2021 Predictions: healthcare

Healthcare, globally, has never experienced a year like 2020. The effects of this year will be felt for a long time including not only the long waiting lists that have developed as care has focussed on the pandemic and left healthcare staff exhausted. But also, on how the pandemic forced some digital change to promote more distancing and to deliver massive programmes, e.g. vaccination. This environment will create a need to innovate to cope and likely drive adoption of digital to help staff work more effectively.

In parallel, the NHS will also be changing as it heads towards a new integrated care structure by March 2022. Integrating digital systems across organisations will be challenging but essential work. Some integrated care partnerships are looking at procuring single new systems. Some are looking at how to integrate existing systems. But most have a large technical debt that will need to be addressed to fully realise the benefits from either of these options.

Looking into 2021, there is no doubt that Covid will continue to dominate the healthcare headlines. With the UK’s vaccination programme underway there are real reasons to be optimistic that the pandemic may be brought under control. We can confidently expect the efficacy of the vaccination programme to be the subject of intense scrutiny to bring assurance that the programme itself is meeting the aims of maximising the protection of the population, but also to review the efficacy of the vaccine as new strains of the virus emerge.

While there would be a dominance of Covid-19 driven trends witnessed in 2021, we also see significant opportunities for digital and technology to help remobilise health services and refine their delivery models. In that context, I caught up with healthcare experts Matthew Cooke and Keith Stewart to understand what predictions they have for 2021. This is what I learnt

More use of sophisticated predictive analytics to support capacity/demand modelling

We see real opportunities to use digital tools both to remobilise services effectively and to create a more resilient healthcare system ready for the next challenge, whether another virus or ongoing fluctuations in the impacts of Covid-19. The pandemic has highlighted the challenges of predicting capacity and demand in a rapidly changing and previously unknown situation. This has led many organisations to adopt more sophisticated predictive analytics using various artificial intelligence (AI) approaches rather than traditional predictions based on historical trends. Will 2021 be the year where we see mathematical modelling become the norm in healthcare planning from the strategic to the operational level? There is a lot to unravel.

We will see governance procedures start to return to pre-pandemic models

Healthcare systems had to respond rapidly to develop new ways of working. Governance procedures were simplified and combined with rapid decision making (not waiting for the next committee). Approvals became an iterative and collaborative approach rather than a single submission as exemplified by the approval of new ventilators and vaccines. Approval process that previously took months were safely completed in days. But many see these processes as more challenging to orchestrate. We, therefore, predict that our processes will start to return to the old ways, resulting in delays in implementing change, unless there is strong challenge and robust leadership.

The debate about the use of AI in medicine will continue

While we expect the adoption of AI to support decision making on waiting lists and prioritisation, the use of AI in truly clinical applications is more controversial. There is increasing evidence of the safety and effectiveness of AI-guided image interpretation for reporting scans and x-rays. Its use in clinical decision making will expand but we need far more rigorous evaluations. AI has the potential to decrease inequalities if used wisely but can also amplify present biases. So, we expect more discussions about ethics and inequalities. There is no doubt that AI will have an increasing impact on the delivery of healthcare but is 2021 the year when it moves to be a routine part of care delivery? We suspect not yet: not because AI won’t assist in clinical decision making but rather because in the current climate there is too little emotional and organisational bandwidth to make the decisions to adopt such AI-driven tools. But we do expect the debate to intensify and to see some modest adoption of clinical AI tools in 2021.

We will see increasing use of digital approaches to improve infection control

The need for isolation of individuals has been one of the most challenging effects of the pandemic. With restrictions on visits to the hospital, and self-isolation at home have emphasised the need for better communications that do not rely on face to face contact. Online consultations and remote monitoring will continue to expand, but we will become aware of the advantages and limitations of these routes? Will we see a move to contact lite healthcare in its broader sense? If the trends we see at the beginning of 2021 with the emergence of new, more infectious, strains of Covid continue throughout the year, it is likely that we will see this shift towards low-contact care delivery accelerate.

Covid-19 will continue to catalyse “digital first” agenda in healthcare

The very rapid adoption of patient-facing digital tools during 2020 is testimony to how quickly patient behaviours (and received wisdoms in healthcare) can change. While the use of the NHS App and online consultation tools in both primary and secondary care have scaled rapidly, there is still room for further growth. Arguably consumer-trends will help drive further adoption of these approaches where patients readily accept digital solutions and contact lite healthcare can be the default. We expect to see further scaling of digital-first approaches in existing settings, as well as in mental health services. However, healthcare providers must remain alert to maintain equity of access as more services move to a digital first model.

Clinicians are also telling us they want to see similar strides taken to digitalise the professional-to-professional elements of their workflows. Integration of services across both regions and across historic settings of care will no-doubt help drive the digital first agenda for both patients and clinicians.

As 2021 begins, further tightening of the Covid restrictions have been announced to help relieve pressures on the health service. While we cannot predict when, we remain hopeful that the successful delivery of the UK vaccination programme will quickly reduce the challenges faced by all those involved in providing care. We would like to take this opportunity to express our gratitude to everyone involved in the delivery of health and social care during the Covid pandemic.

Meet our expert

Matthew Cook

Keith Stewart