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Embracing Change: How 21st-Century Trends Are Reshaping the Allied Health Workforce

It's hard to imagine that this time last century, only a fraction of the workforce that we  now recognise as "allied health" did not exist, or at least, did not exist in the way that we currently recognise those professions.

Those 'newer' professions include sonographers, exercise physiologists, sleep scientists, pedorthists, perfusionists, speech pathologists, developmental educators, health promotion officers... to list only a few. Why have these new professions emerged?

The reasons behind the rise of these new fields are multifaceted. For instance, the advent of new technologies has been a driving force behind the creation of roles like sonographers and perfusionists. Meanwhile, the establishment of developmental educators has been propelled by a shift in societal values—moving away from the institutionalisation and marginalisation of individuals with disabilities towards fostering a more inclusive society. In Australia, this shift was further supported by the introduction of the National Disability Insurance Scheme, which provided a stable, national funding mechanism that contributed to the growth of the developmental education profession. Additionally, the move towards self-regulation helped in professionalising this segment of allied health.

The development of both new and existing allied health professions can also be traced back to historical necessities, such as the need for rehabilitation services following wars. However, a more pronounced shift towards managing chronic illnesses, as opposed to infectious diseases, has significantly amplified the demand for the preventative and restorative services offered by allied health professionals.

We are now at the cusp of potentially accelerated changes in the way our society functions, and consequently, our health workforce.  Revolutionary technologies, shifting demographic patterns, and evolving societal needs are profoundly and irreversibly transforming allied health. From the integration of artificial intelligence (AI) and digital health tools to the increasing focus on personalised healthcare and community health initiatives, we look at the ways in which these trends are not only altering the fabric of healthcare delivery but also demanding new skills and adaptability from allied health workers.

The digital infusion: telehealth and administrative efficiency

Telehealth has transitioned from a convenience to a necessity, with allied health professionals integrating virtual platforms into daily practice. This shift is more than geographical; it's a cultural and practical realignment of the patient-provider relationship. At the same time, the automation of administrative tasks through AI and other technologies is liberating professionals from the shackles of paperwork, enabling them to refocus on the human aspect of healthcare.

Technology is already shifting health care, screening, and diagnosis closer to the patient. The self-testing regime which was rapidly cascaded during COVID, home based screening for colorectal and cervical cancers mark a shift towards consumer-driven diagnostic testing and screening, reducing the need for intermediaries (health practitioners) to intervene.

Since COVID, telehealth has been dismantling geographical barriers, granting patients in remote or underserved areas access to specialised care—this extends beyond consultations, encompassing remote monitoring and digital diagnostics.

Additionally, streamlined administrative processes are reshaping the operational landscape. Electronic health records (EHRs) and automated administrative systems have all but replaced paper-based methods, from appointment scheduling to billing. Tasks can be outsourced to AI, such as identifying patients at risk of being ‘no-shows’ and sending them additional reminders to reduce that likelihood. Reducing administrative burdens means more resources for patient care. These advancements (overshadowed by the spectres of redundancy and job losses), are not only elevating the quality of healthcare but also setting new benchmarks for efficiency and accessibility in allied health service delivery, and increasing allied health professionals’ job fulfilment as they get to do more of what they joined their professions for—caring for people.

Increased demand for personalised medicine

As healthcare moves towards more personalised approaches, including genomics and precision medicine, allied health professionals are required to adapt by gaining knowledge in genetics, biotechnology, and personalised therapy planning. This trend is particularly relevant for professions such as genetic counsellors, laboratory technicians, and pharmacists.

The International Consortium for Personalised Medicine  proposes that the impacts of personalised medicine should include the empowerment of health consumers and citizens, through, for example, the control of health-related data by citizens and increased access to reliable sources of medical information; personally tailored healthcare systems to support health promotion, diagnosis and treatment; and improved flow of data from citizens and healthcare systems to regulatory authorities and research institutes to improve the quality and safety of healthcare.

Communication reimagined

Team collaboration platforms are transforming the way allied health teams interact with patients and each other.

Secure messaging, video conferencing and patient portals have the potential to improve the accessibility and efficiency of allied health service delivery—particularly in the areas of chronic disease management and post-treatment followups. Such ease of digital communication enables continuous patient-provider interaction following consultation or discharge, with some caveats.

This study in Queensland (2018) showed that preference for the adoption of technology for the post-discharge is related to the patient’s age, whether the symptoms were ‘of concern’ or not, and, interestingly, on the type of condition requiring treatment (e.g., cardiac, gastrointestinal, orthopaedic), but also that patients had low interest in adopting ‘new’ technologies, being ones that they were not already using in their day-to-day lives. Further research is welcome, in the post-COVID era, given that shut-downs may have fostered a greater acceptance of new technologies as tools for managing isolation and maintaining connection, as well as managing health needs.

The enhanced communication options offered by these tools facilitates a multidisciplinary approach to care, allowing collaboration among different healthcare professionals, thus improving the coherence and quality of patient care. By integrating patient data from various sources, digital communication tools assist in creating a more holistic view of patient health, leading to informed decision-making and personalised care strategies.

Some older (2017) research suggests that while technology has enabled this communication, the social structures of the care team members also play a role in its most effective use, to manage the potential for inter-professional conflict. This digital evolution in allied health services improves patient outcomes and empowers patients in their healthcare journeys, but health professionals need to adapt to the new way of working—potentially with intervention strategies designed to enhance professional and cultural acceptance—to make the most of the possibilities.

Flexibility and work-life harmony

The necessity of work-life balance is ubiquitous in the healthcare sector, with flexible scheduling increasingly prevalent, supported by the expansion of initiatives like telehealth and broader, real-time access to patient data outside of consultations (e.g., received from patient monitoring technology). The benefits are twofold: allied health professionals can enjoy greater control over their work lives, and patients can access care that fits their schedules. Remote work options such as flexible work arrangements and telehealth consults, once a rarity in healthcare, are now being explored with vigor, particularly in administrative and certain clinical roles.

By avoiding long commutes and having more control over their work schedules, allied health clinicians are experiencing less burnout and heightened job satisfaction. For the healthcare system, this flexibility translates into a more diversified and efficient workforce, capable of meeting patient needs around the clock, and, one hopes, reduced turnover. It especially benefits areas like home health care and telehealth, where non-traditional hours are often required. Flexible scheduling also accommodates the varying peak times of different healthcare services, ensuring that staffing levels align with patient demand, thereby optimising resource utilisation. This adaptability is crucial in managing unforeseen healthcare challenges, such as pandemics or natural disasters, where swift and flexible responses are necessary.

The 'global village' of healthcare

'Globalisation' has made a huge impact across the axes of health inequalities, access to expertise, telemedicine, and evidence-based practice.

Globalisation has facilitated the 'real and virtual' cross-border movement of healthcare professionals, precipitating an exchange of knowledge, skills, and practices. It encourages the adoption of best practices in policy, as well as in clinical service delivery, from various healthcare systems, again leading to improved patient care and more efficient and effective healthcare systems. Employment of health professionals in different jurisdictions and time-zones (regulation permitting) can extend the operating hours of virtual organisations (such as virtual pharmacies, and provide opportunities to more rapidly review and screen diagnostic tests (for example pathology and medical imaging results).

Global connectivity also enables quicker responses to public health crises, with information and resources being shared rapidly across borders, in turn supported by the evolution of communication platforms as discussed above.

Flattening hierarchies for enhanced care

The traditional top-down approach in healthcare organisations is giving way to flatter structures, and less siloed, more multidisciplinary models of care.

The dismantling of traditional medical hierarchies is significantly reshaping allied health service delivery, paving the way for a more collaborative and holistic approach to healthcare. This shift recognises the vital contributions of various healthcare professionals, including allied health professionals and nurses, placing them on a more equal footing with physicians. As a result, decision-making processes are becoming more inclusive, drawing on the diverse expertise of the entire healthcare team.

This collaborative model enhances patient care by ensuring a more comprehensive assessment and treatment plan, encompassing physical, psychological, and social aspects of health. It also promotes a team-based environment where the unique skills and insights of each professional are valued and utilised effectively. Additionally, this flattening of hierarchies empowers non-physician healthcare providers, leading to increased job satisfaction and professional development opportunities, and by explicitly valuing their contributions gives them greater authority and opportunity to lead and innovate.

The notions of professional boundaries, ownership, scopes of practice, and team-based primary care are highly topical—the subject of a Scope of Practice Review in Australia—and examined in detail here and here.

The new employment landscape

The use of AI in many work areas has rapidly become ubiquitous over the past 12 months with varying reports regarding the numbers of staff already displaced. It is easy to assume that high-touch areas of patient-facing care services will be less affected than other areas. However the exponential rate of growth and change in all areas as a result of AI means that the workforce as we understand it today is likely to be unrecognisable in many ways. For example, this article outlining the impacts of AI on allied health is only a year old, but in many ways, already outdated.

The allied health sector is not immune to influence and pressures exerted by the so-called 'gig economy'. With an increase in contract work, professionals may find more variety in their roles but also may face challenges with the relative job insecurity that comes with such employment. This new employment landscape necessitates a fresh look at how we support our healthcare workforce.

The rise of contract work and the gig economy could significantly impact allied health service delivery. Proponents would point out that it allows healthcare professionals to take on temporary or part-time positions, offering them autonomy in choosing when, where, and how much they work. But this view may not consider the broader impact on workers, which is necessary given some elements of the gig economy have been accused of being exploitative.

For healthcare providers, this shift would mean access to a broader pool of specialised talent on an as-needed basis, enabling them to manage. This model could be beneficial in addressing short-term staffing shortages and in specialised areas where full-time employment may not be necessary or feasible, but needs to be carefully managed terms of employee rights and job satisfaction.

Diversity as a pillar of care

Diversity and inclusion are no longer aspirational; they're imperative. As the workforce becomes more diverse, the delivery of culturally competent care becomes richer and more nuanced.

Diversity, Equity, and Inclusion (DEI) are reshaping allied health service delivery, driving a more inclusive and effective healthcare system. By emphasising DEI, healthcare organisations are able to recognise and value the diverse backgrounds and experiences of both their staff and patients. This approach enhances cultural competence among healthcare professionals, leading to more empathetic and personalised patient care. It ensures that treatment plans and health education are sensitive to the cultural, linguistic, and social needs of diverse patient populations.

DEI initiatives in healthcare education and recruitment are creating a more diverse workforce, which is crucial for addressing health disparities and promoting equity in healthcare access and quality; this better equips healthcare providers to understand and address the unique challenges faced by marginalised groups. As AI enhancements become more prominent in healthcare service delivery, it is important that these technologies are developed equitably. In The Untapped Potential of Nursing and Allied Health Data for Improved Representation of Social Determinants of Health and Intersectionality in Artificial Intelligence Applications: A Rapid Reviewthe authors found that data around social determinants of health and intersectionality were limited in allied health AI literature, and emphasised the need for leveraging rich contextual data collected by nursing and allied health professions in the training of healthcare AI technologies in order to be representative and lacking in bias.

DEI is not just an ethical imperative in the 21st Century, but a practical strategy to enhance the quality and reach of allied health service delivery, making it more responsive to the needs of a diverse global population.

Lifelong learning as a career cornerstone

Continuous education is the new norm, with allied health professionals expected to stay abreast of the latest clinical and therapeutic advances and healthcare delivery methods. The proliferation of online learning opportunities has made this a more accessible reality than ever before, along with prospects of creating genuine connection and learning networks through communities of practice. This, in turn, supports the potential for global movement of allied health professionals through access to new career opportunities in other regions.

Health professionals who engage in regular training and development are more likely to contribute to improvements in healthcare delivery, from refining patient care protocols to adopting new healthcare technologies; this not only enhances the skills and knowledge of individual practitioners but also elevates the overall standard of care through continuous improvement and innovation.

Continuous learning also supports career advancement and job satisfaction among healthcare workers. Ongoing professional development not only supports the maintenance of, and development of new, competencies, but can motivate allied health professionals more in their roles, teams and organisations, supporting good workplace culture and a healthier and more sustainable workforce.

The rise of sustainable healthcare

Sustainability is now a critical consideration, with the healthcare sector scrutinising its practices to minimise adverse environmental impact and social impacts. The shift towards adoption of Environmental, Social and Governance (ESG) principles is not just good for the planet; it's now more and more commonly being seen as integral to good business and ethical practice, and a social responsibility.

By taking a holistic view of sustainability underpinned by ESG frameworks, healthcare businesses ensure that their governance structures and decision-making processes are explicitly designed to minimise the negative consequences which flow from the decisions that they make, and to maximise the positive ones.

An obvious example is considering the supply chain when procuring new products to ensure that, at all points, workers are not exploited and practices are environmentally sound. In the post-COVID world, technologies like electronic record-keeping and the shift towards telehealth, have direct environmental consequences in addition to increasing access to healthcare and supporting work-life balance (both positive social consequences).

Adoption of ESG principles also improves the attractiveness of businesses for external investment in an increasingly environmentally and socially conscious investment landscape. It literally is good business.

A data-driven approach to health

The allied health field is increasingly guided by data analytics, with evidence-based practice becoming the standard for patient care. This data-driven approach underpins a more precise and outcomes-focused mode of operation, ensuring that both health outcomes and scant resources are maximised.

By harnessing the power of big data, healthcare providers can analyse vast amounts of information, from patient records to treatment outcomes, enabling more informed and effective decision-making, and enabling treatments to be tailored to individual needs, considering factors like genetic predispositions and lifestyle choices. This approach, now often super-charged through the use of artificial intelligence and machine learning, facilitates the identification of trends, patterns, and correlations that inform evidence-based practices, resulting in early identification of conditions, and improved patient care and outcomes. The authors of this article from the European Journal Cardiovascular Nursing float the possibility of ChatGPT being used to assist allied health clinicians and researchers.

.The utility of these tools in practice depends, of course, on the availability of the underlying data in accessible formats, which emphasises the importance of EMR and public health datasets. The lag in adoption by low income countries of EHR and public health reporting risks further increasing disparity in health security between their citizens and those of developed economies.

The evolution of work attire

Even something as traditional as work attire is in flux, with a move towards functional and comfortable clothing that reflects the active and diverse nature of allied health roles.

The traditional healthcare uniform, often rigid and uncomfortable, is being replaced by clothing and footware designed for functionality and ease—breathable, flexible fabrics that allow for greater movement and durability, are crucial for the physically demanding tasks healthcare workers often perform. Ergonomically designed clothing reduces the risk of work-related injuries and increases comfort during long shifts, directly impacting staff well-being and efficiency. Additionally, these clothing options often feature antimicrobial properties, enhancing hygiene and safety in healthcare settings. The psychological impact of wearing comfortable attire should not be underestimated; it can increase job satisfaction and morale, leading to better patient care.

Conclusion

The allied health workforce is at the forefront of a major paradigm shift. The transformation brought about by these trends presents challenges, certainly, but also abundant opportunities to enhance patient care, improve job satisfaction, and redefine what it means to be an allied health professional in the 21st century. As we look to the future, the continued evolution of allied health will undoubtedly play a pivotal role in addressing the complex health challenges of our time, emphasising the importance of adaptability, innovation, and a commitment to comprehensive care.

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