Around the world there is an acceptance that health services are at least a decade behind other industries in the use of information technology to increase productivity and quality. Unfortunately, where healthcare often has stood out is in problematic, overspent and underwhelming IT implementations — from the UK’s National programme for IT (NPfIT), to the USA’s Healthcare.gov, to developers like Google, who saw their innovations fail to take off. Paradoxically, even “successful” implementations have sometimes made efficient care delivery more difficult, rather than less, with recent surveys of US physicians showing electronic health records (EHRs) among the principal causes of professional frustration.
The approach of most healthcare providers to extracting productivity improvements through technology so far has focused on back office efficiency and improving simple transactions, while leaving the vast majority of patient-facing activity unchanged. While the hotel, transport, retail, communications and banking industries are almost unrecognizable from 15 years ago, the promise of ‘digitally transformed’ healthcare has remained over the horizon for most systems.
Looking to those that have transformed the way care is delivered — and realized genuine efficiency and quality gains as a result — it is clear that success isn’t achieved by replacing analogue processes with digital ones. It’s about rethinking the purpose of services, reengineering how they are delivered and capitalizing on opportunities afforded by data to adapt and learn. Where technological interventions have failed, technology has simply been layered on top of existing structures and work patterns, creating additional workload for healthcare professionals.
I think we’re about to come to the next era of medicine …as much as 30 percent of what we do today we will do differently …how we evaluate patients, how we follow up on patients, how we bring the expertise in between clinicians, how we manage patients in a hospital, how we think about even the role of the hospital.
— Robert Pearl, Kaiser Permanente, US
This report aims to cut through both the narrow ambitions of ‘doing the same things, but digitally’ and the often fanciful predictions of many reports about technology’s potential to transform healthcare. We have examined the real-life stories of success and failure around the world to find out what really works in realizing productivity gains in health, how organizations can get this right (or wrong), and how the delivery of healthcare is realistically going to change in the years to come. We have identified seven evidence-based big opportunities, and seven practical lessons to capitalize on them.
We have found that substantial gains in terms of productivity and health outcomes are possible — and have been demonstrated — from specific areas of health IT. As the history of frequent disappointment and failure shows, however, digital technologies will not deliver these improvements on their own. Through interviews, analysis, and KPMG’s own experience achieving digital transformation with healthcare providers around the world, we have identified seven key lessons from those that have successfully realized the benefits and overcome the setbacks.
It’s imperative to remember that technology is an enabler — the focus needs to be less on implementing the system and more on implementing the changes in the business enabled by that system.
— Liam Walsh, KPMG in the US
Some will look at the years ahead and see a glorious nirvana in which the messy and inefficient services of today are transformed into predictive, coordinated and personalized care. Others will see a dystopia of doctors becoming slaves to algorithms and patients drowning in a sea of data and additional expectations. Both are possible, but a look at what leading providers have already achieved — described in this report — should be cause for optimism. We conclude with our own vision of how healthcare is likely to change in the next 10 years, including that: