As the world mourns the loss of one of the greatest scientists of the modern day, Professor Stephen Hawking, much of the narrative surrounding his passing has focused on his health rather than his theorems. As a 21-year-old, he was diagnosed with amyotrophic lateral sclerosis, which would progressively paralyse him.
Doctors anticipated he would live for only two years. Yet, with the support of dedicated carers and innovative technology, he reached the age of 76; undertaking complex scientific research, writing books that have changed the way the we look at the world, and lecturing along the way. He achieved all of this despite being unable to use his hands to write or his voice to speak.
Continuing advances in healthcare technologies have enabled us to extend the limits of longevity beyond the imagination of our forefathers, and to overcome medical barriers in ways that once would have seemed impossible. However, the challenge this incredible success brings can be seen in hospitals around the world, where demand for healthcare is outstripping the ability to serve.
The evolving face of healthcare
As we extend our abilities to cure and manage disease, we increase demand to do so. This demand is exacerbated by the growth in chronic medical conditions. Where once people required help to address isolated episodes of disease, they are now treated for multiple, lifelong conditions.
The healthcare systems we engage were not designed for this type of care. Furthermore, many populations are aging, and hence require more support over a longer duration. The current model of care delivery is being forced to re-invent itself in order to survive this unsustainable burden.
Recognising this need for change, Singapore’s Ministry of Health announced a paradigm shift in the approach to care, seeking to bring together a wider ecosystem of players to improve the health of the nation. ‘The Three Beyonds’ aims to shift healthcare from the hospital to the community; to move from healthcare towards health; and to transition from a focus on quality to value. Achieving sustainable change in these three directions requires new ways of thinking and delivery.
A human-centric design approach, which identifies the resonant, motivating points for the different stakeholders in this new health ecosystem, could be the secret to success. Designing for multiple-wins, by understanding and reflecting multiple stakeholder perspectives in our solutions, will help realise a new collaborative care model across the nation.
A human-centric design approach, which identifies the resonant, motivating points for the different stakeholders in this new health ecosystem, could be the secret to success.
The three shifts
In order to shift healthcare beyond the hospital to the community, we need new integrated care processes that run across the entire continuum of care. Collaborations will be established that bring together parties from very different parts of the health ecosystem. We will ask citizens to trust new parties with their health and well-being needs.
Data will flow across this evolving ecosystem in new and powerful ways, informing partners of citizens’ emerging care needs even before they occur; and technologies will enable us to experience healthcare at home, reducing the need for hospital visits.
To achieve these new ways of working, people must buy in to the concepts and have faith in the solutions. This cannot be achieved with a top-down design approach. We need to design with a human lens, in order to build trust and confidence into the model for sustainable implementation. This in turn allows us to eventually create solutions that provide real and financial value – which leads us to the other ‘Beyond’: the shift from quality towards value.
The transition beyond quality to value frequently focuses on the cost-effectiveness of treatments, looking for medications that return the best health results at the most affordable price. Whilst undoubtedly an important consideration, value should offer more than a financial return on investment. We should engage patients to understand their desired health outcomes, so that we can tailor the amount we invest to the aspirations of the individual.
Improving patient understanding of the implications of different treatment options and the commitment and cost required for different outcomes allows them to collaborate with their physician to co-create care plans that balance medical and personal objectives. Furthermore, by co-creating the solution with the patient, we are more likely to gain their buy-in towards realising their health goals. Such an approach may help to increase individuals’ ownership of their health, supporting the shift towards preventative health.
Boosting healthy lifestyles
This leads us to the final ‘Beyond’, that of transitioning the focus beyond healthcare and towards health. Rather than concentrating efforts on fixing the healthcare system, and fixing peoples’ health once it has failed, the desire is to focus on improving health so that ailments are less likely to develop in the first place.
Successful preventative health strategies help keep people well, which keeps them out of the healthcare system, thereby reducing the burdens of delivery. Again, understanding human motivations, desires, realities and pain points allows us to design preventative health initiatives that resonate with people, which make healthier lifestyle choices more likely to click and stick.
As we transition towards a new model of health for Singapore, embracing this human-centric design lens will allow us to identify innovative, impactful, and sustainable win-win solutions to these big and wicked challenges.
Tamsin Greulich-Smith is Chief of the Smart Health Leadership Centre at the National University of Singapore’s Institute of Systems Science.
Image from Singapore Sports Hub