Asia is facing many of the same healthcare challenges as the rest of the world. Rates of deaths from non-communicable diseases (NCDs) have rapidly increased across Asia to around 80% in high and middle income countries and around 40% in poorer countries, according to the WHO. This is combined with rising life expectancy (72.2 years in 2010, a rise of 15 years since 1970), which means that people are living for longer but are sicker.
There has also been a shift towards greater patient involvement in decision-making, which requires changes in attitudes and healthcare delivery, but potentially confers benefits such as improved treatment adherence and reduced healthcare utilisation. The challenge then is to prevent NCDs, to reduce disability and disease burden in old age, to manage NCDs in an ageing population and to leverage the power of the patient. Here are some of the innovative healthcare efforts that could be replicated in Asia:
Prevention of NCDs and well-being is a growth area in health. It can be delivered by government, insurers and individual providers through public health messages or initiatives (for example lobbying producers to reduce salt in processed foods), health promotion/education online or face-to-face, or programmes such as exercise classes. There is also scope for innovative collaboration in the delivery of such services. For example, the insurer Aviva offering its members reduced Virgin gym membership to encourage and facilitate a more active lifestyle, which will benefit the insurer by hopefully reducing healthcare utilisation. Kaiser Permanente has also incorporated Silver&Fit, a fitness programme, into its Senior Advantage insurance package which includes gym membership and access to health information online to promote healthy ageing.
Telemedicine provides a number of opportunities to improve the management of NCDs. Automatically transmitted or patient-supplied data reduce the cost of collecting data, which means it can be monitored more regularly. Remote delivery of patient education can be more cost-effective in empowering and informing self-management. Also, interactions with healthcare professionals via online chat services and video or telephone reduce the cost to the provider of consultations and are potentially more convenient for patients with NCDs (who require frequent appointments).
Delegation of tasks can lead to obvious cost-savings if tasks are delegated to individuals whose time costs less, for example nurse-led clinics, and can break down silo working to create a multidisciplinary team. Delegation can also leverage patient power by having patients supply clinical data such as blood pressure readings or training carers to deliver postoperative care.
Protocols and checklists are increasingly used to standardise and increase the efficiency of care, where previously their use focused on improving the clinical quality and consistency of care. For example protocols can facilitate more rapid patient discharge following joint surgery, which is common in older adults. This reduces costs for the provider by reducing the length of stay, which is particularly important for older adults whose outcomes following hospitalisation are poorer. It also enables the safe delegation of tasks and reduces the patient’s risk of infection. Such programmes also rely on the patient taking an active role in optimising their preoperative health and engaging with postoperative care
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