Building a healthcare system that’s Fit for Purpose

As we continue to cautiously manage through the COVID-19 pandemic, it’s important to think about how we can transform our healthcare system to be Fit for Purpose. This includes exploring whether we’re investing strategically in and structuring our health systems to deliver on the Quintuple Aim, an updated term recently put forward by US researchers that sets out five key pillars: improved provider experience, patient outcomes and patient experience, lower cost of care and  health equity.¹

In a static environment, balancing these goals is hard enough. Our environment today is certainly not static. The pandemic exposed and exacerbated existing challenges across Canadian health systems.

In my role, I have an opportunity to work with the many healthcare organizations that are taking action to address these challenges. As the pressure to transform continues to grow, we see further opportunities for organizations to adopt solutions to manage and mitigate rising demands and shore up capacity while delivering on the promise of the Quintuple Aim.

The changing landscape for Canadian healthcare

Before exploring the solutions in detail, it’s important to first examine some of the forces of change creating pressure on the healthcare system. A key issue is our aging population. Based on estimates by the Canadian Institute for Health Information, seniors accounted for about 17% of Canada’s population in 2017. In the next two decades, this is expected to rise to about 25% of the population. Coupled with a rising prevalence of dementia that will result in more patients requiring higher levels of support in their final years, we can expect to see even more strain on our already fragile acute and long-term care sectors. And as healthcare organizations grapple with these pressures, they continue to try to catch up on procedural activities that were paused during repeated COVID-19 waves in the last two years.

Embracing a better path forward

To stay ahead of these forces of change, many organizations are embracing opportunities to shift demand away from our institutional care system. Examples include:

• Developing a holistic aged care pathway that shifts activities to the community and the home: Solutions such as supporting informal caregivers, reforming senior home care programs to improve access to activities of daily living services and incorporating remote monitoring and safety technologies not only mitigate demands on our acute and long-term care systems but also offer a much better aging experience to seniors. 
• Supporting a transitional care pathway: Similar to community support for an aging population, it’s important to look at solutions to help move patients out of acute settings sooner while supporting their recovery and ensuring they’re not readmitted.
• Harnessing data analytics to improve health outcomes: Many healthcare organizations are tapping the power of data and analytics to better understand the needs of the population and create specific use cases for improving care pathways and outcomes.

How organizations can further increase capacity to meet rising needs

While these efforts to shift demand from institutional care are making a difference, the healthcare system faces a critical need to embrace other ways to strengthen capacity and resilience. Our experience during the pandemic made this clear, especially as acute and critical care capacity became key determinants in the adoption or loosening of public health measures during each wave of COVID-19.  

The good news is there are many opportunities for healthcare organizations to increase capacity. Examples include: 

• Renewing physical infrastructure: By some estimates, more than 70% of key medical equipment used in our hospitals is beyond its product lifetime. With governments ready to make generational improvements to physical infrastructure, healthcare organizations will need to identify value capture opportunities to support these investments, as well as the steps necessary to ensure they execute these projects on time, on budget and, ultimately, on scope to deliver the outcomes promised.
• Unburdening your people: By investing in back-office transformation, organizations can create more efficient and effective human resources, finance and supply chain processes, practices and technologies, which ultimately relieves pressure on frontline workers and leaders.
• Creating health human resources capacity: Over the next decade, a significant portion of healthcare workers will be at or beyond retirement age. Coupled with recent exits during the pandemic, now is the time to address the critical staffing shortage across the sector. Beyond national and provincial human resources strategies, we need to embrace immediate solutions such as focusing scope of practice, stratifying and targeted upskilling of key workers to address shortages in the short and medium terms.
• Advancing the digital agenda: While we’ve seen significant progress in the last two years, healthcare organizations need to make sure they maximize operational capacity and harness the full potential of some of the digital solutions they’ve adopted and explore the potential of others.

Helping you create sustained outcomes for the future

These are just some of the opportunities for healthcare organizations to ensure sustained outcomes as they look for ways to better navigate the pressures they face and create capacity to deliver on the goals of the Quintuple Aim. At PwC Canada, we’ve seen how a human-led and technology-enabled approach to these challenges can help organizations accelerate the transformation needed in our health system. This will be key to not only addressing the most pressing challenges of today but also becoming more resilient in the future.

In my new role as PwC Canada’s Healthcare Leader, I look forward to mobilizing our community of solvers, building trust and partnering with stakeholders across the health system to solve these important problems. To discuss the path forward for your organization, please contact me at any time.

_{1 Nundy, Shantanu; Cooper, Lisa; Mate, Kedar, “The quintuple aim for health care improvement,” JAMA, January 21, 2022.}