The great potential of medical service centres

Deloitte takes the position that healthcare needs to be organised in a fundamentally different way in order to fully realise the potential of virtual care. "What you see is that in recent years there has been an increasing focus on health instead of healthcare," says Jordy van Neste, senior manager of digital care.

"More and more attention is being paid to self-management and citizens are increasingly using apps and wearables to keep an eye on their vital signs. Starting from self-direction and using the data from those apps and wearables will have an increasing influence on the design of healthcare and on the individual. Citizens are increasingly becoming consumers of care who receive the care they need close by. This is in line with the social trend we see outside of healthcare, where service is increasingly being brought to the citizen and the citizen is central to this. It is inevitable that this development will also take shape quickly within the healthcare sector, given the staffing problems and rising healthcare costs."

Focus on the citizen

The medical service centre is a good example of how care can be organised differently to realise the potential of virtual care. Such a medical service centre supports healthcare institutions in providing care close to the citizen. A well-known example is the recently merged organisation Naast - ZCN, which, as an independent medical service centre, assists healthcare organisations in their care towards patients, clients and citizens. To this end, specialised staff is available 24 hours a day for notifications from various virtual care tools. For example, they can remotely assess an ECG or watch the intake of medication via video calling.

Healthcare organisations have also discovered the applicability of medical service centres to bring care to citizens' homes. Hospital group Santeon recently was the first to pass the 'quick test' for the IZA transformation funds for the establishment and execution of the Santeon home proposition.

Mirte van de Louw, senior consultant digital care, explains: "Medical service centres are set up in such a way that they enable the healthcare professional to focus on providing care for the people who need it. In this way, it enables citizens to take measurements at home and be monitored. Think of blood pressure values, for example or glucose - which are measured at home and passed on to the centre to have a remote assessment of whether or not that data remains within the bandwidth determined by the treating healthcare professional. A medical service centre can also independently read measured values or respond to an incident if something is not going well at home and assistance is needed." Van Neste adds; "The advantage of this works both ways: it relieves the pressure on healthcare and it offers comfort for the individual."

Reports received by the centre that fall outside the bandwidth can be prioritised based on, for example, the severity and type of signal, so that they can be dealt with efficiently. "These signals can also be assigned to one of the available employees, based on their specific expertise," says Van Neste. "If physical care is needed, a healthcare professional from one of the partner organisations in the vicinity of the citizen is contacted. This can be the treating healthcare professional, a district nurse or even a caregiver."

360-degree view of the citizen

Essential to making this set-up a success is to bring together data from different sources.

Van Neste: "A digital care platform in which the patient data from the EHR/EHR and from the apps or wearables come together and can therefore be assessed in conjunction to achieve a 360-degree picture. That is the basis of the platform that is used to serve customers as well as possible. Based on an existing platform, Deloitte has developed a version for medical service centres in collaboration with the healthcare organisations. At the moment, we see healthcare organisations themselves experimenting with a variety of pilots with solutions that we believe are difficult to scale up."

"Exactly," adds Van de Louw. "Make use of what already exists. Uniformity in processes, the use of standards and flexibility in technology are the basis for scaling up. In the solution, bandwidths are provided for the values entered and measured by the citizen that the doctor can adjust for each individual patient within the care pathway. In this way, the digital application can be used to make healthcare smarter and more efficient."

Staffing

Fear that the medical service centre will pull healthcare professionals away from regular care - where there is already a shortage of staff - is unjustified. "A different type of professional can work in these centres," says Van Neste. "Think of employees who are no longer able to do the physical work. In this way, they can still be very valuable for healthcare. The same applies to lateral entrants, re-integrators or people who want to work part-time in addition to caring for the children."

Van de Louw adds: "People with a different educational background can also work in these centres, for the support tasks. This creates more room for task differentiation. And also consider the possibility for a healthcare provider to outsource the staffing for the night shift to the medical service centre. This also contributes to efficiency improvements in healthcare."

Scaling up

Medical service centres are still under development. Both are positive about the opportunities for upscaling. "You can see that there is more and more regional cooperation in healthcare," says Van Neste. "This is also in line with the objectives formulated in the Integral Care Agreement. Essential to this is the increased involvement of health insurers."

How healthcare professionals view the role of medical service centres still varies. "There are enthusiastic initiators, but others still have to cross the threshold," says Van Neste. "They want to be clear about whether this is best for the patient/citizen. But when they see that it leads to them having more time for those patients who really need the care, they are often positive." Van de Louw: "I recently spoke to a doctor who said that it gives her much more focus in her work, because she can concentrate on the patients who actually need care, instead of short follow-up consultations."

Citizens are often positive about the opportunity that a medical service centre offers them, both say. "They are open to it," says Van Neste. "Citizen care means comfort for people. And that works both ways: it not only means that they no longer have to go to the hospital for unnecessary consultations, but also offers them the knowledge that the continuous monitoring means that their health situation is always kept in sight. But for further afield in the future, there is much more potential in it than just focus for the healthcare professional and comfort for the citizen. The data collected in this way offers - anonymised - enormous opportunities for research, prevention and personalised care."

In the short term, we will focus on bringing together the existing solutions and learn from what is already happening in industries other than healthcare. We can learn a lot from the business world, where service centres have been used for a long time to contribute to a better customer experience. Look, for example, at the banks that have closed more than 80% of the locations and offer services remotely and mostly digitally, these kinds of trends can also be seen in healthcare. Think of creative partnerships with organisations that can relieve you immediately, such as at medical service centres.

*) This article was also published in ICT&health magazine