Why Salaso

Healthcare is changing. Or perhaps more accurately, healthcare needs to change. And Salaso was founded to make that happen.
Not a day goes by without a fresh story about over-worked clinicians, or patients unable to access the services they expect. In the last few months, a wave of familiar winter illnesses has left health services in Ireland, the UK, and across Europe ‘on the brink of collapse’.

It doesn’t have to be this way. Better healthcare for all is possible. And it isn’t just a matter of resources (although yes, they would help). It is about re-thinking the way services are delivered, and particularly the way that the healthcare industry takes advantage of advances in technology, to secure the best possible care for all.

Diagnosing the problem

In truth, there are no easy answers to the challenges healthcare systems face today. But it is certainly true that if you ask healthcare professionals to discuss what needs to happen, you are likely to hear the same complaints about the way things are done today. Here are just a few, in no particular order:
  • An over-reliance on acute and hospital settings, with their accompanying high costs, for even routine care
  • A related difficulty in moving patients seamlessly through multiple care settings, sharing data and expertise across those settings, and thus providing holistic patient care throughout the entire system
  • Lack of support for digital and other remote therapy and treatment options, which can both improve efficiency and patient satisfaction
  • A general lack of preventative care, particularly clinician-led care, which in turn means an increase in patients presenting with serious medical issues further down the line
The list could go on, but it might be wiser to stop and identify what connects all these challenges. Those connections could be summarised as follows: An inability to deliver the right care in the right environment, use the time of clinicians where it most counts, and as a result, reduce costs and improve care for all. Most of this isn’t new. Every major healthcare system in the world is moving towards an “integrated care” or “continuity of care” model, one that explicitly addresses these concerns. But most are doing so at a painstakingly slow pace, one that isn’t helped by the huge burdens already imposed on clinical staff, burdens that make any movement in the right direction almost more painful than the status quo. But it is vitally important to keep our eyes on the goal. Integrated care means:
  • Care consistently delivered in the right, and most cost-effective, context
  • Patients able to engage with healthcare systems on their own terms, but clinicians in control
  • Integrated management of patients across multiple settings
  • Improvements in operational efficiency and productivity
  • A new emphasis on prevention, in which clinicians identify and manage risks before they become acute disease

Looking at this wish list, most would agree that information technology has a role to play in our response. But it is an area that is frequently misunderstood, and one that if implemented poorly can make matters worse, not better.

The perfect platform for preventative medicine

There are any number of technologies that a patient may interact with for lifestyle, wellness or health purposes. digital therapy can be a vital tool in changing the way healthcare is delivered.

The simplest and most obvious way technology can help is by supporting remote therapy. Whether that is actual interaction with a clinician, or simply providing the content a patient needs to follow a given course of treatment, the digital therapy that technology allows can deliver significant productivity benefits. It can also make patient’s lives a lot easier, of course.

And digital healthcare doesn’t stop there. Digital health technologies support the collection, parsing and presentation of data back to clinicians. That in turn gives them greater insight, supporting better decision-making and a higher standard of care overall. 

It also gives us the ability to manage patients as individuals, as groups, and even as populations – and follow them across multiple interactions, with multiple clinicians, in multiple settings.In some cases, technology can alert clinicians to patients at risk and recommend interventions. It can save lives.

But technology alone is not the answer. Ultimately, successful healthcare needs clinicians in control: it just needs to ensure that their time is spent in the most effective way possible. We need digital health solutions that support clinicians, help them do more with less, and make their lives easier, not more complicated. We need to combine the best aspects of technology with the human touch, in genuine ‘hybrid care’ approaches.

That is the type of solution that we in Salaso have dedicated ourselves to delivering. And we think the ‘hybrid care’ it supports can make a real difference in health.

What hybrid care looks like in practice

“Hybrid care” as a term is usually used to refer to a combination of in-person and virtual engagements between clinician and patient. As a definition, that is fine as far as it goes, but I believe that as healthcare professionals we should be more ambitious. 

Instead of simply replacing some in-person visits to the doctor with a session on Zoom, shouldn’t we be creating a world in which patients can engage in whichever way that suits them? One in which integrated care is delivered across every potential setting, and where patients can switch between those settings seamlessly, and with every relevant clinician having the information he or she needs?

Shouldn’t we be exploring the areas in which digital therapy isn’t just cheaper, but is better in terms of patient and indeed population outcomes? To give just three examples these could include:

  • Post-operative, clinician-prescribed recovery programs and exercises for oncology patients
  • Ongoing management of musculoskeletal conditions
  • Preventative therapy for patients considered at elevated risk of heart attack or stroke

In each of these cases, digital therapy built on established medical pathways, and delivered within a clinical framework, has the potential to dramatically improve outcomes and greatly reduce dependency on acute settings.

But those caveats are key to the effective delivery of hybrid care. Without clinical oversight, and without an absolute commitment to medical best practices, everyone involved is short-changed – and we are just storing up trouble for the future. What is required is a system that allows digital (and indeed real-world) therapies to be delivered within an integrated, clinician-led framework.

Clinician-led patient management

Healthcare works best when controlled by clinicians. But the time of those clinicians is limited, and something stretched almost to breaking point. Fortunately, hybrid-care implemented in the right way can ensure that clinician time is consistently spent in the right way, and that ‘every contact counts’.

At the same time, it must also ensure that where clinicians are NOT needed, meaningful effective healthcare continues.

To fulfil both these criteria, a system must give clinicians the ability to place patients on the right treatment pathway, and have confidence in the quality of the digital content that supports it. It must also support the delivery of real-time patient feedback and data-driven insights – in a variety of forms – to the clinician. 

With such a system in place clinicians are able to manage patient interaction, adjust care plans if necessary, arrange in-person consultations, or just send feedback electronically. In some cases, they may also want to refer the patient to another clinician or setting, and when they do all associated information follows that patient.

In other words, the clinician remains in control, but his or her reach is greatly extended, and patient engagement increases.

Better outcomes for all

Why does this matter? Because ultimately it means better health outcomes, delivered with the same, or even fewer, resources.

It becomes easier to place patients onto meaningful therapeutic and preventative pathways, and assess their progress, without requiring constant check-ins. It enables patients to find the right health services for them, without having to attend at a physical location first. And it supports ‘round the clock’ treatment and recovery for patients, which in turn means getting them out of acute settings faster than ever.

In short, it goes a long way to making our healthcare systems work for all.