Building a Patient-Centric Health Sector in the Middle East

Consumerization in healthcare, like in other sectors, is placing more power and decision-making in the hands of the patient, a trend that has been accelerated by Covid-19. As consumers of healthcare services and products, patients’ expectations drive their behavior and impact their satisfaction with health systems. Failing to meet patients’ expectations can have broader negative implications like higher levels of seeking unnecessary second opinions or poor treatment compliance. Building a patient-centric health sector and understanding what patients do want and don’t want is therefore crucial for both health sector players’ positive impact on society and their bottom line.

In a recent survey, BCG asked ~2.000 patients in the Middle East about their biggest pain points and expectations, with implications for how to build a more patient-centric healthcare sector. Our findings are of special interest to healthcare service providers, but also relevant for other players in the sector including policy makers, payers and healthcare product manufacturers.

This report provides key findings and takeaways for building a stronger and more patient-centric healthcare sector in the Middle East.

What Patients Want – key drivers of provider selection

Most patients reported specific expectations when choosing a healthcare provider – and the expectations are high.

At an absolute minimum, patients want:

• Best outcomes that matter to patients at appropriate costs (high value)
• Coverage within their health insurance plan
• Availability of the service(s) and specialties they are looking for
• Qualified medical teams as a proxy for the quality of care

Most healthcare providers in the Middle East already excel along these dimensions, for example employing qualified medical teams for a broad spectrum of services, differentiating their competitive positioning by focusing on specific qualification backgrounds, e.g., western board certified professionals (e.g. from the UK, USA) or professionals from other regions. Closely linked to the strategic choice of employed staff, coverage under health insurance plans remains a highly relevant decision to be consciously taken by providers. Who are my target customers? How can I reach them? How can I collaborate with insurance companies to provide services that benefit patients locally and globally? These decisions already define key characteristics of providers, but superior performance depends on understanding the more nuanced differentiators that drive patient preference and behavior.

Our findings point to range of ‘softer’ factors that shape the patient experience such as:

• Convenience along the entire patient journey from ease of booking, availability of appointments, travel distance, and short waiting times
• Look and feel, including modern infrastructure and equipment, as well as comfort and cleanliness
• Reputation of both the institutional brand and the individual doctors which is a proxy for quality of care today in the absence of widespread systematic (patient-reported) outcome measurement and transparency

To win the trust of patients and gain competitive advantage in a patient-centric healthcare sector, providers need to master the ‘softer’ elements of the healthcare experience, alongside the ‘harder’ elements of staff qualifications and quality of care in a defined part of the market.

Today’s patients are forcing healthcare providers to reevaluate their offerings and business models: top providers in the coming years will be those that challenge the status quo, continuously improve, and meet or exceed patients’ expectations at every touchpoint.

3 Ways to Patient-Centric Healthcare

 
There are three overarching ways healthcare providers can further advance the patient-centricity: mastering value-based healthcare, accelerating digital transformation, and reorganizing care around the patient.

1. Master value-based healthcare

Value-based healthcare comes in many forms. At its core is to improve the outcomes that matter to patients over the cost to deliver them – the most important factors also mentioned by survey participants when selecting a healthcare provider.

To improve value, providers need to systematically measure outcomes that matter to patients, link them to the costs incurred to achieve these outcomes and establish a culture of continuous improvement and competition around this equation.

• Santeon Hospital Group in the Netherlands, consisting of 7 hospitals across the country, started its “VBHC @ Santeon initiative” in 2015 and embarked on a journey to jointly improve the value of care. For selected patient groups and medical conditions, the structured process of measuring outcomes, analyzing outcomes, and identifying and implementing best practices in a multidisciplinary team setting lead to clear benefits within months. The breast cancer reoperation rate dropped by 27%, and both patients and professionals embraced the new way of patient-centric working towards better outcomes and higher value in healthcare.
• The International Consortium for Health Outcomes Measurement (ICHOM) is a non-profit organization aiming to catalyze global health outcome measurement and improve the healthcare system around outcomes that matter to patients. ICHOM publishes an international standard set of outcomes and risk factors. It covers more than 50% of the current disease burden, detailing for every provider what to measure when, and laying the foundation to measure, benchmark and compete on outcomes and foster a continuous improvement cycle toward value-based healthcare.

2. Accelerate digital transformation

The relationship between medical staff and patients can heavily influence compliance, therapy decisions, well-being, outcomes, and patient satisfaction. Accelerated adoption of digital solutions has the potential to create more valuable interactions between medical staff and patients, leading to improved outcomes. As well as freeing up time for more personal connection, it dramatically increases patient convenience, allowing them to engage with medical staff both at home and onsite, and gain immediate access to care, innovative digital treatments, and more personalized service. As seen with the pandemic-driven surge in telemedicine and AI Bots, digital transformation can reduce the burden of low-value adding tasks for health care providers and facilitate access for patients. But digital should be seen as integrated enabler to increase efficiency and outcomes – not a replacement for doctors, medical staff, or human support.

• Florida’s Panama City Surgery Center launched Jellyfish, a mobile app that patients use to schedule appointments from home, check in, see estimated wait times, and reschedule appointments when necessary. Thanks to Jellyfish, the center reduced patient wait times by 68%, cut patient time from door-to-registration by 50%, and delivered a 28% increase in completed patient satisfaction surveys.
• Barts Health NHS Trust in the UK launched a virtual e-clinic for kidney patients that allowed GPs to answer patient questions in record time. The e-clinic reduced outpatient appointments by 80% and wait time for specialist advice fell from 64 to 6 days.
• To fix waiting times - among patients’ biggest complaints - Singapore General Hospital developed the world’s largest bed management system based on radio frequency identification (RFID) technology. Staff members check patient status in real time, and search electronically for suitable beds. Wait times fell from 90 minutes to 50 minutes and ED admission times fell from 10 hours to 2 hours.

3. Reorganize care around the patient

Above all, it is important to earn patient trust and keep patients at the center of all initiatives. Two healthcare models will help providers become more patient-centric:

(1) Community-based models of care shift the provision of healthcare services into the community and closer to (or into) patient’s homes. Preventive services and basic healthcare services can be provided in outpatient / community settings, increasing convenience for patients and also reducing costs for the provider, payer and health care system overall. Several Middle East markets such as Saudi Arabia and Abu Dhabi are changing their models of care in this direction, and Covid-19 has only accelerated the shift.

(2) Patient population-based teams offer a multi-disciplinary approach related to a patient’s disease for complex cases. For example, a patient diagnosed with cancer needs attention and evaluation from multiple medical perspectives: oncologist, radiation therapist, surgeon, physiotherapist, radiologist, plastic surgeon, and many others. Internationally applied so-called “tumor boards” are a great example of this multi-disciplinary collaboration, provided in a “Center of Excellence” around patients’ needs. This approach excels at meeting a range of patient priorities, including better outcomes, timely access to quality care, and welcome convenience during a challenging time.

To further increase patient-centricity, payers and systems, together with pharma companies, medtech companies and innovative disruptors, need to jointly re-think healthcare’s funding, payment, provision and consumption mechanisms. Innovative reimbursement plans (e.g., bundled payments, value-based contracts, risk-adjusted capitation models) and solutions (e.g., digital) will be needed to address patients’ specific health concerns and maintain an affordable yet top class healthcare sector.