Advances in science, technology and manufacturing have changed many facets of our modern lives. These breakthroughs often lead to greater efficiencies which in turn bring down costs.
At least, that’s the theory.
But in healthcare, it simply doesn’t hold. Our industry has been greatly affected by ageing populations, poor lifestyle habits, increases in certain chronic diseases, greater patient expectations, patient over-use of unnecessary services/procedures, ever-changing regulations, along with both the benefits (and of course costs) of new treatments powered by scientific and technological breakthroughs. The list goes on.
The Economist Intelligence Unit looked at 60 countries and concluded that annual global spend on healthcare steadily rose in 2014 and, with a slight shrink in 2015, is expected to return to increases from 2016 onwards for at least two years. Those in the industry know that it’s almost certainly going to be longer.
Here in the UAE, the healthcare spend is anticipated to hit Dhs71.5bn by 2020. That means likely annual growth of 12.7 per cent each year.
In some cases we can attribute this spending growth to an increase in demand, but importantly when we look at the picture for individual companies providing healthcare for their employees we are simply seeing costs go up and up with no end in sight.
This is not a situation that is tenable for any business that must simultaneously control costs while delivering quality healthcare to their staff.
So is the situation as desperate as it seems? Or are there in fact ways you can translate healthcare advances into genuine cost savings for your company?
UAE healthcare costs: Where we are and where we need to be
In many industries around the world, technology has been utilised to help lower costs, increase productivity and improve quality. But this has not necessarily been the case in healthcare, with a US Congressional Budget Office report in 2008 stating: ‘Roughly half of the increase in healthcare spending during the past several decades was associated with the expanded capabilities of medicine brought about by technological advances.’
So some of the breakthroughs which should be reducing costs are in fact increasing them. The solution therefore is all about application – how and when these new breakthroughs are used. With that in mind, let’s examine a few examples to give a sense of how you can continually improve medical outcomes while reducing both short and long-term spend.
• Pharmaceuticals: New-to-market, cutting-edge pharmaceuticals are not cheap. But new medications also bring with them the potential to reduce costs when compared to more expensive, longer-term treatments. So it’s a question of selection. In keeping with the ‘prevention’ approach, there are many new drugs that have preventative qualities. Just to give an example, the Pre-Exposure Prophylaxis (PrEP) drug has been shown to work in the prevention of contracting HIV. So the saving here would be around not needing to provide long-term treatment and care. Other diseases such as Parkinson’s disease and Alzheimer’s may also one day have a similar drug available that is able to limit the number of cases per year, and ultimately the need for as much long-term management.
• Technology: We’re not just talking about expensive MRI and CT scanners that help analyse and diagnose illness and injury in a more efficient and accurate way. There are also advances in remote treatment of patients, with physicians keeping track and monitoring from a distance those under their care. This use of telemedicine (video conferencing where patients consult doctors, undergo tests, or even have cardiovascular or hypertension conditions monitored) means less out-of-office time and travel expense – and is particularly effective when the patient is in remote areas of Africa, Asia or Australia for example.
For those companies with staff based in isolated areas, there are real potential cost savings here.
Other advances such as Google’s diabetic contact lens development – which allows the wearer to monitor blood sugar levels in conjunction with an app – are emblematic of the progression of technology and how it can change the way we manage our health. As always, it’s either preventing or at least staying ahead of the problem.
• Clinical: Procedures such as the introduction of keyhole surgeries – which allow for speedier recovery times and mean more patients can be treated as outpatients – are developments that have the potential to save costs. Keyhole heart surgery patients are usually discharged from hospital in days rather than weeks.
Meanwhile, musculoskeletal disorders (very common among office workers) may in the worst cases require medical treatment – and often these procedures can be carried out with the patient returning home the same day. Laser surgery to treat cataracts also speeds up theatre time and reduces costs.
• Processes: Refinement of processes and finding and sharing ‘best practice’ is a concept that is familiar across all businesses. It allows people to work in the most efficient and cost-effective manner possible, and it’s no different in health centres and hospitals. Finding ways of working more effectively is a tried-and-tested method to reduce costs.
This might be the recycling of a patient’s own blood during operations to preserve stocks, or gaining consensus among multiple orthopaedic surgeons to all use the most successful prosthesis (from a single manufacturer) to reduce re-training time for their teams.
Ideas versus implementation
Medicine advances all the time. Whether it’s the pharmaceutical companies releasing ground-breaking drug treatments, new clinical methods, or the application of pioneering technology – there is an almost constant progression in the world of healthcare.
But as we have seen from the 2008 report by the US Congressional Budget Office, it’s not automatic that the introduction of new procedures and equipment will reduce healthcare spend. There has to be a framework in which the best possible treatment and care is provided for the patient, with a desire and focus on making changes to prevent disease where possible.
By driving an efficient approach across clinical, tech, pharma and procedural areas, management and physicians can guide the industry to a leaner operating model without compromising levels of care.
The year-on-year cost rise has to be controlled – the leaders of the industry in the UAE have a responsibility to steer it towards a more affordable and all-encompassing service.
Implementation of practice and procedures that allow consistently efficient methods of operation will lead to cost savings and a strong sustainable service. And with the next series of medical advances waiting around the corner (including the possibility of cardiovascular conditions and even diabetic foot ulcers being healed by a patient’s own stem cells), the future is rapidly becoming the present.
With lightning fast innovations being presented ever more frequently, it’s already crucial that we learn to work in professional and competent ways which mean that we have a sustainable and scalable system that is also in control of its financial responsibilities.
There’s so much more in the pipeline for healthcare – so we as an industry need to make sure we’re ready to handle tomorrow, today.
Mark Adams is the founder and CEO of Anglo Arabian Healthcare