Five Keys to Sustainable Healthcare
Public spending cuts and demographic changes are putting the health systems in advanced economies at risk. Achieving sustainability hinges on what IESE Prof. Núria Mas defines as a triple challenge: better health, lower costs and better healthcare. Finding the balance between these variables is not easy. But it is the only way to guarantee the continuity and viability of our health systems. These were the ideas discussed by experts at the 21st Healthcare Industry Meeting hosted by IESE and KPMG this week.
Better Health Guarantees ROI
Medical and technological advances over recent decades mean that we are living longer and better. This in itself is worth celebrating, delegates agreed; despite the fact that a higher incidence of chronic conditions and increasing health costs put more strain on the system. The onus is on the sector, therefore, to find innovative solutions and new pharmaceuticals and treatments.
Humberto Arnés, managing director of Farmaindustria, highlighted the challenge of “reconciling three key variables: the system’s sustainability, access to innovation and professional development.” We urgently need to find imaginative solutions, new mechanisms and sources of finance to bridge the gap between the high economic impact that new medicines and treatments have in the short term, and their long-term benefits, he said.
Arnés believes that return on investment in substituting some old treatments with new ones can reach figures as high as 600-700%. This not only benefits doctors and patients but also governments. “Innovation is the lifeblood of our industry and we can never give up on it.”
Lower Costs Through Better Management
Debating the financial aspect, Dr. Josep Santacreu, CEO of the DKV Insurance Group, said it was “an incontrovertible fact that people are demanding that both companies and governments deliver cost-effective treatments.” According to Dr. David Kaplan, global head of clinical solutions at Mercer, there is evidence that “models that put the user at the center of the process are reducing health costs by 30-40%.”
Prof. Mas pointed to research carried out in hospitals in Europe and the United States. Without increasing their budgets, these hospitals were able to improve efficiency simply by reorganizing teams, both human and technical; redesigning workflows with patient involvement; and prioritizing resources and facilities in a way that really delivered health and well-being to the patients.
Delegates agreed that much more could be done to leverage existing resources. To do so means rationalizing clinical activities and operations, which often face two major problems, said Javier Colas, managing director of Medtronic Ibérica. On the one hand, there is the social and political pressure applied by those who (erroneously) believe that greater efficiency implies poorer care (in other words, spending cuts); and on the other, there is a general lack of data for measuring results. This problem is particularly acute in the healthcare sector because of a lack of transparency, he said. His was a view shared by many.
Big Data is the Future
Advances are, in fact, being made in patient care through the measurement and analysis of data. Big data makes numerous e-health applications and initiatives possible, such as digital clinical histories, and mobile apps to monitor clinical data, a variety of conditions and virtual communities of patients.
Stefan Bungart, software director for Europe at GE Global Research, pointed to the enormous possibilities that big data and the so-called industrial intranet are bringing to healthcare. He said that these futuristic trends are already contributing to improved efficiency and cost savings through the development of new services for end-users, and prevention of risk.
Among other key areas of innovation, he said that the computerization of large volumes of data makes it possible to optimize equipment and teams -- maximizing their performance and the return through data analysis. It is also being leveraged to redesign operations, such as improving programming to reduce waiting times and avoid bottlenecks. And in terms of patient care, digitalization is leading to improvements in personalized treatment, with the systematic analysis of medication doses and other safety parameters; and improved integrated care, by identifying patterns, trends and synergies that favor the coordination of some treatments, and even the prevention of some clinical risks.
The Five-Step Treatment
The meeting gave form and content to five steps that Núria Mas outlined as essential for meeting the triple challenge:
Measure, measure and measure. It’s not possible to improve on something that hasn’t been evaluated, so you have to measure “permanently and obsessively,” said Cándido Pérez Serrano, a partner at KPMG Spain and co-organizer of the meeting.
Identify success stories and make sure that you understand them well in order to repeat them with the same results.
Encourage value in health care by prioritizing treatments and processes that really contribute to improving the patient’s health. It’s important to put the patient at the center of the process. They need to be involved and should understand that it is best for them and for the system in general, to receive the right treatment at the right time in the right place.
Align incentives. It’s essential to establish priorities and to do so in a coherent manner. Decisions must be taken in accordance with the motives and needs of the various agents involved, and mindful of the need to measure results.
Encourage a “culture of health.” Education is critical. Efforts must continue to raise consciousness of our shared responsibility to adopt habits that promote good health – prevention, control, and adherence to prescribed treatment. We need to do our utmost to drive the innovations that will lead to improvements in how health systems function, be it medical, clinical, process, management or finance.