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COVID-19 has vividly demonstrated that ‘no health system is an island’ and every country has something to teach and something to learn from the way it’s being managed.

Mark Britnell is the Global Head of KPMG’s Healthcare team that spans more than 45 countries. Below he offers ten insights of how health systems around the world are reacting to the pandemic and becoming more resilient as a result. In addition, a review of high-level considerations are also provided.

Dr. Mark Britnell

Global Head of Healthcare, Government and Infrastructure
KPMG International

Senior Partner
KPMG in the UK

1. Digital front door

COVID-19 has caused health care systems and organizations around the world to rapidly adopt digital healthcare solutions. In many countries, the ‘digital front door’ has become the ‘only front door’ for patients to access clinical services. Hospital out-patient and general practitioner appointments across the world have been transformed with as much as three-quarters of all consultations now taking place virtually.

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Spotlight: Digital front door

When the pandemic crisis abates, we do not foresee the digital front door closing because patients and providers have embraced the convenience and flexibility of this type of care. Now and when we enter into a post-COVID-19 new reality, a key concern for any health system will be scaling and sustaining these digital interactions.
 

2. Clean and dirty sites

In response to the pandemic, health systems across the globe such as China, Spain and the US have introduced strict infection control measures including the separation of COVID and non-COVID patients, to prevent spread in hospitals and care homes.

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Spotlight: Clean and dirty sites

While an effective infection control measure, a side effect of implementing clean and dirty sites has been reduced capacity, particularly for non-urgent procedures. Now and as we enter the post-pandemic new reality, meeting the backlog of elective cases will be a challenge and will require new patient flows through systems to manage this.
 

3. Hot and cold sites

In response to the pandemic, some countries are establishing hot and cold sites. Cold sites deliver non-COVID care in order to lower infection risk, operate efficiently without interrupting acute work and create capacity for elective procedures. Establishing hot and cold sites will be imperative to delivering the kind of new patient flows necessitated by COVID-19. Public Private Partnerships have been formed in some countries to help expand public sector capacity in this way.

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Spotlight: Hot and cold sites

  

4. Scaled up primary and centralized specialty services

With COVID-19, we have seen that there has been a continued push by health systems towards delivering care in the right setting, especially in out-of-hospital care settings (e.g. primary care, home and community care, etc.). This rapid increase in demand has exposed the lack of scale and centralization of the primary care and specialty services, which will be necessary in facilitating any health system’s entry into the post-COVID-19 new reality.

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Spotlight: Acute care, Cancer care, Primary care

  

 5. Aged care services

Elderly populations are particularly vulnerable to COVID-19 and managing the spread of the virus has been a challenge in long-term care facilities across the globe. Amidst this dark time in the sector, a few countries have stood out by taking quick action to protect the lives of their elderly.

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Spotlight: Aged care services, In Singapore and South Korea

COVID-19 has exposed flaws in how health and care systems are organized. Traditionally, aged care services have not been seen as a part of the health system, many governments have recognized this oversight and are taking action. Now and in the post-COVID-19 new reality there is an urgent and ever-increasing need to invest in and effectively integrate aged care services with health systems.
 

6. Supply chain reliance and back office transformation

In addition to the health impact of COVID-19, there are considerable commercial impacts being felt globally particularly in the area of supply chain. The coronavirus has exposed the vulnerabilities of offshore and “just in time” supply chains that rely on lean manufacturing principles. Many governments have taken the lead on procuring Personal Protective Equipment (PPE), some like Russia, the US, Germany and Saudi Arabia have seen the relocation of critical supply production in-country. Furthermore, in some places local supply chains for PPE have cut through regulations and bureaucracy and forged new relationships between manufacturers, universities and procurement specialists.

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Spotlight: Domestic production

As the ‘new reality’ steps in, health systems will need to digitally transform their supply chain models and other middle and back-office functions to be more resilient and responsive to changing clinical priorities. Greater resilience can be achieved through:

  • Larger inventories
  • Supplier diversification
  • Nationalization or regionalization of supply chains

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Spotlight: Analytics and modelling, Digital supply networks

  

7. Command centers

Health systems and organizations in some countries have realized the importance of data-driven insights in strategic and operational decision making. Command centers similar to air traffic control systems, are being developed to manage care in much more effective and efficient ways.

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Spotlight: National systems, Regional systems

While some health systems are making progress in these areas, globally most lack a centralized, data-driven, smart system that can manage resources and assign patient volumes effectively and efficiently which will be helpful in navigating the post-COVID-19 new reality.
 

8. Agile workforce

Healthcare workers have been the heroic face of the pandemic. During the response phase, health systems and providers discovered that their workforce planning and deployment models had limitations. Below are examples of a few systems who were able to evolve their models to overcome some of these challenges:

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Spotlight: Remote working, Flexible regulation, Top of  licenses

To prepare for a ‘staff slump’ due to physical, mental and emotional exhaustion and support operations in a post-COVID-19 new reality, workforce models will need to transform to become agile, employ data-driven insights, and empower their workers.
 

9. Institutional and health system governance

COVID-19 has exposed the need to work collaboratively to deal with the challenges it has placed on workforce, supply chains and infrastructure, amongst others. Through our global network, we have heard of widespread local, regional and national cooperation and this is a trend looks set to increase, as health systems move towards the post-pandemic ‘new reality’.

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Spotlight: Institutional and health system governance

  

10. Project management

Given the fast-paced nature of the changes being implemented in most health systems, an agile project management approach has been adopted by some countries. For instance, in the UK the NHS employed this approach when they converted an exhibition center into a temporary hospital (Nightingale London) in just nine days.

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Spotlight: Project management

To support the post-COVID-19 new reality, providers and governments will need to adopt more agile approaches to project management that allow them to implement rapid changes and performance improvement initiatives.

  

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