Driving better patient outcomes
The national service plan for health is focused on the delivery of the right care, at the right time, and closer to home. This can be achieved through reimagining care pathways, understanding needs, and leveraging data and technology to improve patient and clinician experience, writes Claudia Carr, Partner, BearingPoint Ireland.
The introduction of healthcare regions by the HSE, was driven by the benefits to be achieved through the decentralisation of decision making to allow for a more localised management of healthcare services, and reflect the different needs of local populations. There is international evidence to support that this approach leads to better patient outcomes, wellbeing and overall improved efficiencies of the delivery model.
Transitioning to a delivery model that supports this goal requires close collaboration and coordination between all parts of our health system. This goes beyond primary and secondary healthcare providers and includes roles that are played by other healthcare professionals, pharmacies and community support services.
In a fragmented system with several stakeholders and record management systems, the challenge becomes identifying what is the right care, where is the right place and when is the right time.
New possibilities
Improving patient experience and outcomes requires a holistic approach to patient care. Both patients and healthcare providers must be involved in the design of care pathways.
In many cases the cost of early intervention, and preventative measures, reduces the risk of complications at later stages in the patient journey, many of which can result in a significantly increased cost of care and poorer patient experience. For the most part patients themselves can be empowered to manage and understand their own needs and when intervention is required. Responding to those needs rapidly, is key.
Challenges in accessing GP services can lead to an increase in presentations for unscheduled care in acute hospital settings including already crowded emergency rooms. However, the ease of access to digital systems, and advancements in AI technologies, can alleviate some of these pressures and reduce the risks of delays in accessing support services for day-to-day healthcare, in addition to mental health support services and management of chronic disease.
Irish private healthcare insurance providers now report that between 20 per cent and 30 per cent of GP consultations are now managed through digital channels. For the most part, these appointments are scheduled at a more convenient time for the patient, have a shorter wait time and can be completed in the comfort of their own home, reducing the need or cost of travel. They are also working directly with pharmacies to administer vaccinations. Such measures are generally more convenient for patients, but also release capacity and wait times for community-based GPs for in-person consultation with patients.
With 46 per cent of Europeans experiencing mental health challenges, demand for services is increasing, and accessing treatment can be challenging. Generative AI is being used by clinicians to quickly diagnose, assess patient needs, and prioritise appointments.
| TalkToAlba is a Generative AI tool for clinical psychology which supports recruitment, initial interview, assessment and treatment of patients reporting mental health issues including transcribing and assessing clinicians’ meetings with patients. Patients appreciate the convenience of engaging at a suitable time, and clinicians report time savings and improvements in the quality of information available to inform diagnosis and treatment plans. |
The building blocks for change
There are a number of factors that need to be addressed to support the implementation of technology augmented treatment pathways. This includes both electronic patient records, and wider acceptance and adoption by both healthcare professionals and patients.
An electronic patient record accessible by healthcare professionals can support an individual. Despite data privacy and security concerns, many people prefer to share relevant medical records with their treatment providers. This includes medical history, medications, adverse reactions, and allergies. Solutions now exist for patients to manage and store their own records, but accessing those maintained by healthcare providers remains challenging.
| When establishing the Decision Support Service (DSS), the Mental Health Commission engaged potential future users as experts by experience during service design. This included obtaining their feedback through facilitated workshops on the design of the digital platform, and associated training and communications materials. They continue to provide input on the continuous development of the service. |
Lack of digital literacy is often a barrier to patients adopting technology solutions. However, organisations that engage with clinicians and patients on digitalisation have seen positive results. Community healthcare teams and peer support networks play a crucial role in supporting adoption.
| Increasingly NHS Trusts analyse data and outcomes to inform decision making on community based patient supports, including hospital at home, based on need. This has led to significant reductions in hospital admissions and an overall reduction in cost of care for patients with long term conditions. |
From a healthcare providers perspective, the introduction of additional technology can be seen as an additional burden. Investment in the appropriate resources to support adoption and patient pathways at a community level, including hospital at home services, has been proven to reduce the overall cost of care per patient.
People needs first, solutions follow
An integrated community care model which includes home care, GP and hospital at home services, can result in a lower cost of care and better patient outcomes. Resulting benefits support many of the goals of the regional healthcare system model including the more efficient use of resources, and flexibility to meet the changing needs of communities. This includes building funding models that focus on patient outcomes rather than the location where care is provided.
Technology can enhance patient and clinician experiences, but it must be integrated thoughtfully. Redesigning the entire patient journey with service designers, patients, and healthcare providers is crucial. Adoption depends on meeting stakeholder needs through structured change management, communication, outcome measurement, and continuous improvement.
Claudia Carr is a Partner in BearingPoint Ireland
