Revolution vs. Evolution: Disruptive Approaches to Counteract Demographic Change

The ongoing demographic change with its profound consequences is nothing new for our health sector and its players. Increasing shortages of skilled workers, aging societies, and rising costs: For decades, expert forecasts predict a collapse of our healthcare system due to demographic changes. Nevertheless, political and economic actors remained inactive. No comprehensive reforms and only isolated forays to cope with the emerging healthcare crisis found their way into the economical and political landscape. The results of this rigidity can be observed in all corners of the system and will come to a dramatic head in the coming years. In order to to maintain high-quality care while at the same time being cost-effective, the evolution of our healthcare system must become a radical revolution driven by every single player.

Increasing demand, less care capacities

The lack of skilled workers and increasing issues in terms of recruiting are a common problem within the entire healthcare landscape. There is not only a lack of doctors, psychotherapists and trained nurses in inpatient and outpatient care. The medical technology and IT sectors are starting to groan under the consequences of demographic change. More than 1.8 million open vacancies are expected in the healthcare sector by 2035. Around 20 percent of all practizing doctors will retire in these years, which will contribute to an acute lack of care, especially in rural areas. Even the pharmaceutical industry, which for a long time was particularly popular with applicants due to its high budgets, is now affected by the shortage of skilled workers.

Parallel to the shortage of skilled workers, the demand for healthcare services is increasing. Inpatient doctors currently deal with about 19.8 million cases of treatment per year. This number has risen by more than 2.5 million in the past ten years. Since societies are getting older and older, there is no end in sight to this development. By 2030, researchers predict an increase in life expectancy for men in Germany from 78 to almost 82 years and for women from 83 to 86 years. Due to this change, the number of annual contacts with a doctor and the total number of health services used will rise accordingly. Innovative treatments and medications against e.g. cancer or cardiovascular diseases, which affect older generations, are becoming increasingly expensive due to more patients and rising therapy costs. This puts a strain on the statutory health insurers, which are already running out of their budget. As a result, costs for statutory health insurance could increase by up to 35 percent by 2030. At the same time, the pressure on private health insurers is growing: attractive contributions for privately insured persons while maintaining cost-effectiveness as an insurer could become difficult or even impossible to realize from 2030 onwards.

From evolution to revolution: courage for radical recreation

Until today, the healthcare sector is trying to make use of time-honored and well-established model solutions to defy the demographic challenges outlined above. However, using more resources and higher budgets is only a drop in the bucket and not a long-term solution for facing the crisis. From a long-term perspective, these coping mechanisms will cause damage to the quality of healthcare and the actors‘ business model. In order to turn evolution into a promising revolution, disruptive approaches are needed, which cannot be limited to hiring and HR procedures. Demographic change is not an HR problem – it is a business model problem!

New job profiles such as the Community Health Nurse already mentioned in the latest coalition agreement of the German Government, or newly created care services such as the models of health kiosks and Medical Care Centers (MVZ) are initial ideas to alleviate the approaching challenges through more efficient structures. However, they offer only a rudimentary disruptive solution to an increasingly acute problem. What we need is the consistent use of technology as a substitute for human resources – something that many players in the field still negotiate.

It is necessary to break down the legal barriers that stand in the way of digital disruption within industry to date and protect long-established sovereign rights that we will no longer be able to afford in a few years. Three bottlenecks must be solved as striking examples:

  • Diagnostics: today it is still in the hands of medical practitioners – but it can also be done digitally
  • Treatment decisions: today it is still in the hands of medical practicioners – but it can also be done digitally
  • Dispensing medication: For this, we need a pharmacist or PTA – but platforms and machines can also provide this service

There are many restrictions and legal barriers that still shape our image of good medicine, but at the same time prevent us from rethinking and developing excellent digital care. We are already able to establish completely virtual care paths in standard care today. We need fully automated medicine that can sustainably compensate for bottlenecks and shortages of skilled workers.

Only if companies and administrations get the opportunity to reduce and replace staff workloads by using digital tools, professionals will be able to focus on the most important element of healthcare: The patients who really benefit from human interaction.

The pain of some players will pay off

Today‘s healthcare system in its current structure will neither be able to stop nor withstand the consequences of demographic change. A comprehensive and area-wide digital offensive, which entails a structural reorganization of the sector and its individual players, is inevitable in order to ensure sustainable, high-quality healthcare. That requires the courage to act today, even if letting go of established processes may seem painful for some players at first. It is worth actively shaping demographic change instead of merely enduring it and seizing the opportunities of a newly emerging healthcare system that offers all actors the chance to prove themselves.