Towards the virtualization of healthcare

Before the COVID-19 outbreak, GP practices and hospital outpatients in the UK were providing around 400 million face-to-face appointments each year¹, while planning to save ‘300 million trips’ for patients through more digital GP consultations.¹ Telehealth in the US had surged with medical claims increasing by 624% from 2014 to 2018.¹

The growth of virtual healthcare offers pressurized health systems a chance to expand access to healthcare, cut their operational costs and address bigger systematic challenges: reducing waste; cutting foot traffic into the hospital and patient length of stays; bridging gaps between siloed clinical departments; and, supporting staff and patient journeys.

According to a report by management consultancy, Deloitte: “Virtual care also has the capability to inform, personalize, accelerate, and augment care across the care delivery spectrum, from disease prevention to treatment to ongoing monitoring.”² “It will enable simple collaboration and the sharing of data and insights across the complete circle of care. Taking the mystery out of care and treatment plans for the family and caregivers of patients, while maintaining privacy, becomes more effective in the virtual-care domain.”

Hospitals as buildings and service providers were designed to bring care under one roof; all in a single place so people would know where to go to when they were ill. Where do you go in a virtual future? Many of us are hard-wired to the concept of ‘hospital = care’, but as virtual care becomes integrated into processes and workflows, the very idea of the hospital - a place where care is delivered - changes quite dramatically. If healthcare becomes more virtual, then technology will begin to shape the physical design of the future hospital, how people interact with it, the activities it undertakes and what it looks like.

The hospital of the future is not a physical location with waiting rooms, beds and labs. It will be a network with nodes and connections. Technology will be the starting place of new spaces and will allow us to approach health and care in new ways.

Potentially, a virtual healthcare facility can reside anywhere - in your home, inside an old telephone box or in a public washroom. It is part of a wider healthcare delivery system. The hospital of the future is, then, not a physical location with waiting rooms, beds and labs. It will, instead, be a network with nodes and connections. Technology, in other words, will be the starting place of our new spaces and will allow us to approach health and care in new ways.

Healthcare will be accessible anywhere. A virtual healthcare experience will allow for continuous monitoring of patients anywhere, so that care is provided wherever and whenever it’s needed. This means retail-type outlets close to residential areas; specialist hubs, in-patient facilities, outpatient clinics and ambulatory facilities, all connected into a single network. In other words, technology won’t remove the hospital’s central role in care delivery. Instead, it will expand its reach beyond its own walls, to create a much bigger system, in which the hospital itself plays a less centralized role³. And in reaching that goal some key trends are accelerating change and addressing the operational challenges of hospitals.

Cited as ‘the major disruptive event of the decade’⁴ and purported by some to be a ‘Black Swan Event’⁵ – the term popularized by former Wall Street trader, Nassim Nicholas Taleb in his book Fooled by Randomness - COVID-19 stalled the hospital’s revolving door and kickstarted a shift to virtual care by immediately altering the way doctors and patients interacted, and reducing traffic inside hospitals.

Medical appointments went online, workers began remote work, equipment monitoring was adopted, elected procedures were delayed or cancelled. Remote monitoring technologies such as telemonitoring, telemedicine, mobile monitoring all grew at speed. Telehealth adoption rates lagged around 11% in January 2020 in the US—but spiked amid the coronavirus pandemic to 36% in August 2020.⁶

The revolving door of the hospital was already a big problem before COVID-19. In 2018, there were an estimated 142 million visits to emergency rooms in the US, up from 100 million in 2008.⁷ The pandemic highlighted that hospitals are too overloaded: covering too many different clinical specialties, accepting a wide spread of low-to-high acuity patients.

Jeevan Gunaratnam, a former NHS Director, who is now Director of Independent Sector & Community Diagnostics at Philips explains the issue further: “The bandwidth for hospitals to plan was reduced to zero during COVID-19. Patients also stopped going to hospital, delaying procedures, clinical work and elective procedures and staff were were quickly redeployed as part of the COVID-19 response.”

Jeevan Gunaratnam continues: “A lot of healthcare’s needs could be addressed without ever stepping foot inside a hospital. And if you do that across the board, you have reduced traffic inside the hospital and can reconfigure that hospital to deliver higher value care - more complex care and procedures that really add value.”

The use of virtual health technology for screening, monitoring, and e-visits, as well as the patient’s preference to stay away from the hospital during the pandemic, offered a glimpse of healthcare’s future. Could more healthcare be delivered virtually or elsewhere? Will healthcare as a result become more decentralized? Experts see a future determined by which clinical services make sense for a hospital and the speed of innovation around new care models that allow more space and ‘bandwidth’ for hospitals to focus on acute care. This inevitably drives a shift to models for out of hospital care as much as on-site care.

Stuart Wilders, Marketing Operations Manager for Solutions at Philips explains: “Separating patients out represents a new streamlining opportunity for healthcare. For a long time, hospitals have been accessible to everyone. There is a strong case for pinpointing the activities that don’t necessarily need to happen inside a hospital and shifting their provision to out of hospital care. If you do that across the board, you will reduce traffic inside the hospital and can reconfigure that hospital to deliver the more complex care and procedures that really add value. Patients also won’t have to travel great distances for diagnostics. Ultimately, this model supports the health providers in being better able to spread resources, knowledge and learning across the geography.”