2018-12-06

Nästa vecka får Stockholm besök av Zayna Khayat, en av Kanadas ledande strateger och innovatörer inom hälsa och sjukvård. I sitt arbete har Zayna berört flera av de stora framtidsfrågor som många av världens hälso- och sjukvårdssystemen står inför, såsom åldrande, innovation, digitalisering etc.
I dagens blogginlägg* skriver Zayna om ett av de stora skiftena som håller på att ske i Kanada och USA, men även i Sverige, nämligen förflyttningen av vård från sjukhuset till hemmet. I inlägget listar Zayna sex spaningar inom området.  

Som vanligt står skribenten själv för innehållet i inlägget. Kommentera gärna på vår hemsida eller i sociala medier.

Trevlig läsning!

ZaynaKhayat

The future of healthcare is the Home

Zayna Khayat

Many years ago, when you asked someone what image comes to mind when they think of healthcare, they might have said ‘hospital’, ‘red cross’ or ‘stethoscope’. Today, there is a shift towards associating health(care) with the home. I agree with the Dutch public servant Erik Gerritsen who said, “We are moving care from waiting rooms to living rooms”. This vision statement has been backed by major policy reform where the Netherlands removed €2B from the ‘cure’ (hospital) budget and reallocated €1.5B to home, community and primary care.
The home setting offers a greenfield of opportunity to challenge old assumptions about how people want to – and can – receive health services, and self-manage.

Exciting changes in 2019 & beyond
Here is a roundup of emerging and exciting ways that the boundaries between traditional formal institutional care settings and the home are blurring.

  • Hospital-to-Home programs: In the US and Canada, bundled care models in areas like hip and knee or cardiac surgery are allowing earlier discharge of patients to the home, supported by proactive home care and virtual supports. The INSPIRED hospital-to-home model for patients with COPD is a great example that has been scaling across Canada.
  • The hospital without beds: A growing cohort of hospitals like Bellevue Medical Centre in Washington and Women’s College Hospital in Toronto, are shifting their operating model to exclusively offer outpatient care – even surgery – to thousands of patients a day, with no overnight stays. These models greatly rely on robust virtual care and remote monitoring capabilities, as well as strong partnerships with service providers in the community.
  • The hospital without patients: The next step up from the hospital without beds, is the hospital without patients! Mercy Virtual hospital in St. Louis has been the hallmark case study for this rebasing of the hospital model: fully decentralized locations where patients are cared for either in hyper-localized satellite sites or directly in their homes.
  • The home-spital: The quality and variety of care services available in the home is approximating (and even surpassing) that of many hospitals when they were first built more than a century ago. Although services such as chemotherapy, infusion, dialysis, etc have been ‘available’ in the home setting, they are still largely accessed in physical clinics today. With emerging availability of supports in the home coupled with technologies for remote monitoring (sensors), self-management tools, and new business models, patients will increasingly see the home setting as a viable alternative for these services.
  • From hospital to health village: Many hospitals are reinventing their operating and business models to shift from a focus on ‘sick care’ to a more mission-aligned focus on ‘creating health’. Some hospitals like Bruyere in Ottawa have been acquiring nearby real estate to create new home and community models such as affordable seniors’ living.
  • Neighbourhood models of care: New models of home care are evolving to support people with complex medical and social issues in ways that traditional fee-for-visit transactional home care cannot. The Dutch Buurtzorg model of neighbourhood care is getting traction globally, with more than 20 countries now replicating aspects of the model.

The future of healthcare will continue to form around shifting client preferences and expectations, fiscal pressures and opportunities presented by budding new technologies. These changes are narrowing the gap between institutional and home care. It is an exciting time to be in healthcare as we watch the signals and future trends emerging in Canada and around the world.

ZK headshot

Zayna Khayat är framtidsstrateg och leder ett team som arbetar med nyskapande innovationer vid SE Health, ett socialt företag med nationellt uppdrag i Kanada. Företaget tillhandahåller hemsjukvård, utbildning och olika typer av hälsolösningar.
Tidigare ledde Zayna arbetet med ”Health System Innovation platform” vid MaRS i Toronto, en av världens största hubbar för innovation. Hon har också initierat och varit med och utvecklat Health Innovation School i Nederländerna.

Den som är nyfiken på fler framtidsspaningar kan anmäla sig till Zaynas två öppna föreläsningar vid Karolinska Instiutet den 10 december.

* Inlägget är en nedkortad version av ett blogginlägg som Zayna nyligen skrev för Hospital News (november 2018).

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