Dr. Marta Zanchi, founder and managing partner of Nina Capital’s Global Healthech VC, explains how nurses are empowered to complete treatment via telehealth oversight, making primary care more accessible to the aging European population.
A consistently higher life expectancy and lower fertility rate means that the European population is aging rapidly. More than five-fifths of the population are already over 65 years old, while more than half of Europe are over 44 years old. This demographic change has implications for an already tense healthcare system. The number of primary care appointments required each year is projected to increase significantly, with older patients taking on a disproportionate share of consultations.
Elderly and at-risk patients must be protected against inflated latency bulging, which can harm the standards of care, especially for patients with long-term conditions. In the UK alone, almost a third of NHS patients with conditions such as lower back pain, arthritis and diabetes reported not receiving adequate support from local services. Missing treatment or delayed treatment can lead to worse health outcomes and ultimately more expensive hospital interventions.
A Rival delivery model across primary care is essential to improving efficiency, affordability and accessibility for everyone to address these challenges.
Changing primary care workforce
According to the World Health Organization (WHO), Europe is short of primary care physicians. Since the Covid-19 pandemic, the healthcare system has already suffered from a critical workforce shortage that has already stretched its primary care capabilities to its limits. Europe has an estimated shortage of 1.2 million healthcare professionals, and could face a deficit for 4 million healthcare and social care workers by the end of the decade. In the UK, the number of general practitioners (GPs) practices have fallen by nearly 20% over the past decade.
Additionally, many regions struggle with geographical incongruence in GPS, resulting in a particularly pronounced shortage in rural areas. Germany has 5,000 free GP practices, which has had a major impact on remote communities. As a result, many patients are forced to spend time only for basic care.
Without reforms in our primary care system, the shortage of European physicians is set to exacerbate quickly as the population of European physicians is aging. For example, in Germany, more than a third of GPs are over 60.
With a significant percentage of these doctors heading out and younger generations selecting specialties outside of general practice, the primary care system is facing an upcoming capacity crisis. Burnout is driving the problem. Long periods, stress, and lack of resources have led to more clinicians leaving their professions. Without reform, these trends will converge to exacerbate the crisis.
Empowering nurse
One way to address the rise in the number of elderly patients and the decline in the number of primary care physicians is to allow nurses to carry out the basic procedures traditionally reserved for physicians. This includes administration of vaccinations, managing mild infections, and assessing cases of colds and mild pain. This is a practice that is already well used in countries such as Finland, the Netherlands, New Zealand and Australia. In Finland, for example, 30 out of 50 patient care have been fully completed by nurses.
This system allows physicians to concentrate on more complex and critical cases, while also reducing costs for patients who have to pay for medical expenses. The financial burden of treatment may be important for many, and WHO is important when it discovered that the number of Europeans forced into poverty following medical costs is on the rise.
Given proper supervision, nurses can allow more procedures to be performed on patients. Resistance to this from the Medical Association is often focused on patient safety concerns, but these can be addressed by ensuring surveillance through modern telemedical tools.
Distance medicine supervision
Ensuring nurses can safely manage their treatment requires adequate supervision from their doctors. The most convenient way to enable surveillance is to allow doctors to oversee treatment remotely in real time via video calls via telemedicine book supervision. This ensures monitoring without putting a serious burden on the physician’s time.
Using telehealth to reduce primary care waiting times is already a common trend in the US, and Amazon’s one medical subscription service allows members to consult remotely with healthcare professionals. Other companies such as Transcarent are also active in the niche.
This system also benefits patients, particularly in rural areas. Telehealth supervised treatment allows more rural patients to receive care in local practices, even in areas with a limited number of doctors. This helps to make treatment more comfortable and convenient for older patients and other patients who are less travelling. In the US, providers like Homewald offer similar telehealth services, allowing older people to receive local treatment. Lilliancare is pioneering the service in Europe and is beginning to resume rural GP practices across Germany.
However, for this system to succeed, two factors must be combined. First, these care companies must have the right financial incentives in place to be sustainable and prosperous. Second, investing in digital infrastructure is important. Rural areas in particular need reliable broadband access, a secure telehealth platform, and proper training for both healthcare providers and patients. If properly supported, telemedicine supervision could reconstruct the primary care environment across Europe.
Future preparation
We must now take action to reform our primary care system and protect against the aging population and shortage of health professionals. Distance medicine supervision is a safe and scalable solution that has already proven effective in many regions.
Policymakers should also consider incentives to encourage collaboration between physicians, nurses and other healthcare professionals when building a more integrated model of care. Importantly, reforms need to place patients in centres to ensure that care is safe and accessible in rural and remote areas.
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