As Executive Vice President, Health System Solutions and Government Affairs at PointClickCare, Bill Charnetski is on a mission to expand the health-tech ecosystem while improving patient outcomes and system productivity. Prior to this role, Charnetski served as the Chief Health Innovation Strategist for the Government of Ontario, Canada, and he led AstraZeneca’s global government affairs and public policy work, among other roles. Charnetski is currently developing a “system-wide approach” to grow PointClickCare’s business beyond its successful B2B model, as well as a high-performing, strategic government and regulatory affairs function for the company in the U.S. and Canada.
In this Vision Series interview, Charnetski shares his vision for a health care system that is truly equipped to serve the modern aging population. He explains how it can be achieved by focusing on integrated care, optimally investing resources for value-based care, and leveraging technology to digitize the entire patient journey. Charnetski also talks about how the interconnectivity and early warning capabilities from Collective Medical solutions can help us identify vulnerable populations and determine the proper path of treatment.
For me, there are a couple of very important components. First, it has to be integrated care. We must look at delivering the right care in the right way at the right time to everybody, and seniors is a subset of everybody. In delivering health care globally, let alone in any country, we should be doing it under a value-based care model. You’re looking at real patient outcomes relative to the real cost of delivering those outcomes on an integrated basis.
The second thing is, we need to pay appropriate attention to the long-term post-acute care (LTPAC) sector of our health system. That means more than just doubling down on regulation when a problem is identified. That’s the easy thing to do for regulators. The harder thing to do is to properly resource those who are delivering care so that they’re able to deliver that value-based care on an integrated basis to seniors and others.
Lastly, as the COVID pandemic has shown, we need to have a digitized care delivery model for everyone, including seniors. We need to have a system where regardless of where the person is in the care continuum, we know where he or she is, what their conditions are, what their treatments have been, and what they’re susceptible to. There’s no excuse now — given where technology is and how relatively inexpensive it is — for not having that digital health system.
I think COVID has highlighted at least the downside of what happens when you don’t know who [is] sick, who is probably sick, or who you’re suspicious of being sick. Now we’re in a vaccine environment where you may not know who’s been vaccinated the first time, such that you’re a hundred percent positive that three months later they’re going to get the right second vaccination. All of these things are relatively straightforward technologically, but the downside of getting it wrong is significant.
I’ll take the easy one first. I think the pandemic has accelerated it. Some things happened out of necessity and they will be virtually impossible to reverse. The obvious one is virtual care. Policymakers around the world had many reasons why they felt virtual care would not necessarily be the best path to follow in many situations. In a country like Canada, people were hung up on the notion that it would do nothing more than increase the volume of care that doctors would provide and balloon the health delivery budgets.
At least economically you could understand that resistance.
On the other hand, I loved when someone said to me recently, “So when’s the last time anyone visited a cardiologist and was actually touched physically by the doctor?” Much insight is gleaned [from that interaction], but it’s from test results, not physical poking and prodding. Therefore, you could have predicted the development of remote monitoring and other remote cardiovascular capabilities. By necessity, during the pandemic, the types of virtual care delivered and the reimbursement models for delivering that care were accelerated. That genie won’t get back in the bottle, and as we’re seeing in the U.S. and other countries, there’s real consideration now being given to how you reimburse those models going forward.
I’m fortunate enough to have had a varied background that’s taken me to the top levels of government, business and law. I really enjoy working on system-wide solutions in areas where regulation affects the ability to be excellent in business. I spent 10 years in global pharmaceuticals with AstraZeneca, first in Canada and then out of the global head office in London, England, where, among other things, I ran global government affairs and public policy.
I then came back and worked with the government of Ontario. That’s a 14-million patient, publicly funded single-payer system where I was the first Chief Health Innovation Strategist for the province. That role was created to help drive the behavioral change on the inside of the ministry and in the health system to enable it to adopt and scale innovation faster and more broadly than it had previously. At the same time, we worked to match health care and health-tech solution providers, with the ultimate goal being to leverage health as an economic driver; which is not common in Canada. The idea is to grow the health-tech ecosystem while improving patient outcomes and improving the productivity of the system. Before that, I was a corporate law partner at a firm called Torys LLP, which is one of Canada’s top law firms and is now an international law firm. Along the way, I spent three years as a senior political advisor in Ottawa, the nation’s capital.
If you put all that together — law, government, and business — as someone who wants to make a difference, I leapt at the opportunity to join a very strong and fast-growing Ontario headquartered global leader in providing solutions in the senior care market, particularly when the vast majority of the business is in the U.S.
I would digitize, and I would do that because it would greatly improve the quality of care for the resident, as well as the economics of the model.
Our integrated care platform is designed to do just that. At the end of the day, I would adopt the technology that allows the integrated care platform to be created. Across the continuum of care, this single platform follows the patient or resident where they are in the system; flags, as a result of either population health or more personal factors, what issues they might face; and then ultimately allows you to allocate your resource optimally to the people who need it most within the system. Frankly, more resources into long-term post-acute care will be required, and that will come if data insights show what outcomes are actually happening at what time and at what cost.
My wife runs a large retirement home in Toronto, the equivalent of assisted living in the United States, so I have insight into what it looks like on the ground from that perspective, forgetting about my day job.
So, watching my parents age, listening to my wife’s experiences and working at PointClickCare, I feel like if I had a magic wand, I would create environments where people could not only age in place, but age in a community where people are at different stages of care. It feels to me that as the demographics shift, creating an environment where there’s almost a second community that includes people who don’t yet need chronic care would be a good development for society.
The goal is a positive setting where people who are healthier and able are engaging with those who are more vulnerable, but everybody has a purpose and everybody can thrive. Events and lifestyle and nutrition — all these things would be tailored to a different phase in life.
Yes. As it is in many other parts of technology, the most exciting thing is the potential of AI and machine learning. I would love to see that realized for senior care. The ideal would be predicting which person is going to need that high level of care at that age.
There are places where you go and you feel very positive about the experience of the people who live there and then there are others that are more institutional. There will soon be the opportunity to create experiences for people using relatively inexpensive technology.
With the benefit of the more complex analytical capabilities, we might be able to replicate environments through virtual reality technology. With those capabilities, we can create a better, more positive, more enjoyable experience.
It’s critical. Our integrated care platform incorporates the data insights that come from information gleaned on a population health basis.
Ultimately, it sounds trite, but the goal is to encourage and effect the seamless transition of people through the care continuum. It’s that simple and that complicated. With our focus on digitization and the critical role that data insights play, that enables the operators — whether it’s of the network or the system — to understand better how to allocate resources throughout that care continuum.
Then, the digitization, our Harmony product and our integrated care platform – together – are an example of where you can have the data associated with that patient or resident follow them through the journey with low risk of error. A manageable amount of human resources is required to help them through the journey at much lower cost ultimately because you’re reducing readmissions and regressions. To have a corporate focus and professional focus on integrated care is a foundational part of that.
The best solutions will come from the public and private sector working together. That’s the case in every highly regulated industry, whether it’s health or not. It was the case before COVID, and it will be the case after.
It’s 2021, any notion that somehow the private sector is bad in health, and the public sector is good in health is a fallacy. There’s been so much evidence generated that the best results come when the public and private sectors truly collaborate. That is the most efficient allocation of resources. It’s the way to create value in the health system.
It would be a real shame if regulators around the world, because they have faced something outside of their control, doubled down on regulation in particular areas. That would be a miss. You need the public and the private to look together at how to invest in beds and staffing and technology, to do those things we described: provide integrated care, properly resourced in a digitized way.
I would ask all policymakers in every jurisdiction to resist the urge to just double down on things that weren’t the cause of the problem, just because it lies within their control.
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