Why does my GP or specialist need to be in the same country as me, the patient? If I’m already paying out-of-pocket to see a GP (which some of us are) or a specialist (which most of us are), and I can undertake that appointment online, why wouldn’t I go with a service that has high quality, immediate availability, is easily accessible and affordable? If that happens to be in another country, does that really matter?
Much is made by the media of the coming wave of demand for health services, and the growing inability of our health systems to cope with the growth in the number of (largely chronically) sick people. In Australia, supply and demand projections for most State and Territory public health systems show that, on the current trajectory, healthcare will consume 100% of government spending by approximately 2040. Something has to give.
The panicked reaction of most governments in the face of this looming crisis has been to allocate a significant proportion of our limited resources to the acute end of the healthcare spectrum, pulling resources away from prevention and early intervention. This is a terrible strategy in the medium to long term and not a great one in the short term. If we can’t affect demand for health services through prevention and early intervention then we will never keep up on the supply side. There just isn’t enough money.
Enter digital health and the era of globalised healthcare. The possibility of new models of care, connecting patients and health providers through mobile devices and the internet. Supporting appointments with remote patients.
What the majority of health policymakers have forgotten is that, once we have digitised patient health information and many models of care, there exist a number of new possibilities for meeting demand for health services. And once we accept that these (often remote) models of care are not only possible, but likely to become the norm, there are some interesting consequences…
Why does my GP or specialist need to be in the same country as me, the patient? If I’m already paying out-of-pocket to see a GP (which some of us are) or a specialist (which most of us are), and I can undertake that appointment online, why wouldn’t I go with a service that has high quality, immediate availability, is easily accessible and affordable? If that happens to be in another country, does that really matter? Digital health is enabling truly globalised healthcare in new and exciting ways.
In case this seems a bit abstract, let me give you a personal example…
A little over two years I was diagnosed with moderate sleep apnea due to a prolapsed tongue base. Following a diagnosis through a sleep study, I now wear an mandibular advancement splint at night, which has stopped me snoring and massively improved my sleep quality.
In addition to this I discovered SleepImage – a digital health sleep device that allows me to perform a mini sleep study (whenever I want) in my own bed, assessing my sleep quality through a 2-lead ECG and a technique known as Cardio-Pulmonary Coupling. After wearing the device overnight, I can upload my data to my SleepImage account, and discuss the results with my sleep physician. Who just happens to live in Denver, Colorado. That’s half-way around the world from Sydney, Australia.
My point here is this… As an often out-of-pocket health consumer (and many health service providers have forgotten that we are consumers, not just patients), I will follow value, quality, accessibility and lower cost around the world. Increasingly for GP and specialist services that will mean that I am receiving health services from other parts of the world via digital channels. Obviously for acute and inpatient services this is much less likely, and certain specialities work much better via these modes than others.
Does this emerging model of healthcare delivery pose risks for quality and safety? Of course it does. Does it require greater regulation? Yes, it needs urgent attention. Is this inevitable? Just you watch…
And let’s just wait and see what globalised healthcare does for our assumptions about future supply and demand. I believe that some of our coming wave of healthcare demand will be met with high quality, lower cost overseas supply, acting as a brake on much of the rampant inflation in healthcare costs that we see today. Without doubt, our future healthcare system will be globalised.