increasingly used for pain treatment and rehabilitation. Digitization comes in many forms and their potential seems almost unlimited. A widespread misconception is that they will replace the healthcare provider. Their role is changing for sure, but I don’t believe that they can be replaced. Technology is there to help them, not replace them. It will help take the tedious repetitive tasks off their hands, allowing them to focus more on their core tasks of taking care of their patients.
It is also paramount to work on more efficient decision-making and adapting the structures accordingly. Regarding decisionmaking, the sixth state reform has led to more complexity and major challenges in the health sector. If we look at prevention for example, general prevention measures and (inspection of) quality in hospitals have become regional competences. This means the regions make the investments. However, their investments result in revenues (less unnecessary expenditures) for the federal government. We should invest in better chronic disease prevention by allocating a larger share of the health budget to prevention. The benefits should go to those who invest and get good results. Another example is the policy regarding mobility aids. This has also been regionalized, giving the 4 communities the competence to set their own reimbursement procedures and accents.
What do you see as the main challenges facing the medical device industry? The first challenge is definitely the earlier mentioned deep reform of the health budget. Today no less than 20% of this budget is wasted because of suboptimal incentives. Let’s look at hospital financing for example. Hospitals in our country get money for their number of actions, regardless of the health outcome. Thus, they are encouraged to perform acts to be paid regardless of whether these acts are really necessary or not and whether they are creating health gains for the patient or not. In other words, they are paid to do something, not to keep someone healthy. This all but encourages them to use technologies which enable them to be more efficient and work more qualitatively. Let me take the example of low variable care: these are standardized procedures (cataract surgery, hip replacement…) with low risks. Hospitals receive a lump sum for this kind of interventions which include both diagnosis and care itself. A quality component could be added in the financing scheme, rewarding the absence of infection or penalizing the occurrence of an infection for instance. By doing so, hospitals would no longer buy the cheapest devices, but would also look at the value that better-quality products could provide.
© iStock
In short, the complex and layered political decision-making process in Belgium does not exactly facilitate things and quite frankly in some cases it is unclear who is responsible for what. The current structures and administrative procedures reflect this complexity. The much needed “Redesign” of the health administrations (FPS Public Health, FAMHP and NIHDI) is aimed at improving this but things are moving slowly. All this makes it very difficult for new technologies to get adopted. Even though the right data are available, the assessment and implementation procedures of new technologies will have to be speeded up if we want to avoid already outdated applications to arrive on the market. Let's not forget that industrial cycles are much shorter than political decisionmaking processes!
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