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NAVIGATING THE FUTURE OF HEALTHCARE INFRASTRUCTURE

July 11, 2024
by Healthcare World

The landscape of healthcare infrastructure is undergoing a significant transformation, says Mansoor Ahmed, Executive Director Middle East & Africa, Colliers 

Driven by a myriad of factors, including advancements in technology, evolving patient preferences, increasing focus on patient-centered care, and the need for improved accessibility and efficiency. Traditional models of healthcare delivery, primarily based on hospitals and clinics, are being reassessed, with notable shifts towards alternate care delivery models.

The driving forces of change

1.Ageing population – The global population is ageing and the World Health Organization estimates that by 2030, 1 in 6 people will be 60 years and above, while the share of the population aged 60 years and above will increase from 1bn in 2020 to 1.4bn by 2030. Older adults have different health care needs than younger age groups and are more likely to have multiple chronic conditions. This will drive the shift towards alternative care delivery models ensuring that relevant care is being provided in the most appropriate setting.

2.Proactive approach to health – Healthcare delivery is shifting towards a more preventive model that accounts for the wider determinants of health. This change is driven by a rise in chronic illness, environmental risk factors, personalised approaches to lifelong health and economic pressures. Consequently, there will be a heightened emphasis on tailored patient care rooted in early detection, predictive analytics stemming from genetic analysis, and ongoing monitoring of diverse data sources.

3.Changing disease patterns – The lifestyle disease burden is a significant global health challenge and accounts for 63 per cent of the total disease burden, necessitating healthcare infrastructure focusing on preventive care, disease management, and patient education. Outpatient clinics, community health centres, and disease-specific treatment centres play crucial roles in delivering continuous care, monitoring disease progression, promoting lifestyle modifications, and preventing complications associated with chronic conditions.

The prevalence and burden of non-communicable diseases is significantly more in the GCC and contribute 75 per cent and 71 per cent of the total disease burden in the UAE and KSA respectively. This has led to a significant increase in the demand for specialised healthcare facilities, particularly Centers of Excellence which have gained increasing prominence throughout the region.

4.Evolving patient expectations – Patient preferences towards accessible and convenient care are also driving a fundamental shift in healthcare delivery, prompting healthcare organisations to embrace innovative technologies, redesign care delivery models, and prioritise patient-centered approaches. Now healthcare organisations can enhance access to care, improve patient satisfaction, and achieve better health outcomes for individuals and communities.

5.Financial pressure – Healthcare systems globally are facing mounting financial challenges, as healthcare spending continues to consume a significant portion of countries’ gross domestic products (GDPs). In many countries, hospital care accounts for the largest share of those expenditures, amounting up to more than 1 trillion dollars in costs in the US alone. OECD countries spend roughly 38 per cent of their total health expenditure on hospital inpatient care. There is a growing recognition that to ensure healthcare remains accessible and economically viable, it must transition towards lower-cost settings or minimise the length of stay in acute care settings whenever feasible. This shift aims to address individuals’ health concerns at earlier stages and ideally prevent the onset of more serious conditions. By focusing on preventive and early intervention measures, healthcare systems can promote affordability, sustainability, and improved health outcomes for populations worldwide.

6.Healthcare workforce shortages –To address this challenge, there is a growing trend of increasing investments in automation and artificial intelligence (AI), aimed at easing the strain on healthcare staff and equipping them with advanced tools to provide predictive insights for clinical decision-making. Automation can streamline routine tasks, such as appointment scheduling, medication reconciliation, and documentation, allowing healthcare staff to focus their time and expertise on direct patient care.

Emerging alternate care delivery models

1.Virtual Care and Telemedicine
Though virtual care and telemedicine services were integrated into most of the healthcare systems even before the onset of the pandemic, telehealth emerged as a powerful weapon against COVID. As telemedicine extends beyond consultations to include remote monitoring of patients’ vital signs and health parameters, healthcare infrastructure requirements expand to incorporate wearable devices, sensors, and remote monitoring platforms. These technologies enable proactive management of chronic conditions and early detection of health issues. By reducing the need for face-to-face appointments and hospital admissions, virtual consultations contribute to optimising bed utilisation and resource allocation.

2.Hospital at home and remote patient monitoring
The “Hospital at Home” care model revolutionises healthcare delivery by bringing hospital-level expertise and services directly to patients in their homes, using advanced technologies such as remote monitoring and telemedicine to offer a comprehensive range of medical services outside of traditional hospital settings. It also entails healthcare service providers traveling to patients’ homes, in addition to providing virtual care.

3.Value-based care
Value-based care is a healthcare delivery model that focuses on achieving the best possible outcomes for patients while controlling costs. In this model, healthcare providers are reimbursed based on the outcomes and quality of care delivered, rather than the volume of services provided. This shifts the focus from quantity to quality. The use of technology in healthcare will significantly enhance the future of value-based care as advanced data analytics and AI will help gain deeper insights into patient populations. This will enable identification of at-risk individuals and customization of interventions based on their specific needs.

4.Ambulatory care centres
There has been a shift towards ambulatory (same day) surgery driven by advances in clinical approach and technology (anesthesia and pain control etc) and minimally invasive surgery. This shift towards outpatient procedures not only reduces healthcare costs, but also minimises the risk of infection and allows for recovery to take place in the comfort of patient’s own homes.

5.Retail clinics
The retail sector thrives on accessibility and convenience for customers, and healthcare is following suit. Retail clinics, situated within retail stores, pharmacies, or supermarkets, capitalise on the convenience and accessibility valued by customers. Offering transparent pricing and self-payment options, these clinics address the demand for affordable healthcare and are expanding to include specialised services such as mental health support and chronic disease management. Some are even integrating basic lab and radiology services, enhancing diagnostic capabilities and patient-provider connectivity.

6.Personalised and concierge medicine
Personalised and concierge medicine models cater to individuals seeking highly customised and proactive healthcare services. Personalised medicine tailors treatment plans to individuals’ unique genetic makeup, lifestyle factors, and health goals, optimising therapeutic outcomes and minimising adverse effects.

Micro Hospital

Micro hospitals, also known as neighbourhood hospitals or community hospitals, are smaller-scale healthcare facilities that typically offer a limited range of services compared to traditional hospitals. Offering cost-effective services with lower initial investment and operational costs, these facilities prioritise preventive and primary care, aligning with the shift towards population health management.

Conclusion

Various factors and adoption of emerging alternate care delivery models such as shift towards outpatient and home-based care, value based reimbursements, advances in healthcare technology, such as telemedicine, remote monitoring, are all facilitating the delivery of care outside of traditional hospital settings, supporting the trend towards shorter hospital stays and decentralised care delivery. This trend will help alleviate the pressure on inpatient facilities, freeing up capacity for more acute cases and lowering overall healthcare costs.

Hospitals will remain integral to the healthcare landscape, yet they are poised to transition towards focusing primarily on delivering highly specialised care. The trend of moving less complex services out of hospitals will accelerate, influenced by advancements in clinical practices and technology, growing consumer expectations, financial pressures from payers, and opportunities for healthcare providers to deliver care in more diverse settings. Additionally, there’s a growing need for hospitals to evolve into Smart Hospitals, integrating technological innovations into care delivery processes. This transformation is crucial for enhancing patient outcomes, improving operational efficiency, and adapting to the changing healthcare landscape.

There is an opportunity to redistribute services in a way that provides the right care at the right time in the right place and by the right person. We will see healthcare being delivered through a decentralised network of ambulatory clinics, retail clinics, and home-based monitoring, coaching, and treatment. Moreover, the inclusion of long-term care and rehabilitation facilities will further enhance this network, offering specialised care for individuals requiring extended support and recovery services.

These shifts in healthcare delivery models will significantly impact the healthcare infrastructure planning. It is imperative for both public and private sector healthcare providers to consider these changes ensuring that these dynamics are incorporated within national and regional needs assessment studies, fostering a forward-looking approach that promotes spending efficiency and future-proof infrastructure rather than solely relying on historical trend analysis.

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