take part in several workshops, receive industry mentorship, and compete in a Hackathon weekend where they will build their idea into a prototype.
The top three winning solutions will be awarded $32,000 in funding to scale the idea into a functional product to take to market over a 10-week accelerator program.
He said digital technology had already opened what had traditionally been a closed shop (due to the lack of a central data location) to more innovation, competition and disruption in the industry.
“We as a health insurer need to get our ducks lined up to make sure we can participate effectively,” Mr Bransby said.
“Otherwise we’ll wonder what happened to us when suddenly the health of our members is managed by someone that has come out of left field … could be Google, or Apple, any of those players could emerge.”
New players
Arguably this is already happening in Australia.
Three years ago, telecommunications giant Telstra engaged its board to investigate how it could support the improvement of health outcomes via distinctive software and technological solutions. The result was Telstra Health.
Director of strategy and commercial Tim Kelsey said Telstra Health was now Australia’s largest healthcare technology service business.
“The business was set up with the backing of Telstra as a vehicle to deliver an operating system that would enable safe, efficient, high value services,” he said.
“Telstra Health is here to harness the information revolution for Australians; it’s about putting new digital technologies to work for patients and their professional advisers.”
Mr Kelsey said the objective of Telstra Health was to work with potential partners in both public and private health services in co-production, to configure technology around a particular problem rather than offer a boxed up pre-solution.
The government welcomed the new healthcare player to the sector by awarding Telstra Health the five-year National Cancer Screening Register contract in May this year.
Telstra Health won the bid to consolidate bowel and cervical cancer screening nationally, replacing the state and territory-operated system by delivering a single database with one record per patient. As of May 2017, the register will manage cancer-screening records for more than 11 million Australians.
In Perth last year, Telstra Health announced it had successfully implemented an electronic medical records system at the recently completed St John of God Midland Public and Private Hospitals (see hospitals list on page 23), providing access to data across different platforms and departments.
Telstra Health has also assisted Silver Chain in providing its Hospital in the Home services, and in July this year Amana Living partnered with Telstra Health using its eHealth platform to launch Amana Living eConnect, the nation’s first virtual support service for people living with dementia.
“We want to support ways in which health economies can share data securely and more effectively so that doctors, clinicians, ambulance services and patients are able to communicate in real time about conditions and treatments,” Mr Kelsey said.
The recently established Australian Digital Health Agency (which has today announced Mr Kelsey as its chief executive) also plans to leverage digital platforms to deliver a higher quality, more interconnected and more efficient health system.
This is considered a step towards the creation of a centralised depository for all the data about population health, and will assist in making information more accessible for both patients and provider.
WAPHA’s Ms Durrington said this idea of sharing data and forming strategic partnerships to collaborate in the market was key to ensuring the successful transition of the healthcare sector to a new era as consumers and governments demanded better outcomes and lower costs.
“We all know what the burning platform is and we all need to work in a way that winds back the cost,” she said.
“No single organisation or part of government can do this on its own; it is about working collaboratively across the system to work in a more shared direction to address the critical issues.”
