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Global Healthcare Megatrends: Clinical challenges

There are more than 7 billion people on the planet today. Our growing global population has triggered some of the biggest healthcare challenges we’ll ever face. Listening to clients in Australia, Canada, Singapore, United Kingdom and United States, I believe many of these issues are universal. This post is the first of a five-part series that explores the clinical, population health, financial, regulatory and technical challenges we share as a global healthcare community.

Caring for more patients than ever before

Worldwide healthcare providers are seeing more patients than ever before. In part, because we’re living longer. In developed nations, there has been a huge increase in life expectancy over the last 50 years, and experts believe the trend will continue.

For example, U.S. citizens had a life expectancy of 68.2 years in 1950, which jumped to 76.6 years in 2000, and is expected to reach 83.9 years by 2050. Not only does that mean caregivers have more patients overall, but these patients are aging and require more health care.

Other cultural and economic factors contribute to an increasing number of patients. As middle classes expand in some nations, they seek more health care, more often. Countries that adopt universal health care models will also increase the patient population.

This growing number of patients heightens another global challenge: a shortage of primary care providers.

Providing the right caregiver at the right time

With more patients, the healthcare industry needs more caregivers. Several countries are employing “physician extender” positions to handle and coordinate routine care.  These staff additions free the physician to provide expert care. Physicians can then practice at the top of their licensure, which is a better use of resources.

It also helps with clinician satisfaction as they are focusing their time on the patients that need their help the most.   However, in some cultures this approach is more of a challenge, as patients may insist on seeing only the physician.

There is also an increasing types of sites of care.  No longer will a patient only be seen in the physician’s office.  They may also receive care in pharmacies, schools, offices and grocery stores.

We must remember that quality clinical care is not just that patients can see any caregiver.  It’s that people receive the right level of care, no matter where they are.

Driving towards a single patient record

Most countries we work in are all large enough that choosing a single electronic medical record (EMR)* to facilitate data sharing is simply not an option. So everyone in the world is looking for ways to connect a virtual single patient record.

Even as EMRs gain traction in developed countries, we still struggle to communicate between organizations. Patient data does not easily flow among caregivers.  New technologies are now appearing in the realm of Healthcare Information Technology to standardize and connect various systems.  This technology will be at the hub of future healthcare delivery facilitating the movement of information between the many stakeholders of healthcare at the point of care.

Many cultural factors affect healthcare communications worldwide, including language. There are more than 6,900 languages spoken on this planet. Roughly 5% of the world’s population speaks English as a first language, which takes third place to Mandarin and Spanish. This variety affects the single patient record on a most basic level: How do we manage patient data in different languages?

Measuring to ensure best practices

Many countries have identified important clinical measures. For example, it might be simple rates of immunization among children and influenza vaccine among adults. Or it could be more complicated measures of chronic diseases, such as regular HbA1c evaluations for diabetic patients.

Some countries are ahead in this process. Most developed countries have reporting requirements aims at improving quality of care.  These is a movement towards setting up parameters that result in rewards, similar to Meaningful Use in the United States. Because it’s not just about “checking the box” by ordering a certain test – it’s about improving outcomes.

As we look at all of these clinical requirements, it’s clear that proper use of EMRs can make a difference. There is still a lot of work to be done, and specific challenges to address in each region. But I’m encouraged by the progress I see globally.

Do these clinical challenges resonate in your part of the world? What other aspects would you add?


* Electronic Patient Record (EPR) is another term for Electronic Medical Record (EMR) or Electronic Health Record (EHR).

Editor’s Note: In Dr. Samo’s next blog post, he’ll describe the challenges of population health management.

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