The coronavirus disease (COVID-19) pandemic which started as an outbreak in one country, and very quickly travelled around the world, makes a strong case for investment in global public health and has resurrected the debate of universal health coverage (UHC).
An estimated 400 million people around the world lack access to basic health services. Each year, close to 100 million people are pushed into extreme poverty because they have to cover their own health costs. These numbers have increased with COVID-19 and will continue to increase as people lose jobs, health insurance and health expenditures rise due to COVID-19 related spending on testing, treatment and vaccines.
The shift to value-based healthcare (VBHC) is fundamental to achieving UHC objectives of quality healthcare, financial protection and equitable access to healthcare. These systems are already stretched, riddled with chronic diseases and complex morbidities that have been further exacerbated by COVID-19.
It is crucial to optimize the efficiency of health systems and deliver patient-centric care where the focus is on health outcomes that truly matter to the patient and society. To achieve this, here are the three ways VBHC can enable UHC in a post-pandemic recovery world.
1. Data-driven approaches optimise care delivery
Throughout the global effort to mitigate the spread of COVID-19, many traditional services have rapidly pivoted towards innovative remote access care. The inherent inertia in legacy healthcare systems was swiftly superseded by an urgent need to facilitate remote healthcare delivery, which has created a digital health boom.
The value of digital health in advancing the UHC agenda has increasingly been validated by support from the World Health Organization who agreed on a mandate for digital health as a tool for advancing UHC.
In particular, Telemedicine has allowed for greater levels of doctor-patient engagement regardless of location, thereby significantly increasing the geographical reach of healthcare personnel. Other capabilities of digital health include e-learning and mobile-learning tools that can drive greater preventative and health-seeking behaviours consistent with UHC.
The value of data captured by these elements gives greater clarity to the ‘digital divide’, highlighting how underserved populations lack the tools to engage in appropriate health-seeking behaviours. This allows for targeted approaches to care delivery for patients living in digital deserts – enabling them to access care through alternative models such as mobile clinics.
This data-driven approach to optimising care delivery is consistent with VBHC as it focuses on improving outcomes. WHO Director-General Dr. Tedros Adhanom Ghebreyesus states that: “harnessing the power of digital technologies is essential for achieving universal health coverage.”
COVID-19 has accelerated this digital transition and we must harness the power of data to identify key pain points and blind spots in our healthcare delivery models, and expand coverage to more of the world’s population.
2. Better healthcare access and outcomes improves population health
Despite many countries nominally providing UHC and improving access, there are still many problems related to quality of care and missed opportunities for improving outcomes. To maximise the efforts that improve health coverage, we must move beyond access and benefits packages to an emphasis on quality of care and health outcomes – a defining pillar of VBHC.
Digital health and data-driven care are increasingly recognised as drivers of UHC and we must ensure that these tools involve systematic collection and analysis of comprehensive health-outcome data. By meticulously tracking health outcomes for appropriately segmented groups we can measure the impact of health interventions independent of access.
These models have been embraced by several countries, and it’s expected that the seismic shift to digital health in the aftermath of COVID-19 will increase take-up of value-based decision-making. Rwanda is often touted as a developing country with a noteworthy healthcare system, which includes significant use of computerized medical records and comparatively high healthcare outcomes.