Navigating Change in Healthcare: Q&A with PwC Health Research Institute’s Ben Isgur

It’s long been said that the greatest wealth is health, but what happens to those who don’t have access to either? Providers are working harder than ever to make healthcare more accessible and affordable, while simultaneously navigating a rapidly changing industry. This has led to the emergence of a new health economy, characterized by patient-centric, value-based care.

At Workday’s annual Healthcare Summit held during Workday Rising, Ben Isgur, who leads PwC’s Health Research Institute (HRI), shared insights into the new health economy. We had the opportunity to talk with Isgur after his keynote to discuss how changes to the industry will impact providers and the impact that technology will have on their success.

With more access to information than ever before, consumers are more conscientious about their healthcare choices. If you look at the new funds flow and the changing reimbursement system, for example, there’s increasing demand from consumers to obtain more value from their healthcare expenditures since they have more skin in the game. Consumers are often walking away from getting care, foregoing elective care, or seeking alternatives to costly in-patient facilities because they don’t think they can afford it—even if they have health insurance.

At the same time, there’s more pressure on providers to lower costs and improve accessibility. Nowadays, consumers have several options: they can go to a retail health clinic, urgent care clinic, or telehealth provider. This will have a huge impact on the traditional health system. In fact, when we surveyed physicians last year, a high percentage of them told us that they’ve already changed their operating hours—extending them or opening up on the weekend—because they know they have to be competitive to meet consumer demands.

It’s becoming more important for healthcare organizations to become conveners, partnering closely with other organizations to deliver better care. The convener role used to be something that was nice to have, but today it’s a core competency and it will continue to be. While the scope of the role may vary across organizations, all providers must be able to pull together the relevant private and public players, volunteers, and funding sources to holistically care for patients.

Healthcare is becoming more fragmented as new options for care delivery emerge, and providers, payers, and employers need to come together to connect the dots. This is already happening in different communities across the U.S. Seventy-three percent of provider executives and 50 percent of payer executives surveyed by HRI said their organization has created or is creating partnerships with allies in local communities—including schools, grocery stores, churches and others—to address social issues.

Providers need to identify the gaps they have and the organizations they’ll need to work with to fill them, whether it’s a retail health clinic, technology company, rideshare service, or urgent care center. They also need to work with clinics, pharmacies, retailers, and nonprofits to guide clinical and behavioral treatment decisions, using technologies such as remote monitoring tools and cognitive analytical applications that can synthesize vast amounts of information.

First and foremost, delivering value-based care won’t happen overnight. It’s going to be a long journey that providers will need to continue to think about. To survive the changes, providers will need to achieve transformative cost savings, which requires new operating models and technologies that allow them to balance the requirements for care delivery and cost containment across multiple reimbursement models.

While it’s not a silver bullet, healthcare providers won’t be able to deliver better care without fully embracing technology. To achieve the best clinical outcomes, they need to standardize care pathways, use qualified clinicians, integrate care and wellness programs, and customize care delivery at the individual level—all of which technology can help optimize. Healthcare was a little late to the digital party, but successful providers must be able to balance standardized care pathways with tailored care protocols for the individual consumer.

As providers continue to adopt and implement new technologies, they’ll generate valuable data that will lead to more insights and opportunities. Data analytics will help guide decisions for clinical pathways, and predictive analytics will provide clinical and behavioral insights about individual consumers so providers can direct them to the most appropriate care and support programs with the highest chances of success. Of course, these insights can be limited by the type of technologies that organizations are using.

At the operational level, the biggest changes are being driven from outside the traditional healthcare system. Providers are moving away from legacy and proprietary systems that were specifically designed for healthcare to cloud-based technologies that were designed for larger parts of the economy. These technologies are then configured for healthcare and have the ability to quickly adapt to changing needs and integrate data to make it more easily accessible to employees and leaders, with comprehensive dashboards and reporting around finance, supply chain, and HR data.

As a healthcare leader, part of your job is interpreting the information you have on your workforce and making decisions around it. You have to understand what your employees need to ensure they can keep up with the changes. In the future, we’re going to see a lot more of humans and machines coming together in healthcare to deliver better care.

Technology is rapidly changing the industry, and we can’t just rely on medical and nursing schools because training and education doesn’t stop after you graduate. With new innovations and treatments constantly emerging, providers need to invest in upskilling their workforce and shift to a more continuous training model.

Just as important is having a real-time understanding of the issues that your employees currently face because the patient experience is very closely tied to the employee experience. Health systems are trying to do better in terms of real-time monitoring of the consumer experience, but I think what goes hand-in-hand with that is the real-time monitoring of the employee experience.

The provider of the future is really more of a concept than a physical entity. It’s not just about building locations across town, it’s about providing care wherever consumers want it—physically, virtually, or outside of the traditional hospital setting. Things are moving away from the old model of a very expensive, centralized health system where consumers go to the providers. Consumers may not even consider hospitals to be the health system of the future. Instead, they might think of it as a technology company, a retail health company, a payer, or some combination that we can’t even imagine right now.

More and more, consumers are looking for guidance, so the successful health systems of the future are going to be the ones that find ways to guide consumers to the appropriate digital pathways. There’s a lot of promise there, but the challenge will be figuring out how a formal health system can interact with new technologies. Consumer-focused digital technology will feel very different than it does now. We’re seeing a lot of incredible innovations, even around drug delivery and prescribing practices where technology-enabled pills can indicate when someone has taken their medication. There’s a lot of really interesting, sophisticated technologies out there that are providing a lot more data and information for clinicians. So, just as you have to expand your view of what the physical space looks like, you also have to expand your view of how treatment, diagnosis, and cures will change because of technology.