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Summarize the article and comment: Personal or professional experience(s)- Accelerating the health economy of tomorrow Transforming health systems and embracing innovation amid a pandemic As the COVID-19 pandemic continues to unfold, its extensive impact on healthcare is altering the very nature of health systems worldwide. What’s changing? Existing trends, which formerly grew incrementally—such as telemedicine and data-driven models—have accelerated substantially, resulting in a sooner-than-expected arrival of tomorrow’s healthcare ecosystem. COVID-19 is rewriting the rules so quickly that in order for health organisations to thrive in this interconnected network—what we call the New Health Economy—each must adapt and develop a new strategic identity for the future. The task to repair, rethink and reconfigure models will help players emerge stronger from crisis—and deliver healthcare, reinvented. COVID-19 accelerators Virtualisation of health Analytics-driven modelling platforms Supply chain healing Reprioritisation of social determinants of health : The New Health Economy is being accelerated by the pandemic and post-pandemic planning The elements of the NHE have been building towards a more interconnected health ecosystem. But the pandemic has increased the speed of the transformation. The New Health Economy ecosystem Platforms and support Includes public health resources, digital infrastructure, equipment, facilities and services to connect and deliver care Sick Care delivery Includes the clinical/medical services and supporting channels individuals can access Vaccines, diagnostics and therapeutics Includes R&D, product innovation, manufacturing, distribution and sale of medical devices, and the equipment and pharmaceuticals used in an individual’s care Financing and payment Includes all public and private sources of financing for an individual’s medical and wellness services Government Wellness Includes nonclinical aspects (social determinants of health) that can affect an individual’s engagement with their well-being, health and healthcare Well Employer Virtualising health Beyond telehealth to diagnostics, delivery and therapeutics For more than 50 years, professionals have been using communications technology to bring healthcare to remote areas. Even as connectivity grew exponentially, telehealth enjoyed only incremental growth over the decades. An Ipsos survey of primary care physicians from 21 countries conducted just before the pandemic struck found that only 27% were using telemedicine, despite the proliferation of smartphones and new payment strategies from governments, private insurers and employers that are aimed at increasing access.1 By shutting down physical gathering places, COVID-19 drove a host of services that previously had been conducted in person into digital spaces. The coronavirus erected walls at major healthcare access points. In Scotland alone, video healthcare visits increased by 1,000% in the weeks following the epidemic’s onset.2 Ping An Good Doctor, a Chinese mobile telemedicine platform, reported in February that the number of newly registered users had grown tenfold since COVID hit.3 An April 2020 PwC survey of 27 entrepreneurs and investors from German digital healthcare start-ups found that 80% had seen an increase in how frequently customers used their products, as well as a big jump in new customers.4 At-home diagnostics and remote-monitoring tools were rolled out more aggressively during the pandemic. For example, the US Food & Drug Administration (FDA) in May issued an emergency use authorisation for the remote heart monitor patch from G Medical Innovations for patients being treated for coronavirus with drugs that can affect cardiac function.5 In June, the UK’s National Health Service teamed up with the London-based health technology company Huma to provide remote monitoring for COVID-19 patients. The touchless concept, long employed in the financial services sector, began to take hold in healthcare to reduce the need for physical contact with surfaces and people. Long resistant to digital channels, pharmaceutical and medical-device sales representatives had to figure out how to support clinicians’ needs remotely, including physician training and patient education.7, 8 Taken as a whole, these changes are advancing a different approach to patient care. Consumers, who are primarily at home, sit at the centre of the experience, and the industry adapts to serve their needs. The embrace of virtual care holds the promise of a shift from the traditional episodic model of care to one that is continuous and engages consumers when they are not directly interacting with the health system. Such a continuum-of-care model enables health systems to proactively engage high-risk patients virtually, rather than cancel appointments. What will health system DNA edits look like? Telehealth explosion continues: Increased consumer demand will prompt public and private providers and payers to rethink the care model and decide which services to deliver in person and which should be virtual. Pharmaceutical and life sciences companies will invest in technological changes to facilitate the digital care revolution. Home diagnostics and wearables spread: Mobile devices will connect the health system to patients where they live. The disproportionate risk the coronavirus poses for older patients will increase use of remote continuous patient-monitoring tools. for this population, which typically has higher rates of chronic illnesses. Remote patient monitoring will allow providers to release hospitalised patients sooner. Services that support consumers with the technology required for remote care, such as home diagnostics, will grow in popularity. • Life sciences R&D and clinical trials go remote: The pandemic will accelerate the shift to recruiting patients online, using artificial intelligence to make communication and scheduling more convenient, and moving trial sites closer to consumers. These changes must be coupled with efforts to attract a more diverse pool of candidates to clinical trials (see Figure 2). • Virtual workforce expands: Healthcare organisations will adopt new workflows, train existing staff on necessary skills for increasingly digital roles and hire talent from outside industries with expertise in virtual customer experiences.9, 10 Many health organisations will keep a portion of their administrative staff working from home permanently and reduce or reconfigure their real estate footprints. Organisations will have to re-engineer their culture to maintain connection and engagement with distributed workforces. Figure 2: Virtual trials may gain appeal in the wake of COVID-19 Would you be more or less likely to participate in pharmaceutical research for a COVID-19 treatment if you were able to participate in the clinical trial from your home? Most likely to participate Older (65+ years of age) Covered by Medicare White In the US$100K household income bracket Most have chronic conditions, many complex Source: PwC’s Health Research Institute, COVID-19 Consumer Survey, 2-8 April 2020, of US adults Least likely to participate Younger (18-24 years of age) Covered by a health insurance exchange plan Nonwhite In the US$25K or less household income bracket Healthy skeptics who generally avoid interacting with the health system What will health system DNA edits look like? Communication moves from transactional to continuous: More health systems on their own or via partnerships will start connecting data about patient encounters and the preferences and social circumstances shaping everyday health- and healthcare-related decisions. And they will use that information to provide a more seamless, customised experience and stay connected to patients between encounters. Resources matched to needs: Scenario planning and modelling systems will find broader applications that help target resources to areas of need more effectively. On-the- ground tools that provide real-time information on patient volumes, occupancy, staffing, supplies and other metrics to inform hospital decision-making will grow in popularity. The continued growth of virtual healthcare will offer more flexibility to match clinician supply with patient demand. Alternative players make headway: Data-savvy existing or new virtual health- or retail-focused players with deep pockets and an appetite for risk will deliver patient care experiences that are easy to navigate and offer more seamless care. These players will offer consumers an alternative to traditional provider systems and will be able to reach patients in areas underserved by traditional players. Players address interoperability blockers: One of the biggest barriers to effective use of data is the inability of information systems to talk to one another. Growing demand from consumers for tech-enabled care and from healthcare players who need data access to improve care and operations will force regulators to set and enforce interoperability standards. The pandemic has revealed one area of neglect in the New Health Economy: the global web of nodes for the movement of drugs, medical supplies, technology and innovation. The medical supply chain’s reliance on offshore manufacturers, many located in China and India, for active pharmaceutical ingredients, generic drugs, and medical and basic supplies caused panic worldwide as borders closed and access was restricted. The shortage of PPE was particularly troubling because it exposed frontline workers and patients to undue risk of COVID-19. Healthcare providers had to scramble to find new PPE sources, with some providers forging relationships with nontraditional vendors that adapted their facilities to make items such as masks and face shields.19 In the first months of the pandemic, insufficient COVID test supplies, especially swabs, and ventilator shortages hampered testing and treatment before alternative sources could be found or developed and production at existing suppliers was increased What will health system DNA edits look like? • Access to real-world data is preferred: Regulatory bodies, the delivery system and consumers will rely on nontraditional data for just-in-time diagnostics, drugs and treatments. Access to consumer data and data analytics capabilities will be an advantage. “Traditional data sources, such as claims, only tell us a small part of the patient story,” said Vipin Gopal, chief data and analytics officer at Eli Lilly and Co., in an interview with PwC’s Health Research Institute.27 “Digital solutions enable us to understand the patient in a much deeper fashion, paving the way for personalised patient engagements and improved outcomes.” • ‘Glocalisation’ takes off: Life sciences companies will develop multiple global nodes, some closer to home, for production, supplies and inputs, so they can reduce risk from natural disasters, pandemics, trade conflicts and other disruptions. The sector will look more closely at the possibility of data sharing standards to allow for cross-industry collaboration where commercially appropriate, which will help companies make better use of existing capacity across the industry. • Governments and consumer advocates seek transparency and security: Life sciences supply chains will face increased pressure for more reporting on and transparency about the inventory of active ingredients, in-process goods and finished goods. Many governments will invest to ensure sufficient supplies of critical medicines for public health emergencies. Such efforts could come in the form of national stockpiles and, as is the case in the US, public funding for a private-sector initiative to build in-country production capabilities for priority drugs and their active ingredients. The COVID-19 pandemic has been a time of enormous strain on healthcare systems and the people they serve. But it also has shown what’s possible when the healthcare industry, governments and social services organisations work together to address a crisis. Now is the time to build on the pandemic-wrought changes that support the shift of health systems into modular ecosystems of delivery, innovation and wellness—all tied more closely to the consumer. The COVID crisis could elevate consumerism to a new level by changing the way people want to engage with the healthcare system. The forced embrace of virtual care combined with the emergence of consumer-focused digital platforms will accelerate consumers’ push for convenience in care delivery. At the same time, the response of health organisations will affect consumer demand. How quickly will clinical and experience technology evolve to support different care delivery models, such as retail and virtual? To what extent will healthcare organisations expand to deliver public health interventions? How many organisations will be able to coordinate and orchestrate care across providers and payers with data integration and connected workflows? How will changes to supply chains, materials, people, facilities and capital affect care access and capacity? The speed of evolution may turn on how these questions are addressed. While consumer demand for change may differ by country or even region, the overarching trend will and should be towards empowering consumers and personalising care. These goals should inform the DNA changes throughout the healthcare industry.

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