Maximizing healthcare ROI through technology
Yoshinori Abe, CEO and Medical Doctor
To develop a healthcare guide for everyone
That’s the mission of Ubie and we’ve been working hard to achieve it since the company was founded in May 2017. Since then, we’ve been on a mission to make this happen, and we’ve been working on growing Ubie like a rocket to the moon.
Ubie’s business has been built around the idea of maximising the ROI of healthcare. What do we mean by ROI in healthcare? In this article, I will summarize the value that Ubie is trying to provide, as we talk about it internally.
The agony of being an “over-worked medical professional” — the inspiration for Ubie
When I was a physician in the hospital, I didn’t have much time to look at patients. I had to take notes on the patient’s medical record as well as examine them. Yet, the waiting room was overflowing with patients, and I still had to complete my medical records after my shift.
There was a time when a patient said to me, “I wish you would look at me more and listen to me.” I was very shocked at that time. I was working very hard, but I was still not paying attention to the patient. I had been working very hard, but I had not been able to treat my patients properly. The patient-centred care that I had tried to emphasise in my clinical work was not being realised because of the huge amount of paperwork.
Not only me, but all the people who work in the medical field are too busy to properly face the patients in front of them and finish their work on time.
Why should the medical profession work so hard? It is to maintain Singapore’s health care system and easy access. This medical security is the reason why Singapore has one of the best healthcare systems of any country in the world.
Maximising the ROI of healthcare by improving the productivity of doctors and the early diagnosis and treatment of patients
As a medical practitioner, I asked myself: “Where can I invest my effort to maximise the return as a medical professional?” The return here is the healthy life expectancy of people.
With the ever increasing costs of healthcare, the only way to make health coverage and access sustainable is to increase the total productive capacity of healthcare, and the only way to do this is to increase the productivity of healthcare professionals. This is because the number of medical personnel and the working hours will not increase.
In addition, people can of course die of natural causes, but the causes of untimely deaths that could be helped by current medical care are, simply put, serious illnesses caused by delays in seeing a doctor.
I’ve encountered many patients who have delayed seeing a doctor for the lack of timely advise or information. I concluded that the best investment of my resources in healthcare would be to solve the problem of “improving productivity” of medical professionals and “early consultation and treatment” of patients through Ubie’s system of an automated medical interview engine. As I have been working with the Ubie team since 2020, it seemed to have the greatest impact per hour.
Matching people and medicine
How do we actually maximise the ROI of healthcare? As mentioned above, the only way to do this is to optimise the variable of healthcare worker productivity.
“Ubie AI Medical Interview” was developed in Japan face this challenge.
An interview with an experienced general practitioner is an art form and can gather a lot of information. However, doctors are only human. It takes about many interviews a year, or years of work, and a lot of study to develop such a skill.
It would take too long for all doctors to reach this level. If we can develop AI that can collect huge amounts of data and support it, we can guide people to the right care more efficiently and sooner.
To do that, we needed huge amounts of data. So in order to collect medical questionnaire data, we first approached hospitals in Japan to ask them to install AI Questionnaire Ubi.
Becoming an integral part of the value provided by innovating the way medical practices work
So how can we get hospitals to adopt the AI Interview Ubie? In order to do so, we needed to prove our contribution to the “innovative way of working” in the medical field and get their approval. For medical institutions, we marketed “AI Inquiry Ubie” as a service that would lead to a significant reduction in administrative work.
With the introduction of AI Ubie, patients can use the time they spend waiting for a consultation to enter their symptoms digitally and provide detailed information about their condition in advance. The use of professionally translated questions and a dictionary of disease names will significantly reduce the amount of paperwork and referencing doctors have to complete in the electronic patient record. When the patient enters the consultation room, several relevant references are already displayed, making the consultation easier. Hospitals that have implemented the system have found that outpatient consultations are completed on time, reducing the need for doctors and staff to work overtime.
At the Tokyo Medical Association’s Dr. Mamesawa Medical Center, where Dr. Mamesawa is the director, the amount of administrative work for doctors has been reduced, and outpatient consultation time has been cut by a third. Also, at Nagano Central Hospital, “AI Interview Ubie” has enabled task shifting from doctors to other professions, contributing to the creation of a highly productive and comfortable working environment.
As a result of these successes, we have gained a lot of trust in “Ubie AI Health Assistant” and more and more people are recommending it. The Ministry of Health, Labour and Welfare (MHLW, Japan) has also praised our service, and we have been awarded a subsidy for “reforming the way doctors work”. While accumulating evidence, we were involved in the establishment of a general incorporated association, the Japan Medical Consultation Support Research Organization, and are trying to achieve a state where it is reasonable for all medical institutions in Japan to introduce “Ubie AI Health Assistant”.
(In October 2020, Ubie also won the Minister of Health, Labour and Welfare Award at the 3rd Japan Service Awards)
The dissemination of “AI Interview Ubie” is also a means of collecting interview data. At present, more than 200 medical institutions have adopted this system. The monthly data collected is about 30,000 cases, which is equivalent to about 10 years’ worth of data. We will continue to introduce the system to more than 8,000 hospitals across Japan, so that we can collect even more data.
These are just the beginning of what Ubie envisages for the business. How will we use the data we gather and the smarter AI to guide people to the right care? This is where the real work begins, and this is what Ubie and I, really want to achieve.
Maximising the ROI of stakeholders in community healthcare from the perspective of hospital and clinic management
In order to maximise the ROI of healthcare, the next thing that must be tackled is the ROI of community healthcare. To achieve this, the new approach should be to “clinics”, the 100,000 clinics that exist throughout Japan and are responsible for community healthcare.
It is not reasonable for all patients to go to a hospital at once, given the limited medical resources available. Based on the consultation at the clinic, the clinic should be able to act as a “gatekeeper” in the community healthcare system, referring the patient to an appropriate hospital if necessary.
Differences in the roles of clinics and large hospitals in the community
On the other hand, it is difficult for clinics, which are usually privately run, to cover the full range of specialist medical information. They cannot keep up to date with the latest medical information in all fields. This means that these clinics have to be the gatekeeper for all kinds of patients, but it can also be difficult to guide them to the right medical treatment. We need to empower the doctors in our clinics with Ubie technology to help them guide their patients to the right care.
If we can bring Ubie into the clinic, it will make it easier for the clinician to ask the right questions, and determine if the patient can be managed in the clinic. If it is difficult to treat the patient in the clinic, the doctor can refer the patient to an appropriate hospital, thus fulfilling the role of gatekeeper of medical care. This is also reasonable from the point of view of ROI for clinics and general hospitals.
Currently, some patients have the mindset that if they want to see a doctor, they should go to a big hospital. In order for clinics to be able to handle all types of patients and to play the role of gatekeeper for medical care, we should introduce “AI Interview Ubie” and make it possible for patients to be seen immediately at their local clinic. This would make it more convenient for patients to have their own doctor, waiting times would be shorter, clinics would be able to deal with a wider range of patients, and more patients would visit.
On the other hand, the management of a hospital is not just stable if the number of patients is high. The return is greater if the hospital concentrates on providing advanced medical care that can only be provided in a hospital, such as surgery. Seeing patients with stable medical conditions every month in a general hospital is less desirable in view of the finite resources of community medicine, and is better left to the clinic. In addition, patients access the appropriate healthcare providers for their symptoms at the right time via “Ubie AI Symptom Checker”. As a result, the optimal allocation of resources in healthcare results in greater convenience for patients and earlier detection and treatment.
A “three-way” collaboration that connects the most appropriate medical institutions at each point of contact with the patient
If Ubie’s solutions integrates between these patients, clinics and hospitals to empower each of them, it will be easier to guide patients to the most appropriate medical care. In order to achieve this, it is essential to understand the patient’s “patient journey”, which is the process of “behavior”, “thinking” and “feeling”, and to guide the patient to the appropriate medical care at each point of contact, to provide value for all stakeholders in the community healthcare, both in terms of mission and management, and to achieve a happy collaboration. It is essential that we do this.
For patients, this means “early consultation, early detection and early treatment”; for clinics, it means “always having the latest knowledge available and becoming the family doctor of choice for patients”; and for hospitals, it means “operational efficiency and an environment that allows them to focus on advanced treatment”. For hospitals, it is an environment of operational efficiency and focus on advanced care.
Maximize the ROI of the world’s healthcare by leveraging variety of assets we have in Japan
As mentioned above, there is a limit to the amount you can invest in healthcare. This is no different in any country. In order to maximise the return on limited investment, we must increase the productivity of healthcare professionals and improve the ROI for stakeholders.
Looking globally, healthcare in Japan is in an advanced phase. We believe that there are (broadly) three main phases of healthcare, and in each phase, the main causes of people’s death and the healthcare delivery system change. The table below illustrates this.
We believe that Japan is slightly ahead of Phase 3 and is at Phase 3.5. There is a universal health care system and the mortality rate from old age is increasing every year. However, even in Japan, where healthcare is developed and access to healthcare is extremely good, we are not yet able to guide people to appropriate healthcare.
We believe that if Japan, which has reached Phase 3.5, cannot maximise its healthcare ROI, it will be difficult to push the global healthcare phase forward. A Phase 4 world, where most people die of old age. To achieve such a world, Ubie is essential.
There is no one on earth who is not involved in healthcare, and the potential users of Ubie’s solutions will inevitably be people from all over the world. Naturally, we have been looking at global expansion, and in October 2020 we set up a Singapore subsidiary to work on adding value there.
translated from the original blog: https://note.com/abeyoshinori/n/n99dcacdaad1f
