Healthcare Leaders Look Beyond The Crisis United States - Philips
A resilient futureHealthcare leaders lookbeyond the crisisUnited States1The Future Health Index is commissioned by PhilipsFuture Health Index 2021 A resilient future – United States
Contents03 Foreword04 Research premise05 Learning from the past, optimistic about the future09 Taking a three-step approach to digital transformation14 Building sustainable systems to deliver future-proof care19 Conclusion21 Glossary of terms22 Methodology24 Sources2Future Health Index 2021 A resilient future – United States
ForewordThe COVID-19 pandemic has tested the resiliency of health networks,technologies and most importantly, our healthcare workers, but it has alsohad a surprising impact on how healthcare leaders see the future ofhealthcare. In the U.S., the pandemic forced health systems to hit pause ontheir transition to value-based care, quickly pivoting to scaling emergencyand ICU care to support their communities, while accelerating the use oftelehealth technologies and other innovative approaches to care delivery.In the 2021 Future Health Index report, we find healthcare leaders takingthe tough lessons learned in the crisis and applying them to the future ofhealthcare.Joseph FrassicaHead of Research the Americas andChief Medical Officer North America, Philips3Telehealth is currently having its moment, with many of these leaderslooking at new ways to extend care into their communities. At the same time,they also understand the need to invest in Artificial Intelligence (AI)-basedsolutions. As they tackle the challenges of operational efficiencies, datamanagement and interoperability, they are also positioning themselves totake full advantage of this emerging technology.Future Health Index 2021 A resilient future – United StatesEncouragingly, they are also looking to tackle some of the biggest socialissues that the pandemic has brought into sharp relief, including the need toaddress the issue of health equity. Over 68% of the healthcare leaderssurveyed indicate that their hospital or health facility is either currentlydeveloping or intends to develop plans to address health disparities withinsocially disadvantaged communities. Sustainability similarly becomes a focusas 67% of leaders say that implementing sustainability practices three yearsfrom now is a top priority.Moreover, these healthcare leaders understand that they can’t go it alone ifthey are going to make a meaningful impact on healthcare, and are lookingat strategic partnerships to help drive innovation. Whether it be with otherhospitals, B2B health technology organizations or more traditionaltechnology players, they are looking for partners to give their staff the digitaltools they need to deliver quality care.There will certainly be more challenges ahead, but today’s healthcare leadershave a confident outlook for their own health systems and for the health ofthe nation.
Research premiseIn its sixth year, the Future Health Index2021 report is based on proprietaryresearch across 14 countries.The research considers how healthcareleaders* are meeting the demands oftoday and what the new reality ofhealthcare post-pandemic might look like.Specifically, the report explores thechallenges they have faced, theirinvestment in digital health technology,and a new emphasis on partnerships,sustainability and new models of caredelivery, both inside and outside thehospital.This is the largest global survey analyzinghealthcare leaders.AcrossResponses from almost143,000healthcare leaderscountriesCountries included in the researchAustraliaIndiaSaudi ArabiaBrazilItalySingaporeChinaNetherlandsSouth AfricaFrancePolandUnited StatesGermanyRussia*Healthcare leader is defined as a C-suite or senior executive working in a hospital, medical practice, imaging center/office-based lab, or urgent care facility who is a final decision maker or has influence in making decisions.4Future Health Index 2021 A resilient future – United States
1ThemeLearning from the past,optimistic about the futureDespite the heroic efforts of medical staff, the COVID-19pandemic has revealed long-standing vulnerabilities inhealthcare systems around the world. At the same time,the crisis has also accelerated much-needed progress incare delivery for both patients and providers in the UnitedStates1, including a radical shift to remote or virtual care.As US healthcare leaders look ahead, they feel anincreasing sense of optimism, and belief in the resilience oftheir own healthcare facilities and the US healthcaresystem as a whole.Healthcare leaders in the US are also maintaining a focuson the adoption of value-based care. While the pandemichas necessitated an increased focus on volume over valuemetrics2, roughly half of healthcare leaders in the US areplanning innovation in payment models in the future.5Future Health Index 2021 A resilient future – United StatesI’m really confident that treatment [is getting] better andbetter and better it’s really amazing what we can dowhen we get out of our own way.IT Director, Hospital, US
Theme 1 Learning from the past, optimistic about the futureUS healthcare leaders tackle short-term pandemic challengesPandemic drives focus on virtual careTop current priorities of US healthcare leaders:At the time this research was conducted, the United Stateshealthcare system continued to grapple with very highpatient numbers, lockdown orders, limited testing and stalledvaccine rollouts.2 As a result, the majority of healthcareleaders in the US rank preparing to respond to crises asamong their top priorities currently, in addition to facilitatinga shift to remote or virtual care. They are more likely thantheir peers across many of the countries surveyed toprioritize this shift to remote or virtual care.Preparing to respond to crisesDespite short-term challenges, leaders expect little long-termimpact from staff burnout and attritionFaced with over 1.8 million new hospital admissions of patientswith COVID-19 between August 2020 and March 20213, it isunsurprising that US healthcare leaders are more likely thanthose across most of the countries surveyed to cite thepandemic as one of the external forces most impeding theirability to prepare for the future (87% vs. 68% 14-countryaverage).74%United StatesFacilitating a shift to remote/virtual care69%89%14-countryaverageFrance79%80%65%Germany NetherlandsWhile roughly half (47%) of healthcare leaders in the UnitedStates believe clinical burnout and attrition as a result of theCOVID-19 pandemic will have at least a moderate impact in theshort-term, only 12% expect this level of impact in the future.These findings correspond with the results of last year’s FutureHealth Index Insights report4, where roughly three-quarters(79%) of younger doctors in the United States said theirexperiences as a healthcare professional working during thepandemic have had either no impact on their likelihood to stayin medicine or made them more likely to stay in the nyNetherlandsUnited StatesLevel of impact of clinical burnout and attrition expected by UShealthcare leaders on their hospitals or healthcare facilities dueto the pandemicLonger-term (once the pandemic recedes)1%Severe impact3%Major impact9%Moderate impact58%30%Minor impactNo impact at allNote: due to rounding, percentages may not sum to 100 percent.Base (unweighted): Total healthcare leaders (United States n 200; 14-country avg. n 2800; France n 200; Germany n 200; Netherlands n 200)6Future Health Index 2021 A resilient future – United States
Theme 1 Learning from the past, optimistic about the futureA strong sense of optimism for the futureUS healthcare leaders confident in the resilience of theirhealthcare systemHealthcare leaders in the US are more likely than those acrossmany of the countries surveyed to say they are confident in theability of their country’s healthcare system to deliver quality careas they look toward the future.Healthcare leaders who are confident in the ability of thefollowing to deliver quality care as they look toward the future94%88%My country’shealthcare systemUnited States81%Most healthcare leaders in the United States also believe that thepolicies and plans put in place during the pandemic are helping tobuild a more resilient healthcare system. For example, in March2020, new federal requirements issued by the Centers forMedicare & Medicaid Services (CMS) empowered theUS healthcare system to increase hospital capacity, expand thehealthcare workforce and increase the use of telehealth.5Healthcare leaders who agree that current healthcare policiesand plans in their country are contributing to building a resilienthealthcare systemUnited States84%14-country average81%France94%Germany96%Netherlands86%75%My hospital orhealthcare facility14-country averageBase (unweighted): Total healthcare leaders (United States n 200; 14-country avg. n 2800; France n 200; Germany n 200; Netherlands n 200)7Future Health Index 2021 A resilient future – United States
Theme 1 Learning from the past, optimistic about the futureCrisis sparks a reappraisal ofvalue-based careValue-based care aims to pay for value rather than volume by incentivizing providers and otherstakeholders to improve access to care and health outcomes while reducing the cost of care.Despite the effects of COVID-19, the United States government has maintained its desire to linkhealthcare payments to value-based care – pushing for half of Medicaid and commercialcontracts to be in value-based reimbursement models by 2025.6 In line with this, roughly half ofUS healthcare leaders say they are still planning to pursue it in the future despite the challengesof the pandemic, and in greater numbers than those across most of the countries surveyed.Adoption of value-based care52%25%Say they plan to pursue a shift toward value-basedcare in the futureSay they havedeprioritized the shifttoward value-basedcare due to theCOVID-19 pandemic8%Base (unweighted): Total healthcare leaders (United States n 200)8Future Health Index 2021 A resilient future – United StatesSay they startedpursuing a shifttoward value-basedcare but decidedagainst it
2ThemeTaking a three-step approachto digital transformationAs healthcare leaders in the United States adapt to the immense changes of the past year, they appear to be taking athree-step approach to digital transformation.Short-term investment in telehealth toshore up care delivery during thepandemic. Key policy andreimbursement model changesenabled rapid uptake.7Investment in artificial intelligence (AI)to ramp up as the pandemic recedes,and as leaders look to technology todrive operational efficiencies andimproved care outcomes in thelonger term.Partnership and collaboration withother private hospitals and B2B healthtechnology companies to facilitate theuse of these technologies.AI has great promise and I think it’ll continue to permeate not just the EHR and the clinician point ofview, but through the internet of things – all of the devices that will increasingly become integral topatient self-care and to their remote interactions with clinicians.Chief Medical Informatics Officer (CMIO), Integrated Delivery Network, US9Future Health Index 2021 A resilient future – United States
Theme 2 Taking a three-step approach to digital transformationStep one: build a lasting digital health legacyHealthcare leaders invest in telehealth during COVID-19US healthcare leaders are currently investing intelehealth in higher numbers than those across the largemajority of countries surveyed, suggesting large-scalerecognition of the value of virtual care delivery. Thefoundational work in telehealth adoption andinfrastructure development being done in the UnitedStates today will likely continue to deliver benefits in thefuture, even as healthcare leaders shift investmentpriorities to other technologies.Healthcare leaders who say telehealth is one of the digital health technologiesthey are most heavily investing in now and in the future89%64%40%CurrentlyResearch from McKinsey8 found that 57% of UShealthcare providers view telehealth more favorablythan they did before the pandemic. As important astelehealth has become amid COVID-19, the FutureHealth Index shows that they expect their investmentin telehealth to drop significantly three years fromnow. One potential reason could be that leaders willhave already built a lasting foundation upon whichfurther digital transformation and future healthcaredelivery models can be built.14-countryaverage83%64%30%24%United StatesInvestment priorities shift as leaders look to years ahead77%83%FranceGermanyImage TBCNetherlandsThree years from nowTypes of telehealth healthcare leaders are most heavily investing in now and inthe ofessionaltelehealthThree years from nowBase (unweighted): Total healthcare leaders (United States n 200; 14-country avg. n 2800; France n 200; Germany n 200; Netherlands n 200) Telehealth as stated here is representative of both healthcare professional-to-patient telehealth as well as healthcare professional-to-healthcare professional telehealth10 Future Health Index 2021 StatesStates24%71%15%
Theme 2 Taking a three-step approach to digital transformationStep two: invest in artificial intelligence (AI)Investment in predictive technology and AI to increasedramatically in three yearsPredictive technologies such as AI and machine learning havethe potential to transform both the delivery of healthcare –through diagnosis, treatment and patient engagement – andalso the working experience of healthcare professionals.9For example, according to a study published in Cancer, the useof AI is enabling clinicians to review mammograms faster andwith 99% accuracy, reducing the need for unnecessarybiopsies.10While US healthcare leaders are focused on gettingfoundational telehealth infrastructures in place today, as theylook beyond the immediate needs of the pandemic, they see AIemerging as a key investment priority to help them prepare forthe future of care.US healthcare leaders expect to seek a range of benefits fromthe implementation of AI, with optimizing operationalefficiency and integrating diagnostics being among the keyareas for investment three years from now.Healthcare leaders who say their hospital or healthcarefacility most needs to invest in implementing predictivehealthcare technologies to be prepared for the futureUnited States7%Currently11 Future Health Index 2021 A resilient future – United States57%26%Three yearsfrom nowCurrently40%Three yearsfrom nowDigital health technologies US healthcare leaders are mostheavily investing in now and in the future: AI technologies47%11%AI to optimizeoperationalefficiencyBase (unweighted): Total healthcare leaders (United States n 200; 14-country avg.n 2800)14-country averageCurrently38%34%3%AI to integratediagnostics1%AI to predictoutcomesThree years from now32%2%AI for clinicaldecisionsupport
Theme 2 Taking a three-step approach to digital transformationStep three: drive change withstrategic partnersNon-traditional players seen to help improvecare modelsAs healthcare leaders consider ways to boostinnovation in their hospitals and the broaderhealthcare system, non-traditional playerssuch as technology companies can take animportant role. These organizations have thepotential to introduce new technologies andscientific discoveries to help improve caremodels.11,12In addition to reallocating budget to allow forinvestment, roughly one-third of UShealthcare leaders say that prioritizingstrategic partnerships and collaborations isnecessary to successfully implement digitalhealth technologies within their hospital orhealthcare facility.To drive forward digital transformation, UShealthcare leaders want to collaborate mostwith other private hospitals and healthcarefacilities as well as B2B health technologycompanies – at higher rates than the averageof those surveyed across the 14 countries.Top organizations healthcare leaders want tocollaborate with to drive digital transformation withintheir hospital or healthcare facilityOther private hospitals/healthcare facilities47%29%B2B health technology companies36%28%Health IT/informatics companies36%27%United StatesBase (unweighted): Total healthcare leaders (United States n 200; 14-country avg. n 2800)12 Future Health Index 2021 A resilient future – United States14-country average
Theme 2 Taking a three-step approach to digital transformationBold plans hit by lack of budget andstaff experienceConstrained budgets, staff inexperience and staff shortagesare impeding progressUS healthcare leaders face a number of barriers to progress,with financial constraints, staff inexperience with newtechnologies and staff shortages most frequently cited asimpeding their ability to prepare for the future. In theFuture Health Index 2020 report13, younger US healthcareprofessionals voiced similar concerns, with many feelingthat their medical education failed to provide them with keynon-clinical skills necessary for their day-to-day work.Difficulties with data management and a lack ofinteroperability are among the biggest barriers to theimplementation of digital health technologies cited by UShealthcare leaders. Similarly, in the Future Health Index2020 report13, most younger healthcare professionals in theUnited States (68%) said that interoperability betweenplatforms needs to be improved to ensure healthcare data isused to its full potential.Top internal barriers impeding ability to prepare for the %31%Staff’s lack ofexperiencewith ilosTop barriers to the adoption of digital health technologieswithin the hospital or healthcare facility50% Difficulties with44% data management35% Lack of interoperability/dataacross technological37% standardssystems and platforms28% Financial/budgetarywithin21% constraintsmy hospital/healthcare systemBase (unweighted): Total healthcare leaders (United States n 200; 14-country avg.n 2800)13 Future Health Index 2021 A resilient future – United StatesUnited States14-country average
3ThemeBuilding sustainable systemsto deliver future-proof careAs healthcare leaders in the United States consider lifebeyond the pandemic, they are taking an active role todrive positive changes in where and how care is delivered.COVID-19 has shed light on how socioeconomic factors canaffect health outcomes. As healthcare leaders begin to lookbeyond the pandemic, they are looking closely at how theycan do their part to improve health equity across thenation.There is also a growing consensus among US healthcareleaders that more routine care delivery will take placeoutside the walls of their hospital or healthcare facility inthe coming years, with the use of ambulatory primary carecenters expected to increase.14 Future Health Index 2021 A resilient future – United StatesUS healthcare leaders are making an overwhelmingcommitment to improving sustainability, pledging toaddress the environmental footprint of their hospital orhealthcare facility once the immediate needs of the crisissubside.I think as technology for remote monitoring improves, youare going to see a lot more push to just have people at home.And I think the pandemic really accelerated that initiative.CEO, Private Multi-Practice Facility, US
Theme 3 Building sustainable systems to deliver future-proof carePandemic spotlights healthcare inequitiesThe US leads the world in many areas of healthcareinnovation. But it also lags behind much of theindustrialized world in improving care for some of its mostvulnerable populations. Black, Hispanic and Indigenouscommunities in the US suffer from tremendous healthcaredisparities – experiencing a greater burden of illness,disability and mortality relative to other groups.The evidence is stark: Black infants are more than twice aslikely to die before their first birthday as white infants.14Amid the current pandemic, Black, Hispanic and AmericanIndian or Alaska Native populations are at least 4.7 timesmore likely to be hospitalized for COVID-19 than nonHispanic white people.15US healthcare leaders recognize the role they have to playin addressing these inequities. While few of their hospitalsor healthcare facilities have initiatives currently in place,roughly two-thirds are either currently developing plans toimprove healthcare provision for disadvantaged groups, orplan to in the future.Base (unweighted): Total healthcare leaders (United States n 200)15 Future Health Index 2021 A resilient future – United StatesHospital or healthcare facility’s situation regardinginitiatives to solve for health disparities within sociallydisadvantaged communities6%68%Currently haveinitiatives in placeAre currently developinginitiatives or intend todevelop initiativesin the future
Theme 3 Building sustainable systems to deliver future-proof careCare moves beyond hospital wallsHighest influx expected in ambulatory primary careIn three years, US healthcare leaders expect routine caredelivery to grow outside the walls of their hospital orhealthcare facility, with ambulatory primary care expectedto see the biggest increase. Pharmacies and other retaillocations as well as the home are also expected to grow intheir use for routine care delivery.This may be due to an increased adoption of telehealthtechnology for ambulatory care since the start of theCOVID-19 pandemic. In fact, according to the AmericanMedical Association, ambulatory primary care at ClevelandClinic pivoted from a rate of 10% virtual visits to 80% virtualvisits in 2 months.16 The Centers for Medicare andMedicaid Services (CMS) also created the Acute HospitalCare at Home program to promote at-home hospital careto increase the capacity of healthcare systems dealing witha pandemic surge and to help keep patients safe.17Top locations (outside of the hospital or primary care facilities)for routine care delivery43% 74%16 Future Health Index 2021 A resilient future – United States2%8%Currently16%20%20%23%United States 31pptsAmbulatoryprimary carecenters 13 pptsPharmaciesand other retaillocationsThree years from now14-countryaverage 6 pptsHomeThree yearsfrom nowUnited StatesCurrentlyBase (unweighted): Total healthcare leaders (United States n 200; 14-country avg. n 2800)2% 15%Average proportion of routine care delivery healthcare leadersbelieve is performed outside the walls of their hospital orhealthcare facility14-countryaverage
Theme 3 Building sustainable systems to deliver future-proof careAn immense push toward sustainabilitySustainable healthcare to jump from bottom to top of US healthcare leaders’ priority lists in the next three yearsNon-governmental bodies such as the World EconomicForum are challenging the industry to help build amore sustainable healthcare ecosystem. This isparticularly vital for healthcare leaders in the UnitedStates, since their sector is responsible for about aquarter of all global healthcare greenhouse gasemissions – more than any other nation.18 To addressthis, US government initiatives such as Healthy People2020 have included objectives that advanceenvironmental health.19Across the 14 countries surveyed, healthcare leadersare planning a radical shift in their priorities, with theimplementation of sustainability practices expected tobecome a primary goal three years from now. UShealthcare leaders show an even strongercommitment to change than the average of thosesurveyed across the 14 countries.Healthcare leaders who say implementing sustainability practices at their hospital or healthcare facility isa top priorityUnited States1%Currently67%Three yearsfrom now14-country average4%CurrentlyBase (unweighted): Total healthcare leaders (United States n 200; 14-country avg. n 2800)17 Future Health Index 2021 A resilient future – United States58%Three yearsfrom now
Report conclusion18 Future Health Index 2021 A resilient future – United States
ConclusionA vision of sustainable and patient-centered healthcare, enabled by smart technologyExploring the findings of the Future Health Index 2021 report, several notable themes emergeas healthcare leaders consider what lies ahead:Strong optimismamong healthcare leadersA roadmap for benefitingfrom smart technologies thatconsiders the tools that arecurrently available to them19 Future Health Index 2021 A resilient future – United StatesGrowing interestin sustainability andenvironmental sourcingAn emphasis on strategicpartnerships to fosterinnovation and delivermuch-needed technologyinfrastructureIncreased anticipationof care delivery outsidethe hospital, driven bypatient demand
Appendix20 Future Health Index 2021 A resilient future – United States
Glossary of termsAmbulatory primary care centerOutpatient care centers (e.g., urgent care, walk-in clinics, etc.)Analog hospitals or practiceMost or all patient data is handled in a paper-based format orusing traditional communications, e.g., phone, fax, etc.Artificial intelligence (AI)AI refers to the use of machine learning and other methodsthat may mimic intelligent human behaviors, resulting in amachine or program that can sense, reason, act and adapt toassist with different tasks.Augmented reality (AR)A technology that superimposes a computer-generated imageon a user's view of the real world, providing a composite view.In healthcare, this can allow a surgeon, for example, to see livedata or 3D medical imagery in their field of vision whenperforming procedures.B2B health technology companiesCompanies that sell products, equipment, or solutions tohospitals and healthcare facilities.Consumer health technology companiesCompanies that sell or provide wearables, health apps andother technology to the general public.C-Suite -1A hospital or healthcare executive who is a level below the roleof C-Suite. Job titles can include head of department, seniorpartner, or director.Data privacyThe culture expectations, organizational regulations andlegislation that protect personal information from unauthorizeduse and dissemination.Data securityProtecting data against unauthorized access.Digital health recordsTechnology that can store a variety of health information,including medical history, test results, health indicators, etc.Digital health records can be used within a certain healthcarefacility, across different healthcare facilities, by only thepatients themselves, by one healthcare professional or acrossall healthcare professionals involved in a patient's care.Electronic medical records (EMRs) and electronic health records(EHRs) fall within the term 'digital health records'.Healthcare leaderA C-suite or senior executive working in a hospital, medicalpractice, imaging center/office-based lab, or urgent care facilitywho is a final decision maker or has influence in makingdecisions.Digital health technologyA variety of technology that transmits or shares health data.The technology can take a variety of forms, including but notlimited to home health monitors, digital health records,equipment in hospitals and health or fitness tracker devices.InteroperabilityThe ability of health information systems to work togetherwithin and across organizational boundaries, regardless ofbrand, operating system or hardware.Digital hospitals or practicesSimple/basic technologies are used, with most or all patientdata and communications being handled electronically.Digital transformationThe integration of digital technology into all aspects of how ahealthcare business interacts with patients, healthcareproviders and regulators.Global non-governmental organizationsOrganizations such as WHO, World Bank, etc.Healthcare professionalAll medical staff (including doctors, nurses, surgeons,specialists, etc.), and excludes administrative staff.Healthcare professional-to-healthcare professional telehealthVirtual communication between healthcare professionalsthrough sharing images, recommending treatment plans, etc.Healthcare professional-to-patient telehealthCommunication between healthcare professionals and theirpatients via video calls, patient portals, etc.21 Future Health Index 2021 A resilient future – United StatesHealth IT/Informatics companiesCompanies that build communications protocols withinhealthcare systems (e.g., Cerner, Epic, etc.)Machine learningA process of AI that provides systems with the ability toautomatically learn and improve from experience without beingexplicitly (re)programmed.Out-of-hospital procedural environmentsCare centers such as ambulatory surgical centers, office-basedlabs, etc.Predictive technologiesA body of tools capable of discovering and analyzing patterns indata so that past behavior can be used to forecast likely futurebehavior.Reimbursement model limitationsBarriers to healthcare payments and benefits.Remote patient monitoringTechnology that provides care teams with the tools they needto remotely track the health of their patients outside ofconventional clinical settings (e.g., at home), collaborate withthe patients' other healthcare professional(s) and help detectproblems before they lead to readmissions. Examples of thisinclude cardiac implant surveillance, vital-sign sensors athome, etc.ResilienceThe capacity of hospitals or healthcare systems to quicklyrecover from challenges.Smart hospitals or practicesAdvanced connected care technologies are used, in addition topatient data and communications being handled electronically.StaffThis refers to all staff, including physicians, nurses,administrative employees, etc.SustainabilityMeeting the environmental needs of the present withoutcompromising the ability of future generations to meet theirown needs.Telehealth/Virtual careThe distribution of health-related services and information viaelectronic information and telecommunication technologies.Value-based careThe c
healthcare workforce and increase the use of telehealth.5 Base (unweighted): Total healthcare leaders (United States n 200; 14-country avg. n 2800; France n 200; Germany n 200; Netherlands n 200) Healthcare leaders who agree that current healthcare policies and plans in their country are contributing to building a resilient healthcare system
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