Non-communicable diseases (NCDs) are one of the biggest healthcare issues facing policy-makers today.
The figures are staggering. It’s estimated that NCDs (which include cardiovascular diseases, cancer, diabetes and chronic respiratory disorders) claim 40 million lives every year, 17 million of whom are people under the age of 70 and 8.5 million of whom are in Asia.
The realities of modern living — from rapid urbanization to unhealthy lifestyles, lack of physical activity, unbalanced diets and an ageing population — are the root cause of the problem. While NCDs pose a global challenge, it is important to note that developing countries — whose healthcare systems are already stressed with having to fight against infectious diseases and providing greater access to maternity care — are coming under the biggest strain.
All of this raises the following questions: what are the right models to meet this universal challenge? And whose responsibility is it?
While a ‘one-size-fits-all’ approach will not be possible, countries of all sizes and levels of development need to be thinking about, and acting on, three fundamental areas:
- The adoption of new technologies
- Patient education and empowerment
- The expansion of public-private partnerships (PPPs)
A rethink of how healthcare is delivered
Technology is a big part of the solution. It has a role to play across all stages of the health continuum — from healthy living and disease prevention, to diagnosis, treatment and care at home.
Smartphone and wearable device penetration is higher than ever and is only going to keep on rising in Asia over the next decade. This presents a way for the public and private sectors to monitor and potentially treat patients on a much more individualized basis before. The proliferation of big data is a huge asset for building a more holistic view of patients’ clinical needs — so long as the infrastructure exists to process it effectively.
Another huge benefit of technological advances is the ability to remove boundaries between hospitals and homes, as well as geographic boundaries. By shifting care from hospitals to homes through connected care and remote monitoring, countries can relieve the burden on precious hospital resources and thereby prioritize limited resources for those who need them most.
With the United Nations estimating that 60% of the world’s population aged 65 and above will reside in Asia by 2050, connected care also provides a much needed solution to coping with the growing burden of elderly care.
Transcending geographical boundaries in service delivery, connected care also enables the provision of healthcare in remote communities and urban cities alike — in some cases for the first time. In May 2016, Philips partnered with NTUC Income, the largest insurance provider in Singapore, to support the recovery and overall health improvement of policyholders who were recently hospitalized due to a heart condition. Patients are remotely monitored from the Continuous Care monitoring room in the Philips APAC Center by a team of tele-nurses and doctors. The pilot is currently underway with around 40 participants.
This initiative aims to improve treatment compliance and overall health condition through remote health monitoring, care delivery, education and positive behavioural change. Participants feel more supported and confident in managing their own medical conditions in the comfort of their own homes. When they see the positive effects of adhering to treatment plans and making lifestyles changes, they are more likely to stay committed. This has an immeasurable impact on patients’ quality of life as it improves not only their physical health but also their morale as they decrease the burden of care on their family members.
We can see that connected care is vital to tackling the problems raised by NCDs, but the biggest challenge for policy-makers and healthcare institutions then becomes how to retrofit these new technologies into their existing infrastructure and to upskill populations — particularly the elderly and those in rural areas — to use them.
Empowerment and education
This is where education comes in. A sustainable solution will need individuals to take responsibility for their own healthcare — and this often requires governments to educate and empower their citizens to do this.
By empowering patients to play a greater role in their own healthcare decisions, and by shifting care from institutions to patients’ homes, countries stand to both reduce costs and to ease the pressure on health systems that are already strained from caregiver shortages and capacity constraints.
Prevention should naturally be a focus of education programmes — to encourage healthier habits, and to reduce the burden in years to come. However, public education policy also needs to extend to upskilling populations — and healthcare professionals themselves — on exactly how to use the new technology at their disposal. This isn’t a one-off fix. It needs to be a constant in future health policies to ensure that skills keep pace with technological change and advancements.
This requires a fundamental policy shift in the overall structure of healthcare systems and the economics of healthcare delivery.
The three Ps
Another important topic that governments need to weigh up in the battle against NCDs is the role of public-private partnerships.
In my opinion, a long-term solution will only be possible if the public and private sectors can collaborate on technological development and provision.
This provision of technology and infrastructure to help NCD patients better manage their conditions needs to go hand-in-hand with incentivizing healthier lifestyles in the first place. On the latter point, a range of private sector companies — from wearable manufacturers to insurers — have a part to play.
Image: REUTERS/Edgar Su
We have seen this working well when we actively collaborate with others in the ecosystem, including innovation partners, governments, universities and our customers, to create the best solutions for people and create value for our stakeholders. In Singapore, we collaborate with the Singapore Heart Foundation to raise awareness around sudden cardiac arrest, and the need for more individuals to be trained in CPR and the use of automated external defibrillators to increase the chances of survival. In Malaysia, we work with the National Heart Institute of Malaysia to promote heart-healthy diets, encouraging healthy eating among the population. Closer public-private partnership is also a potential solution to the financial burden that governments, particularly those in developing countries, are struggling with. Here, the public and private sectors need to think more imaginatively about ways of financing care projects, and consider a fundamental shift of pricing to an outcome-based model, instead of pricing based on patient numbers.
Are we ready for technology adoption?
To answer this question, our release of the first Future Health Index (FHI) in 2016 gave us an insight into how countries have embraced technologies like connected care, in order to meet healthcare challenges prevalent in the region. More than 2,600 healthcare professionals and 25,000 patients in 13 countries were surveyed and ranked out of 100 based on three main metrics: access to healthcare, integration of the current health system, and adoption of connected care technology.
Countries in our region like Singapore, China and Australia all scored above the 13-country average of 56.5 and believed in the importance and benefits of connected care. However, there are still challenges that remain to greater adoption of connected care, with the aforementioned countries naming privacy, cost and bureaucracy as concerns. Achieving integrated care also requires new organizational structures, governance, platforms and most importantly, changes in mindset. However, it is reassuring to see that the region is starting from a reasonably strong position in its readiness to adopt connected digital technologies which will ultimately drive healthcare transformation.
A shared problem that needs a shared solution
It’s evident that NCD management will need to extend beyond the four walls of the hospital in the future, and that the path to controlling and curbing the incidence of NCDs is not going to be an easy one.
The pace of technological innovation, proliferation of big data and the development of new business models will all help, but effective, long-term change in managing NCDs will only be achievable if all sectors of society — public, private and the individual — truly work together.
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