How focusing on one person’s health can impact everyone

It starts with one person sitting at a desk, working frantically to meet a deadline, guzzling a fizzy drink and snacking on crisps. That’s lunch. There’s no time for a proper meal, no time for exercise, no time for a good night’s rest, barely time for a smoke. Clearly, this is not a very healthy person.

But what if that person quit smoking, started eating better and got regular exercise? Could those changes affect more than just their health?

‘Our data clearly shows that if we could get all of our employees with below-average health status up to the level of the healthiest employees, we could improve operational efficiency by at least 17%,’ says Discovery Health CEO Dr Jonathan Broomberg. ‘To make this concrete: our contact-centre agents with low health scores – for example, smokers – get worse client-feedback scores, make more errors and take longer to handle client calls. The opportunity for us is obvious and compelling and we are hard at work addressing these issues.’

Enter the ecosystem

Discovery Health understands the powerful impact one person can have on the bigger picture. That’s why the company has built the ‘shared value ecosystem’ – an interconnected world of digital services and networks of healthcare providers who are rewarded for placing the member and his/her health first. Just as in nature, the shared value ecosystem connects and benefits all participants in the system: practitioners, hospitals and patients themselves. While this helps to build a stronger healthcare system and better healthcare at a lower cost, everything is underpinned by focusing on the individual – that one person’s health.

This focus is two-fold. One is the Vitality programme, which incentivises each individual’s healthy lifestyle: exercise, healthy eating, having health and wellness checks, getting enough sleep, managing stress, and so on. The other is the focus on the increasing proportion of people – in South Africa and worldwide – who have at least one chronic condition.

‘The problem historically is that “wellness” has been too heavily focused on “well” members,’ says Dr Broomberg. ‘We have always been concerned that people with chronic conditions don’t really engage with the Vitality programme, so we’ve extended it to reward people with chronic conditions for taking good care of their health and wellness. For example, if you have high blood pressure or another chronic disease, you will get rewards for taking your medication as you’re meant to or for having certain checkups.’

The person at the centre

What is the greater impact of keeping the health of the individual top of mind? The World Economic Forum’s recent Insight Report on healthcare states that, while most healthcare providers and systems track some outcomes and costs, quality as a measurement is often defined as compliance with treatment guidelines, or in terms of patient satisfaction – those measurements don’t focus on actual patient outcomes. In contrast, the report looked at value-based healthcare, calling it ‘a genuinely patient-centric way to design and manage health systems’.

‘A healthcare system focused on actual patient outcomes has the potential to deliver substantially improved health outcomes at significantly lower cost,’ the report explains. This involves the measurement of patient outcomes, costs and value. It also means moving towards coordinated care by integrated healthcare teams and including strong incentives for improved quality of care in payments to health professionals and hospitals.

Because the individual patient’s health is placed first, the shared value ecosystem is built to deliver all of the above. Information is tracked and results, costs and quality constantly assessed. In addition, networks of healthcare providers and hospitals are connected, coordinated and ‘rewarded’ for giving better care. This means they’re not paid simply for delivering care; rather, they are paid more for delivering better care that improves patients’ health.

Discovery Health’s Kidney Care Programme is a good example. Launched in 2008 to improve kidney-failure care and reduce long-term costs, Kidney Care was designed to coordinate chronic treatment for kidney patients through a network of doctors, with the GP at the centre. It also collects detailed data from all dialysis providers for every dialysis patient in Discovery’s schemes. That data noted the following between 2013 and 2016:

Total admission rate: down 16.4%
Renal-related admission rates: down 12.3%
Total length of stay: down 9%
Renal-related length of stay: down 9.8%    

What’s good for one is good for all

So, although the ‘shared value ecosystem’ is not at its core about philanthropy, it contributes to healthier individuals and better healthcare on an ever-growing scale. Part of this includes funding the training of more doctors and researchers – the Discovery Foundation has so far channelled R300 million into just that.

‘We think about the business as not only taking care of its immediate participants, but also the broader society and the communities around the business,’ says Dr Broomberg. ‘If more and more people are healthy, then society is better off. It’s more productive, which means business is more productive, which impacts more broadly as well.’

In a country like South Africa, improving health and health services, one at a time, on a population-wide scale could come with massive socioeconomic effects. Take that one person we spoke about earlier. What if that person was you, and what if all participants in the system around you (including you) focused on your health and how to improve it? The result would be a healthier you, a healthier system and therefore many more healthy individuals. That’s shared value. And that’s the difference one person’s health can make to everyone.

‘A genuinely patient-centric way to design and manage health systems.’