SEMINARS
The value of innovation in Healthcare Executive summary
Central elements of the 2nd Health & Sustainability Seminar held at Harvard Faculty Club (Cambridge, MA, US), April 2012.
EXECUTIVE SUMMARY.
Health systems all over the world are facing big challenges brought about by deep transformations in their political and economic contexts. In turn, they must answer to social changes and health conditions prevailing everywhere: progressive old age in the population, technological development and the inclusion of important social segments to the health systems. All this is leading to an intense international debate looking for innovative formulas that may allow each health system to offer efficient and effective solutions to the challenges presented. The 2nd Health & Sustainability International Seminar, summoned by Gesaworld, was held at the Harvard Faculty Club (Cambridge, Massachusetts) on April 2012 and it was attended by scientists, health professionals, managers of health institutions as well as representatives of governments and public administrations from the sector. The main objective has been to establish a collective way of thinking about three aspects of innovation within the health care sector: • Central elements in the debate on the evaluation of clinical practices and their role in driving innovation in health care processes. • Innovation and the management of health care institutions: approaches and practices in different environments. • Innovative health care systems: strategies to promote continuous improvements in health care technology, processes and models.
2
Gesaworld Group proposed a discussion divided into three thematic panels (clinical practice, management and public policies). A Chairman introduced and moderated each panel and 10 minute intervals were then reserved for various speakers. Following this framework, the discussion was then opened up to all participants. From this framework the participants dealt with many of the elements that are defining the agendas for the transformation of health systems, offering opinions, experiences and results. The following is a summary of the main ideas that came out of this exercise extracted from a broader paper that can we found at healthandsustainability.info.
THE VALUE OF INNOVATION IN HEALTHCARE .
EXECUTIVE SUMMARY.
“Defining the value of technologies and innovation in health”. • It is obvious that there is a need to incorporate other dimensions into the process for evaluating health technologies, such as costs, the preferences of patients, the time impact (short-term/longterm) of the benefits in health and social values (for example with regard to chronicity or palliative care). • The challenge of sustainable innovation is to achieve an integrated vision that links scientific development with the health care needs of the population as much as possible.
“Building bridges between researchers, clinical professionals and regulators”. • During the initial scientific research phase it is essential to have greater dialogue between basic researchers and the clinical professionals in charge of looking after patients. • In turn, the relationship with regulators and funders is also important since the entry of innovative products onto the market depends on them.
“Key Information and evaluation for innovation and reducing costs”. • High quality recording data from clinical practice is needed to monitor and evaluate the results. This information has to be as structured as possible in order to accurately measure outcomes that have to reflect long term health outputs rather than short term episode indicators. • The evaluation must be based on clinical criteria, which have been shown to have an impact in terms of efficiency, quality and safety and also in terms of economic efficiency criteria.
4
“The need for strong primary care”. • Primary health care is providing results in different contexts that reinforce its importance as a central element in the strategy to improve the effectiveness, fairness and efficiency of health systems. • The structuring of primary care must be based on a multi-professional approach that facilitates the implication and the involvement of persons. This approach has been shown to be useful both for the detection of sectors of the population that are at greater risk and for the adoption of therapeutic recommendations and the adoption of healthier habits.
“The way to integrated care”. • The integration of health care is first of all a strategy to improve the care of the patient, starting from the principle that the organizations and professionals in charge of the different phases of the illness must work synchronously to guarantee the continuity of care. • Health care integration has been shown to have impacts in terms of efficiency, effectiveness, quality and patient satisfaction. If this is true in general, it is in the case of the care of chronic patients – where the health-care continuum is a clinical imperative – that this paradigm of professional organization has its greatest potential.
“Patient-centeredness”. • Here the emphasis is placed on the importance of putting the patient at the center of the health care process, but this is also connected to the processes to introduce new technologies to evaluate the impact. • A key element of this link is the patient’s involvement in the objectives to improve his/her own health. THE VALUE OF INNOVATION IN HEALTHCARE .
EXECUTIVE SUMMARY.
“The role of professionals”. • To promote education for professionals who are learning how to work in multidisciplinary environments. Search for coordinated and efficient work aimed at real patient needs and planned in advance by means of agreed clinical evidence-based guidelines. • Health care organizations must encourage physicians, nurses and other health care professionals to embrace a culture of safety and transparency. One way of doing so is by creating multidisciplinary teams that work together to attain small but consistent changes in order to reach specific goals such as reporting, transparency and an overall environment of safety within an organization.
“The intensive use of ICT, an important lever of change”. • Information Technologies are resulting in a true revolution in the way that information is accessed and how clinical care processes are organized. • The deployment of innovations based on ICT generates synergies in communication within the providing institutions, and also among these, and between them and the administration.
“Health care payment systems as drivers of efficiency”. • The importance of finance methods in terms of strengthening the transformation of the system, moving from a payment-per-service method to a pay-for-performance system. • The definition of the results to be evaluated for financing must respond to a clinical logic of value in terms of health, with the participation of the actors involved in the health care process, more than to an administrative logic.
6
“The challenges of public policies”. • Managing the universal coverage of services generates system level costs that can only be tackled by introducing technological innovations to the way patients are managed, the services they are provided with and the care they are given. These challenges concern both the systems that have already achieved universal coverage as well as those that have it as an objective. • Introducing innovations into management through collaborations with non-profit entities and the broad spectrum of alliances with the industry and the organizations that provide health services are examples of how to move towards universal coverage. • Public private collaboration within the framework of a global strategy for the deployment or reorganization of public health services is an instrument that allows us to speed up the processes related to the construction of infrastructures and the management of clinical and non-clinical services.
THE VALUE OF INNOVATION IN HEALTHCARE .
EXECUTIVE SUMMARY.
Challenges for the transformation of health systems : Integrated vision.
Information.
Incorporate the voice of patients. Basic research and clinical professionals.
Evaluation.
Regulators and funders.
Technology Market approaches.
Universal coverage: achieving and maintaining.
High quality data form clinical practice. Allow efficient decision making.
Public private partnerships.
PUBLIC POLICIES
From data to meaning.
Flexible and efficient exchange of information. Best clinical practices.
Results
Evaluation based on clincal criteria.
Collaboration with non-profit, industry and health organizations. Technological innovations for managin, providing and giving care to patients.
Reducing demand and inappropiate hospital stays.
Reducing waste.
Geriatric patients.
Benchmarking. Improvements in pharmaceutical prescriptions.
8
Expansion and strengthening of primary care networks.
Embrace a culture of safety and transparence.
Promote education.
Incentivize change and responsibilities.
People Redesign professional roles.
Dissemination of knowledge.
EHR as an instrument for integration and continuity.
ICT = revolution in access and clinical processes. Synergies in communication.
Patient centered Medical-home. Lower provision costs.
Patient + new technologies + impact evaluation.
Payment systems.
Management
Continuity of care.
Proximity and care.
Chronic patients.
Evaluate actions of each level.
Medical records. Multidisciplinary and clinical leadership.
Multiprofessional approach.
Finance methods as a driver for transformation.
Central element of strategy.
Definition of results on a clinical logic.
Incentives to integration of the various structures.
Defining the value of technologies and innovation in health.
Health care payment systems as drivers of efficiency.
Building bridges between researchers, clinical professionals and regulators.
The way to integrated care.
Key information and evaluation for innovation and reducing costs.
The intensive use of ICT, an important lever of change.
Implementing innovation that has shown results.
Patient-centeredness.
The need for strong primary care.
The role of professionals.
THE VALUE OF INNOVATION IN HEALTHCARE .
Gesaworld, S.A. C/ Comte d’Urgell 204, 5o B 08036 – Barcelona – España T. +34 93 363 03 27
Gesaworld DO BRASIL LTDA. Avenida Paulista, 1499 Cjs 1106/07/08/09 01311-928 São Paulo. Brasil. T. +55 11 3371-3111
Gesaworld CHILE, LTDA. Oficina 404 C/ Padre Mariano 181 Providencia Santiago de Chile. Chile T . +56 2 3621504 Gesaworld MADRID
C/ Génova 15, 3o Ext. Derecha 28004 Madrid. España T. + 34 91 308 22 25 Gesaworld MÉXICO, S.A. de CV
Gob. Francisco Fagoaga No 80 Col. San Miguel Chapultepec 11850 México D.F. México T. +52 55 5276 5050 Gesaworld NICARAGUA
Gesaworld S.A. Oficina en Nicaragua Edificio Málaga, planta baja, Módulo A-14. Managua. Nicaragua T. +505 266 4314 Gesaworld PANAMÁ, S.A.
Calle 52 y Elvira Mendez Edif. Vallarino, Piso 5 Of. A Zona Bancaria Ciudad de Panamá Panamá T. +507 209 5241 Gesaworld PORTUGAL LDA.
Rua de S. Nicolau, No 121, 4o andar 1100-548 Lisboa. Portugal T. +351 21 88 79 220 Gesaworld USA L.L.C
www.gesaworld.com
1625 I Street NW, Suite 620 Washington, D.C. 20006 (EUA) T. +1 (202) 499.4131