Six Ways Future Healthcare Will Emphasize Individualized Care

For the next phase of healthcare reform in the United States, leaders will place more emphasis on individualized care—people keeping themselves healthier and out of hospitals, and finding ways to help themselves better manage their own health, according to a new PricewaterhouseCoopers' (PwC) HealthCast survey report.

Part of this individualized care is related to what is included in the new healthcare reform legislation signed into law last month. Embedded in the reform package are provisions that increase emphasis on illness prevention, positive health outcomes, better coordination of care, and comparative effectiveness research, which includes personalized or customized medicine.

And the U.S. will not be alone, with other industrialized countries following the same trend, the report noted. In response to the worldwide global recession and pressures to stop rising healthcare costs associated with chronic diseases, government and health leaders will likely encourage individuals to take greater ownership of their health—with healthcare systems finding new ways to respond to their needs.

"What is happening to healthcare is no different from other industries. The power of the individual is increasingly influencing how healthcare is directed and delivered, enabled by the technological and the virtual world we live in. And this is by no means a western phenomenon," the study noted.

PwC's Health Research Institute (HRI) conducted more than 200 interviews with global leaders and executives representing hospitals, government, pharmaceutical companies, insurance companies, clinicians, academics, and the business community. These interviews were conducted in more than 25 countries; HRI also surveyed 3,500 consumers in seven countries, and 590 leaders of health plans, providers, government, employers, physician groups, and pharmaceutical/life science firms in 20 countries.

PwC predicted that healthcare will be centered around a framework of six vectors that "customize diagnosis, care, and cure" for individuals. They are:

1. Incentive based payments. Public and private payers will be ending volume- and budget-based payments—instead moving toward payments based on patient outcomes. This could result in a redistribution and prioritization of health spending, PwC said. Three quarters of health leaders surveyed said they favored more incentives for physicians to follow best practice guidelines, and more than 80% of health leaders surveyed said more incentives are needed for patients to be compliant with their medications.

2. Broad-based regulatory reforms. For many nations to tackle major regulatory reforms, they will need to alter how behavioral, genetic, and medical delivery components drive personal health spending.

3. Funding. Worldwide, payment and financing are redistributing funding from sickness to wellness. A majority of global health leaders (80%) surveyed by PwC agreed that healthcare providers should be reimbursed on quality outcomes.

4. Patient communication. When PwC surveyed global health leaders about the most effective strategies to engage individuals in their own health, the top two answers were health education and greater awareness.

5. Electronic medical records (EMR) and IT. By 2020, health systems are expected to move from predominantly paper records controlled by the industry to digital ones controlled by individuals. Ninety percent of health leaders surveyed said making EMRs available to clinicians and patients would make their systems more efficient and effective—but this will be expensive.

6. Workforce. Seventy percent of health leaders interviewed by PwC said their systems would be more efficient if they had more primary care physicians; 79% said they needed more nurses. Systems must redesign care models to meet the expected workforce shortages amid demands for customized care, PwC said.

In addition, individuals' relationships with their healthcare delivery models are changing and will be shaped by five touchpoints that can make care more personalized. Health systems can use these touchpoints as a toolkit to assist patients in changing their roles in healthcare:

Coordinated care teams. Consumers said they want better coordination of care, according to PwC. However, 40% of health leaders surveyed said handoffs among clinicians are difficult or very difficult.

Fluent navigators. No matter where they live, chronically ill patients need help to navigate the health system on their own. While nearly half of global consumers said it was easy or very easy to understand their medical condition, consumers also said it was much harder to access a specialist than a primary care physician.

Patient experience benchmarks. Access to care was the top attribute that defined quality care, according to PwC's survey of global consumers. Many governments are responding to this by setting access targets, such as wait times for primary care, emergency care, and surgery.

Medical proving grounds. In PwC's survey of global health leaders, almost half said they thought medical tourism would increase in the next five years. The medical tourism industry will split between those shopping for low cost and those searching for new science and value.

Care anywhere networks. The definition of access is being redefined through the use of wireless mobile devices, PwC said. One third of consumers surveyed said they would consider healthcare delivered over the phone or Internet. Half of health leaders surveyed said they're expanding access to care in patients' homes, which are increasingly wired with networked devices.