At the start of this brand new year we talked to Tim Heymann, part of the faculty on our new Healthcare programme, about the challenges Healthcare professionals now face and some of the opportunities Healthcare leaders can grasp.
Tim Heymann is a reader in Health Management at Imperial College Business School and a senior Consultant Physician and Gastroenterologist at Kingston Hospital.
He is also a non-executive director of Monitor, the system regulator for the National Health Service in England.
Why is healthcare one of society’s biggest challenges for this century?
“Healthcare is becoming a resource challenge for all developed economies. We have been successful in large part in eradicating or at least effectively containing acute disease and so have managed to create a care ecosystem in which acute health challenges have lessened for most people.”
So, has our focus shifted to the management of chronic disease in our technology driven, rich society?
“The increased life expectancy to which healthcare successes have contributed, for instance in the remarkable fall in perinatal and childhood mortality, has meant societies’ demographic has become older. If someone lives longer he or she has longer in which to gather more diseases!
The role of a public health system is, and always has been, to deliver healthier lives for the population – but the more successful healthcare has been in doing so, the more demand for health resources [to manage older people with chronic diseases] we create.”
With this challenge – the rise of chronic disease – in mind what might the future of healthcare within and around the NHS look like?
“People could take up the time of hundreds of thousands of clinical professionals in face to face care, the traditional approach which is increasingly unaffordable.
We now have a tremendous opportunity to change the way we think about delivering heathcare and in particular using digital technology to support “clinician-light” self-care. Such digitally ‘guided diagnosis and simple treatment’ that people could use for themselves must make financial sense for the NHS – and delivers the ultimate in convenience for people too as digital diagnosis and treatment may all be possible from the comfort of people’s own homes, at a time to suit them.
People have already started to monitor themselves using sensors and devices, and go online to use internet-based symptom checkers for first-line diagnosis.
“Safety netting” with easy access to clinicians, perhaps because of digital access complexity or unusual uncertainty, would remain and may be more accessible than today if those same clinicians do not have to spend their time on simpler diagnoses and treatment with which the digitally-enabled patient could now be best equipped to deal.”
In conversation it became apparent that part of the solution, this new dawn of Healthcare, has already made itself known in our lives.
Many of us are using connected sensors, creating a bluetooth enabled picture of health across the nation. Garmin, Fitbit, smartphone apps and other sensors already map a top line picture of our activity, heart-rate and behaviour, to a certain degree for many of all ages.
How we face up to the challenge of these growing data sources and combine them with the traditional, legacy insights that can be drawn from existing GP and hospital records is one of the frontiers of Healthcare.
How a pioneering spirit and creation of a data-culture could be part of the picture was discussed at Imperial’s Global Business Vision event held in Hong Kong recently, in association with KPMG.
Our instinct, as believers in the empowering nature of modern technologies, would tell us that connected sensors and interfaces – the technology of remedy – would be central to patients being taught how to better manage their symptoms, adhere to medication requirements and maintain mobility and a good quality of life, all without having to leave their residence.
However, Tim pointed out that this could create panic as well as opportunity:
“Any introduction of significant changes in expected Healthcare behaviour needs education; peoples’ expectations will need to be managed carefully. The initial investment in the digital enablement and public education in order to empower self diagnosis and treatment may be substantial. I expect that NHS commissioners and providers, the independent sector, insurers and Government will all need to contribute. But I am confident that the long-term benefit will repay in spades the wisdom of that investment.”
In 2011 a “whole system demonstrator” study for the remote delivery of care – which can be found here – produced disappointing results, perhaps in part due to the limitations of the technology then available.
But does that actually mean the concept is wrong or was it that the education element around the introduction of new behaviours, how to make sense of a new process, was not delivered correctly?
Only further Healthcare pilots will give us the insights we need to pursue our knowledge and understanding of this exciting area.
What are the current economics of the situation?
“Our main cost within the NHS system remains people’s salaries. Any intervention that successfully minimises the physical interaction [between patients and healthcare staff] should free up resource to increase capacity. We need to tackle the demands from an expanding, ageing population without bankrupting the nation.”
One critical element that will help healthcare leaders perform to their best in delivering 21st century Healthcare will be access to the right education and advice. It is no longer enough to be an experienced and skilled practitioner in our increasingly complex world. We must take responsibility for expanding our knowledge and skills to cover innovation and “learn how to learn and adapt” to successfully tackle those Healthcare challenges that society creates.
As a professional with current experience of the UK Healthcare system, what makes a great Healthcare leader? What are the qualities they now need to demonstrate?
“I believe that the most effective leaders in healthcare increasingly need to be open and inclusive. They need to have and share a vision of the future, and be able to accurately chart the direction of travel to reach that goal. The current, recognised ability to maintain the status quo will not be enough. Great Healthcare leaders may be as truly rare as the challenges are great but I am confident that some will step up to the plate. In recent years Healthcare leaders have not had the freedom to make innovative and experimental choices as they have been limited in their freedom of action by resource constraints and political exigency that demand they manage by objective, to meet the latest targets. And despite the rhetoric, NHS structures have proved a block to placing resources at the most appropriate places in the patient journey – for instance in a patient’s home rather than GP surgery or A&E department (owned and run by the hospital) rather than a walk in centre (owned and run by GPs or the CCG). That needs to change too.
And finally… Why is Imperial, in your eyes, a critical part of personal development for healthcare professionals ?
“In my view Imperial College is THE place for healthcare-related research and education in Europe. The College has a track record of innovating with technology and the biomedical sciences for over 100 years. It includes the UK’s biggest medical school and largest academic engineering and technology research facilities. If we are to succeed in meeting the challenges that Healthcare faces in the 21st Century, we need to bring together and apply all such multi-faculty knowledge. For all these reasons I believe that Imperial is THE place to develop our new Healthcare leaders and translate new technology, business understanding and change management competencies into the successful delivery of modern Healthcare.”
This article is part of a series of interviews where we have been talking to some of our programme leaders about how to inspire change and predict future need.