Health should follow other industries which have solved problems by moving production to machines or patients, writes Kaveh Safavi

We generally assume that we can broadly solve our healthcare system problems if we strive to achieve four goals: identify the most expensive patients, coordinate care services, eliminate physician practice variation, and get patients to live healthy lifestyles. But even if we achieve these laudable goals, we will still not fix the problems of affordability, access and effectiveness. Two key elements are missing: productivity and personalisation.

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Healthcare is an unusually labour-dependent sector. Health expenditures grow faster than GDP in any given developed country due to its reliance on labour. The NHS employs 1.7 million people, many of whom have faced years of public sector pay restraint, but that squeeze on health sector pay is unlikely to be sustainable for much longer, particularly in view of ageing citizens and ongoing clinician shortages.

This supply and demand problem is compounded by citizens’ growing expectation that care will be delivered on their own terms, where and when they want it.

Improving productivity means reducing the man hours needed to deliver care. This will depend on one vital strategy: handing over some of the means of care-giving to machines, and to the patients themselves.

Man and machine

This is not a radical strategy – other industries have solved their own, similar problems by moving production to machines or customers. Consumers increasingly want to see these initiatives in healthcare, too.

Artificial intelligence is also likely to have a profound effect on improving productivity and replacing routine cognitive tasks for non-clinical and clinical staff

A new Accenture consumer survey on digital health found that English consumers’ use of mobile and health apps has more than tripled in the past four years, from 13 per cent in 2014, to 48 per cent today.

Perhaps more surprisingly, in view of the traditional one-on-one relationship between patients and doctors, 49 per cent of English respondents say that they are open to the idea of interacting with a “virtual” doctor – because doing so gives them 24-hour access to care and reduces their need to travel.

Digital technologies offer healthcare organisations their first real opportunities to simultaneously make care more productive and more personalised. One example is SilverCloud, an Irish mental health services programme, which combines cognitive behavioral therapy and asynchronous care with in-person therapy, to provide meaningful services and enable six times more users to receive care. And the technology is available to patients who don’t want to enter the formal care system.

Artificial intelligence is also likely to have a profound effect on improving productivity and replacing routine cognitive tasks for non-clinical and clinical staff. If health follows other industries, applications that have immediate payback will allow savings to be reinvested in other use cases.

There is a long way to go before virtual healthcare and AI become ubiquitous. But after the experimental stage, the adoption of these technologies is likely to be swift. Improving the affordability, access and effectiveness of care will depend on the extent we can make care more productive and tailor the biology and service experience to markets of one.