Jeffrey Staples is a health-system executive with nearly 20 years of experience in turnaround management and organizational leadership in China, the Middle East, and Southeast Asia across a variety of organizations, including acute-care hospitals, academic medical centers, and ambulatory-care centers. Before beginning his work as the COO at Metro Pacific Hospital Holdings, he held the role of COO at United Family Healthcare, one of the largest integrated private healthcare service providers in China, and was CEO of Sheikh Khalifa Medical City in Abu Dhabi. Dr. Staples and McKinsey recently discussed his views on the acceleration of health technology in the Philippines and the role of ecosystems in healthcare innovation. This conversation is part of the broader Philippines Growth Dialogues interview anthology, which explores the opportunities and challenges to future-proof the country's next horizon of growth and innovation. An edited version of the discussion follows.
Digital health technology in the fast lane
McKinsey: What emerging healthcare trends can the Philippines leverage?
Jeffrey Staples: Two of the biggest trends in healthcare right now are the shifting demographics to an aging population—where you have an older populace with an increased potential in developing chronic diseases and thus requiring additional access to care—and the big push toward the digitalization of healthcare.
The digitalization of healthcare comprises more than just electronic medical records. It includes integrating systems and providing more convenient access to patients—particularly in the time of COVID-19, where people are afraid to go to the hospital or see the doctor. There is still a need to follow up with their doctors. Patients still retain their health problems, and they need a way to access the system that precludes them from physically having to enter a hospital or see their healthcare provider face to face.
The big push right now in the digitalization of healthcare is in telemedicine consultations. This enables one to obtain a consultation, but true telemedicine is more holistic and comprehensive. It includes a diagnosis, the prescription of medication, and the ordering of lab tests and X-rays, beyond “teleconsultation.” This is where everything is moving right now—and quite quickly.
You hear a lot about digitalization, telemedicine and teleconsultation in places where there’s a mature primary-care network. The digitalization of medicine may put primary-care networks under pressure as patients preferentially access telemedicine consultations rather than entering their primary-care clinics. In places where the primary-care network is less mature and less developed, patients have an increased reluctance to enter hospitals. Thus, there is ample opportunity for primary-care networks to decongest hospitals, increase convenience to patients, and allow patients alternative options to physically entering hospitals. This needs to be integrated with telemedicine.
There is ample opportunity for primary-care networks to decongest hospitals, increase convenience to patients, and allow patients alternative options to physically entering hospitals.
An ecosystem-based model of care
McKinsey: With the increasing reliance on digital technologies in light of the mass adoption of remote working practices, what are your thoughts of linking up healthcare to a digital ecosystem? What are some of the key challenges that providers might face?
Jeffrey Staples: When building a healthcare ecosystem, I think the first thing you have to consider is access to care. And when you think about access to care, you need to consider patient wants and patient habits. On primary care, patients generally don't want to travel very far for it. What they are really looking for is convenience of care.
When you think about access to care, you need to consider patient wants and patient habits.
In the event that the individual has a condition that is advanced, difficult to manage, or requires specific expertise, if they’re able to, they are then willing to travel much further to seek a consultation. This is where advanced tertiary care and quaternary care comes in. You need true centers of excellence with the ability to house significant patient volumes and significant clinical expertise. People are then more likely to travel to the centers, with the potential to fly across the country or even halfway around the world.
You would want to have the major referral centers—the major tertiary and quaternary centers in the Philippines—act as the referral centers for the satellite hospitals, which are the secondary and smaller tertiary hospitals. And then, the secondary and tertiary hospitals can act as referral centers for the primary-care networks.
All this, in theory, can be integrated through digital health technology—telemedicine, teleconsultations, electronic medical records, an integrated system to share X-rays and films, and even a shared laboratory. But the ecosystem has to first consider the convenience of care to patients—the extent that they are willing to travel—and then how to integrate it.
Critical care in the future of healthcare
McKinsey: The pandemic has resulted in healthcare providers reimagining and reshaping how healthcare is delivered. What are some changes you expect to see in the industry?
Jeffrey Staples: COVID-19 has spurred the recognition of the need to strengthen the public–private partnership and to strengthen, encourage, and accelerate the development of the private sector. Government facilities now recognize that they cannot do everything by themselves. The patient volume and the load of critical patients can overwhelm healthcare systems, particularly if they’re focused in public hospitals. The government should look at the private sector as being a critical partner in care where they can provide essential services that the government system cannot.
If you’re looking at the evolution of the healthcare landscape, governments will need to support the growth of the healthcare-insurance landscape, both public and private, with an emphasis on the achievement of universal coverage. That could be public coverage or private coverage or a mixture thereof, with varied gradations of coverage, basic coverage for public insurance, and different levels of private coverage, premiums, and reimbursements. This will help the private healthcare system evolve much more quickly and robustly.
If the virus continues to spread, which it probably will over the next year or two, then the pressure on intensive-care units will unlikely subside. The seasonality of influenza already puts intensive-care systems under immense pressure. Hospitals are going to need to have fungibility or easily expandable intensive-care systems. They will need to have more ventilators, more critical-care physicians, and more critical-care nurses.
And if COVID-19 does turn into a seasonal virus and is potentially more active in the winter months like the flu is, then we can expect more critically ill patients for an extended period of time into the future—maybe in perpetuity, if we don’t have an effective vaccine that will suppress the virus. In addition to the development of the public–private partnership and of insurance and a universal payer system, we need to develop our critical-care infrastructure for the forthcoming 12 months, 12 years, 20 years, 50 years—it really is hard to say.
Comments and opinions expressed by interviewees are their own and do not represent or reflect the opinions, policies, or positions of McKinsey & Company or have its endorsement.