The so-called Fourth Industrial Revolution is in full swing, bringing with it both disruption and opportunity. Most importantly, it brings potential to reshape the world as we know it, better equipping services to deal with the new challenges they face in the 21st century.
In healthcare specifically, digital transformation is impacting broadly and deeply, disrupting business models, services, regulations, and skills supply and demand.
The Chinese challenge
According to the 2017 Future Health Index from Philips, China has the lowest density of skilled health professionals among the 19 countries surveyed (31.5 per 10,000 population), while simultaneously maintaining the highest risk of impoverishing expenditure for surgical care.
The system has been tested to its limits over recent decades, not helped by a lack of focus on disease prevention and early diagnosis and a dearth of skilled healthcare professionals. This has led to overcrowding in the country's most sophisticated hospitals, poor access and, thanks to a disease-curing rather than disease-prevention approach, frequent late diagnosis.
Reforming a healthcare system that's no longer fit for purpose is a high priority, and the Chinese government's objective is both straightforward and ambitious: improve both access and affordability for its 1.3 billion citizens.
Approach
The Chinese government's overarching idea is to move from "disease-centered" care to "big health", aiming to deliver a full suite of health services that cover the entire care continuum, with an emphasis on health management and chronic disease management. This is reflected in the Future Health Index findings, which indicate that the Chinese people and healthcare professionals alike recognize the importance of prevention in healthcare. Nearly two-thirds (62 percent) of China's general population believe that healthcare professionals should focus the majority of their time and resources overall on preventive care. Seven out of 10 (69 percent) of healthcare professionals agree.
One of the main areas of reform addresses decentralization of the country's multi-tiered healthcare system to streamline resources. Separating and directing minor ailments and serious illnesses appropriately into three tiers is critical in reducing waiting times, better utilizing resources across all of China's medical institutions and addressing the issue of overcrowding in tertiary hospitals. Most significantly, all hospitals, regardless of size, will need to share resources, expertise and information to ensure cost savings and efficiencies are realized.
The pressures on an overburdened infrastructure have encouraged, if not forced, the Chinese government to embrace the role of technology in relieving the burden on an overstretched healthcare system. Central to this is encouraging the application of big data to enable precise diagnosis and personalized healthcare. With nearly a fifth of the world's population in China, there's plenty of data out there, but little is collected or organized in a way that can be analyzed. This has made the Chinese government focus on accelerating the rollout of the disease-based standard clinical data repository across a range of therapy areas. By 2020, three digital national databases will be established, incorporating health information, health profiles and medical records.
The use of smart and wearable devices that continuously collect health and contextual data, allowing patient monitoring anywhere, is also encouraged. The scope of such devices is significant, potentially leading to fewer readmissions, more rapid emergency responses, and more immediate care to avoid deterioration or adverse events, such as stroke or falls.
With an imbalance between the allocation of medical resources and utilization between different tiers of hospitals, there are increased calls for a more integrated healthcare network. The impact? Both large and small hospitals will need to share resources and expertise to save money. Building up cloud-based regional imaging centers to support low-tiered hospitals to ensure right-first-time diagnosis, and enabling data-sharing, remote consulting and two-way referral between hospitals are just some of the ways in which digital technology will play a crucial role.
