The evolution of English healthcare

1st May 2019

Published in PharmaTimes magazine - May 2019

Ernst & Young’s Richard Guest says both doctors and patients are open to new digital solutions and expect greater adoption by healthcare providers

While less than one-in-ten patients in England have consulted a medical professional virtually rather than in person, over half (51%) believe it is likely that artificial intelligence technologies will be commonly used for diagnosis and medication management in the next ten years. That’s a big leap.

And while that expectation is ambitious, its underlying implication is certain: the digital revolution is in full swing and evolving the practice of and expectations for our healthcare system – albeit slowly and somewhat unevenly.

In March 2019, EY’s Health Care advisory practice released a global perspective on the adoption of digital technologies in the healthcare sector. Surveying patients and doctors across England, Australia and the Netherlands, the NextWave Health Survey shows that both groups see digitally driven tech as integral to the future of care, even as preferences and expectations change from country to country. Both doctors (178 respondents in England and 530 over all three countries) and patients (2,031 respondents in England and 6,113 over all three countries) believe that emerging health technologies will substantially enhance the patient’s experience, support improved health and underpin the patient-healthcare provider relationship.

But it’s important to note that digitally savvy patients are more enthusiastic than doctors for new technology, especially in England.

Patients have a positive view of the health system in England; doctors less so

More than half (55%) of patients rate the performance of their health system as excellent or very good, but only a minority (40%) of doctors surveyed rate the system as favourably.

This opinion is also reflected in both groups’ appreciation of how healthcare providers are integrating digital health technologies into the system. While 42% of patients feel the English health system does an excellent job at introducing new digital health technologies, only 21% of doctors share the same belief.

That said, both doctors and patients are open to digital solutions and expect greater adoption by health providers, viewing the widespread deployment of certain technologies as both convenient and beneficial.

Anticipation and expectations are high for digital health tech

As new health technologies come online and prove their effectiveness, both doctors and patients become more accepting of their adoption in mainstream healthcare practices. This is most evident with digital solutions that reduce administrative burdens.

A high majority of doctors in England approve of online appointments (85%) and online registration completion (80%). Two in three of these doctors also expect high efficiency from the use of electronic communications (65%) and in-home diagnostic tests (63%).

Yet, as of 2018, less than half of doctors surveyed in England are currently implementing patient portal options (44%) and patient-engagement tools (15%) – innovations focused on reducing administrative burdens and enhancing the patient experience outside of the in-person visit.

Patients believe that digital health technologies are more efficient (49%) and convenient (48%). They are also eager to make use of digital services in their healthcare process whenever possible. Over half (54%) of patients in England surveyed looked online for general research on an illness, injury or health problem, and two in five (40%) sought out information to work out what health or medical condition they or their family might have in the past 12 months.

While counterparts in Australia and the Netherlands are more conservative, patients in England are the most comfortable using mobile health apps (61%, compared to 59% in Australia and 47% in the Netherlands) among those surveyed. Half (50%) of English patients also believe it is likely smartphones will become the primary interface in the health system in the next ten years.

Beyond the smartphone, nearly half of patients in England (45%) are very willing to use on-demand e-visits for minor symptoms checkups. The acceptance rate in England is again much higher than patients surveyed in Australia (36%) and the Netherlands (25%).

In one of the few measures where doctors out-imagine patients in health technologies, more English doctors – two in three (60%) – expect to use smartphones in their practice and delivery of health care than patients, empowering their patients to manage and improve their health and wellness anywhere and at any time.

Given these expectations from patients and doctors around the rise in the use of digital health technologies, health-tech companies are faced with decisions around how to move forward and create new digital tools that can address these predictions, changing the face of healthcare for both patients and doctors. As new technologies enter the market over the next ten years, the English health sector is expected to become an increasingly interconnected and digitally driven system.

Hesitation exists around more disruptive digital solutions

There is hesitation when it comes to major, more transformative technologies that seek to evolve healthcare beyond reducing administrative burdens. Smaller numbers of patients across all three markets we surveyed are willing to receive a diagnosis, drug prescription or undergo surgery via robotic device (25%), or are very willing to be treated through digital consultations and remote monitoring at a virtual hospital with no beds (26%).

However, again when compared to more conservative attitudes among Australian and Dutch patients, the English patient shows a greater willingness to try these new ways of care. One in three patients in England are very willing to be treated by robotic device (32%) or at a virtual hospital with no beds (33%). Almost two in five (38%) are completely or very willing to have a health condition treated with a high-tech product, like a smart pill. Each of these innovations has the potential to significantly transform healthcare, and English patients appear to be on board and ready to experiment.

Yet, while English doctors are prepared for some of these technology advancements, they are generally warier of transformative innovations than the patients they serve.

Over half (59%) of doctors surveyed in England consider video consultations to be effective ways of delivering better and more efficient outcomes for patients, and 47% say telehealth services would enable them to be more productive; but only 13% currently offer virtual visits. Doctors are also more conservative in their predictions of technological change. Only one in three (29%) doctors believe virtual hospitals with no beds are likely to occur in the health industry in England in the next ten years, compared to two in five (41%) English patients.

The key takeaway from these insights? Hesitation exists around major transformative technologies – but a significant proportion of patients in England are willing to try them.

Moving forward, providers must ‘go digital’ to meet health demands

In any industry or market, acceptance and use often lag behind the capabilities of emerging technologies. However, technology uptake in the health industry trails when compared with other industries such as retail, travel and financial services.

This will change. Patients’ experiences in other parts of their lives and disruptive digital technologies are aligning to create a powerful force for transformation. And here in England, many tech- embracing patients appear ready and willing to experiment and adopt innovations in healthcare service and delivery. For the English healthcare system to evolve and thrive, channelling this force is imperative.

Richard Guest is partner, and UK health leader, at EY

PharmaTimes Magazine

Article published in May 2019 Magazine

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