Megatrends in the healthcare industry
•Transferir como PPT, PDF•
2 gostaram•811 visualizações
Presentación realizada en la jornada organizada por Advent, Madrid, 12 septiembre, 2006
Recomendados
Recomendados
Mais conteúdo relacionado
Destaque
Destaque (18)
Semelhante a Megatrends in the healthcare industry
Semelhante a Megatrends in the healthcare industry (20)
Mais de Ignacio Riesgo
Mais de Ignacio Riesgo (20)
Último
Último (20)
Megatrends in the healthcare industry
- 1. *connectedthinking Megatrends in the Healthcare Industry Madrid, September 12th, 2006
- 2. 2PricewatershouseCoPricewaterhouseCoopers September 2005 The HealthCast Series HealthCast 2010 Disruptive Drivers of This Decade HealthCast Tactics Success Strategies for Next 3 to 5 Years HealthCast 2020 Sustainability through Global Lessons Add image here
- 3. 3PricewatershouseCoPricewaterhouseCoopers September 2005 Sustainability is Threatened Projected Health Spending as Percent of GDP OECD countries are converging in spending trends Global health spending will triple to $10 trillion in 2020 7% 9% 11% 13% 15% 17% 19% 21% 23% 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 US OECD w/o US 21% 16% Drivers: • Technological advances • Aging • Rising standard of living • Consumerism • China Source: OECD data, PwC estimates 2003 US per capita spending on healthcare -- $5,670 Rest of OECD -- $2,3521
- 4. 4PricewatershouseCoPricewaterhouseCoopers September 2005 Despite High Spending, Patients Often Don’t Get the Care They Need 0% 10% 20% 30% 40% 50% 60% 70% 80% Breast Cancer Low back pain High blood pressure Depression Diabetes Asthma Sexually Transmitted Disease Hip Fracture Source: McGlynn, et al., New England Journal of Medicine, 2003. On Average, Adults Receive 55% of the Recommended Care for Many Common Conditions
- 5. 5PricewatershouseCoPricewaterhouseCoopers September 2005 Medical Errors Are a Leading Cause of Death Number of Deaths per Year Sources: National Vital Statistics Report, Institute of Medicine Medical Errors Compared to Other Common Causes of Death Medical Errors 44,000- 98,000 Motor Vehicles 47,000 Breast Cancer 41,000 HIV 14,000
- 7. 7PricewatershouseCoPricewaterhouseCoopers September 2005 Is Healthcare Spending Worth It? 0 50 100 150 200 250 300 350 400 1980 1990 2000 Mortality from Heart Attacks in Relation to Advances in Care 1980s Blood thinners Beta Blockers CABG Metal stents Thrombolytics Implantable defibrillators Drug-eluting stents 1990s 2000s Statins ACE inhibitors Death Rate per 100,000 Source: www.cdc.gov/nchs; The Value of Investment in Health Care
- 8. 8PricewatershouseCoPricewaterhouseCoopers September 2005 Adaptable Delivery Roles and Structures Quest for Common Ground Quality and Safety Standards Realignment Incentives Digital Backbone Climate of Innovation Strategic Resource Deployment Building the Sustainability Core: Seven Features of a Sustainable Health System
- 9. 9PricewatershouseCoPricewaterhouseCoopers September 2005 Sustainability Feature 1. Common Ground A vision and strategy balance public versus private interests and provide basic health benefits within the context of societal priorities.
- 10. 10PricewatershouseCoPricewaterhouseCoopers September 2005 Efforts to Encourage Competition Germany Public hospitals are privatized Reduction in costs, competition among private hospital groups The Netherlands Insurance companies contract with providers independently, forcing providers to differentiate themselves. Begins in 2006 Singapore MediShield plus, a government plan that paid for hospital care, is privatized Under way U.S. Medicare outsources drug benefit to private companies, which compete for beneficiaries Benefit starts in 2006 England, Ireland Services, such as cataract surgery, outsourced to private companies Waiting lists reduced Australia Government offers 30% tax rebate to encourage consumers to buy health insurance; premiums are cheaper to early buyers Number of insured Australians increased from 30% in 1998 to 45% in 2002 Canada In 2005, the Canada Supreme Court rules long waiting lists violate patients' "liberty, safety and security" under the Quebec charter. Enforcement delayed til 2006 while debate continues
- 11. 11PricewatershouseCoPricewaterhouseCoopers September 2005 Transferable Lessons: Common Ground - Collaborate across traditional sectors and territory boundaries - Determine what care or benefits are basic to public health and structure an insurance system for the rest - Use regulation to encourage and strengthen competition - Access new sources of capital to remain competitive • New Dutch system has mandatory insurance and basic benefits package. • German hospitals privatized • Outpatient drug benefit outsources to PBMs
- 12. 12PricewatershouseCoPricewaterhouseCoopers September 2005 Sustainability Feature 2. Digital Backbone Interoperable electronic networks accelerate integration, standardization, and knowledge transfer of administrative and clinical information
- 13. 13PricewatershouseCoPricewaterhouseCoopers September 2005 The necessary digital transformation of the healthcare system “Paper kills” Newt Gingrich Former US House Speaker in describing the problems of paper health records
- 14. 14PricewatershouseCoPricewaterhouseCoopers September 2005 The necessary digital transformation of the healthcare system Patient Doctor Information and clinical decisions Medical knowledge Clinical record
- 15. 15PricewatershouseCoPricewaterhouseCoopers September 2005 The necessary digital transformation of the healthcare system MolecularMolecular (Genetic character(Genetic character of self pathogens)of self pathogens) CellularCellular (Types, counts,(Types, counts, receptors)receptors) TissuesTissues (Metabolism(Metabolism pathology)pathology) Organ SystemsOrgan Systems (Anatomic detail)(Anatomic detail) InterventionsInterventions (Orders, meds,(Orders, meds, procedures)procedures) PatientPatient Decision SupportDecision Support Clinical DecisionClinical Decision SupportSupport ComputerizedComputerized Patient RecordPatient Record
- 16. 16PricewatershouseCoPricewaterhouseCoopers September 2005 The necessary digital transformation of the healthcare system M.D.M.D. PatientPatient EHR/EnterpriseEHR/Enterprise SoftwareSoftware Trusted Sources /Trusted Sources / Info. BrokersInfo. Brokers Search Engines /Search Engines / AgentsAgents Gossip Science Collective Patient Experience Case ManagerCase Manager Knowledge Domains Consensus Care Pathways Infomercials Collective M.D. Experience
- 17. 17PricewatershouseCoPricewaterhouseCoopers September 2005 Transferable Lessons: Digital Backbone - Invest in shared IT infrastructure - Leverage technology to eliminate duplication and administrative inefficiencies - Make technology a reason to gather together • EU health ministers move toward trans-European e-health system by 2010 • NHS investing £6.2 billion in national electronic network • 200+ RHIOs under way • 40% of general practices in Australia process claims electronically • CAQH centralizes credentialing and moves toward streamlining claims administration
- 18. 18PricewatershouseCoPricewaterhouseCoopers September 2005 Sustainability Feature 3. Incentive Realignment Incentive systems ensure and manage access to care while supporting accountability and responsibility for healthcare decisions
- 19. 19PricewatershouseCoPricewaterhouseCoopers September 2005 Transferable Lessons: Incentive Realignment Transferable Lessons: - Establish shared incentives to accomplish mutual goals - Make wellness the preferred, if not mandated, lifestyle - Make consumers more personally responsible for the cost of seeking care - Put prices on the menu; disclose charges - Reinforce clinicians’ roles as facilitators of appropriate care • Italy finds limited results from co-pays, focuses on physician referrals • Employers raise consumer contributions through co-pays, savings accounts and co- insurance
- 20. 20PricewatershouseCoPricewaterhouseCoopers September 2005 Rules-based clinical referral Co-pay effect appropriate unnecessary Level of Demand Combining Co-Pays and Physician Incentives
- 21. 21PricewatershouseCoPricewaterhouseCoopers September 2005 Effect of co-pay on physician utilization in Germany, 2004-2005 -8.7%All physicians -11.3%Orthopedist -17.5%Dermatologist -15.1%Gynecologist -11.6%Surgeon -7.9%General practitioner Source: German Resident Doctors Association
- 22. 22PricewatershouseCoPricewaterhouseCoopers September 2005 Designing Incentives for Healthy Lifestyles Obese Overweight Normal Back problems 9.9% 8.9% 6.9% Hypertension 23.4% 12.5% 4.9% Diabetes 9.2% 3.4% 1.3% Heart Disease 7.5% 4.7% 3.7% Source: The Rise in Prelevance of Treated Disease: Effects on Private Health Insurance Spending, Health Affairs, June 2005 Prelevance of Treated Disease by Body Mass Category
- 23. 23PricewatershouseCoPricewaterhouseCoopers September 2005 Sustainability Feature 4. Quality and Safety Standards Defined and enforced clinical standards establish mechanisms for accountability, enhance transparency, and build trust
- 24. 24PricewatershouseCoPricewaterhouseCoopers September 2005 Transferable Lessons: Quality and Safety Standards Transferable Lessons: - Harmonize quality standards - Make error reporting voluntary and anonymous - Incentivize clinicians for outcomes, not activity, through pay-for- performance - Learn from existing systems when designing performance-based reimbursement - Publish or perish - Leverage quality to move the market % who said pay-for-performance efforts had not started in their area 0% 5% 10% 15% 20% 25% 30% 35% 2002 2005 Source: HealthCast 2020 Survey
- 25. 25PricewatershouseCoPricewaterhouseCoopers September 2005 Sigma Defects/Million 1 690,000 2 308,000 3 66,000 4 6,210 5 230 6 3.4 CEO Expectations: Six Sigma Quality
- 26. 26PricewatershouseCoPricewaterhouseCoopers September 2005 Six Sigma Quality Airline Deaths Airline Baggage Handling Missed diagnoses of acute cardiac ischemia in ERs
- 27. 27PricewatershouseCoPricewaterhouseCoopers September 2005 Six Sigma Quality Airline Deaths - better than 6 Sigma - < 3 deaths per million boardings Airline Baggage Handling - approx. 4 Sigma – 6000 mishandled bags/million Missed diagnoses of acute cardiac ischemia in ERs – approx. 3-4 Sigma – 45,000 misses/million Source: Pope, et al, NEJM 342:16 pp 1163-1170, April 20, 2000
- 28. 28PricewatershouseCoPricewaterhouseCoopers September 2005 Sustainability Feature 5. Strategic Resource Deployment Resource allocation – capital, people and service lines -- appropriately satisfies competing demands for access and cost control
- 29. 29PricewatershouseCoPricewaterhouseCoopers September 2005 Transferable Lessons: Strategic Resource Deployment Transferable Lessons: - Organise care around the patient - Move information, not people - Anticipate cream-skimming - Think small • Norway uses telemedicine to decrease costs of transporting patients to central centres • In Australia, 45 hospitals offer “Hospital in the Home” • Spain is building a regional network of 37 small, digital hospitals in Andalusia
- 30. 30PricewatershouseCoPricewaterhouseCoopers September 2005 Sustainability Feature 6. Climate of Innovation Technology and process changes are fostered to continuously improve care, efficiency and outcomes
- 31. 31PricewatershouseCoPricewaterhouseCoopers September 2005 Transferable Lessons: Climate of Innovation Transferable Lessons: - Help workers and clinicians change jobs and processes - Customise drugs and care to patients’ genetic and cultural levels - Value technology’s impact on productivity and lifespan - Listen to consumers • Homecare providers in the Netherlands and US are training nurses and aides to use laptops and handheld computers that are Internet- or cellular-enabled • Beverly is making long-term care centers with family-style meals and family areas • Kaiser trains physicians to talk to patients with a “third person” computer in the room
- 32. 32PricewatershouseCoPricewaterhouseCoopers September 2005 Sustainability Feature 7. Adaptable Roles and Structures Flexible care settings and jobs provide avenues for care that is centred on the needs of the patient
- 33. 33PricewatershouseCoPricewaterhouseCoopers September 2005 Transferable Lessons: Adaptable Roles and Structures Transferable Lessons: - Broaden and leverage nursing more widely - Challenge conventional training and licensing models - Anticipate ways to deliver care to patients who increasingly move and travel • Australia gives NPs limited prescribing rights • In Africa, former patients learn to repair fistulas • The EU has a system for mutual recognition of medical professionals’ qualifications
- 34. 34PricewatershouseCoPricewaterhouseCoopers September 2005 An exploration on the megatrends in the Healthcare industry 1. Healthcare is the industry growing most in the economy 2. Demographic changes and changes in the patterns of diseases 3. Great impact of the new medical technologies 4. Great impact of the innovation, mainly related to IT 5. Concern about quality 6. Appearance of the “new consumer” 7. Changes, but not radical ones, in the way of providing services 8. Change of the paradigm of the biomedical model 9. The emerging health economy 10. A place for new global players?
- 35. 35PricewatershouseCoPricewaterhouseCoopers September 2005 1. Healthcare is the industry growing most in the economy Evolution and forecast % GDP in healthcare in the US Health Spending Projections Through 2013 Stephen Heffler et al Health Affairs-Web Exclusives, W4-79 1993 1998 2001 2002 2003 2004 2005 2013 13,4% 13,1% 14,1% 14,9% 15,3% 15,5% 15,7% 18,4%
- 36. 36PricewatershouseCoPricewaterhouseCoopers September 2005 2. Demographic changes and changes in the patterns of diseases • Ageing of the population • More importance place on chronic diseases • More more importance place on mental diseases
- 37. 37PricewatershouseCoPricewaterhouseCoopers September 2005 3. Great impact of the new medical technologies Health and Healthcare 2010 The Forecast, The Challenge. Second Edition. The Institute for the Future, 2003 RATIONAL DRUG DESIGN ADVANCES IN IMAGING MINIMALLY INVASIVE SURGERY GENETIC MAPPING AND TESTING AND PHARMACOGENOMICS GENE THERAPY VACCINES ARTIFICIAL BLOOD XENOTRANSPLANTATION Development of new chemical entitities by looking at the physical structure and chemical composition of the target and designing drugs that bind to those molecules Advances in the four key areas: energy sources, technology of detection, analysis of the images and display technologies Advances in the fiber-optic technolgy, miniaturization, image digitization and navigational systems for vascular catheters To date, clinical test have been develop for more than 500 human genetic disorders, a number that will continue to grow. That permits predictive medicine and more personalized treatments The insertion of a functional gene into targeted cells of a patient to correct and inborn error or to provide the cell with a new function New uses of vaccines for non-infectious diseases. It is foreseen a new role to prevent virus related cancers and also to treat some cancers The FDA has recently approved products with synthetic hemoglobin, that could be an ideal substitute of blood transfusions That will avoid the scarcity of organs and also to treat some other diseases, such as diabetes and Parkinson STEM CELL TECHNOLOGIES The impact could be really huge. Damaged heart muscle could be substituted, also pancreatic islet cells in diabetics or some kind of neurons in patients with Parkinson’s disease
- 38. 38PricewatershouseCoPricewaterhouseCoopers September 2005 3. Great impact of the new medical technologies 1. MRI and CT 2. ACE inhibitors to treat high blood pressure 3. Balloon angioplasty to open blocked blood vessels of the heart 4. Statins to improve lipid metabolism and reduce risk for coronary heart disease and other vascular diseases 5. Mammography 6. Coronary artery bypass graft 7. Proton pump inhibitors and H2 blockers to treat gastro-esophageal reflux disease 8. Selective serotonin reuptake inhibitors and new non-SSRI anti-depressants 9. Cataract extraction and lens implant 10. Hip and knee replacement “Physicians’ Views of the Relative Importance of Thirty Medical Innovations,” Victor R. Fuchs, Ph.D., and Harold Sox, Jr., M.D Health Affairs, 2001
- 39. 39PricewatershouseCoPricewaterhouseCoopers September 2005 4. Great impact of the innovation, mainly related to IT 1. Pay-for-performance programs 2. Introduction of electronic health records into medical practices 3. Add-ons to EHRs--instant medical histories, coding devices, prescription-enabling modules, or Web sites that permit registration, virtual visits, prescription refills and open-access scheduling 4. Software facilitating office dispensing and prescription writing 5. Software enabling self-care, self-service and self-empowerment of consumers 6. New practice business models (concierge, cash and retail) 7. High tech/high touch remote patient monitoring with patient interactive capacity 8. Personal health records with and without EHRs 9. Disease management programs 10. The transparency movement as part of the consumer-driven care movement The Top 10 Healthcare Innovations for 2006 By Richard L. Reece, M.D., for HealthLeaders News, August 1, 2006
- 40. 40PricewatershouseCoPricewaterhouseCoopers September 2005 5. Concern about quality
- 41. 41PricewatershouseCoPricewaterhouseCoopers September 2005 6. Appearance of the “new consumer”
- 42. 42PricewatershouseCoPricewaterhouseCoopers September 2005 7. Changes, but not radical ones, in the way of providing services It is not foreseen the appearance of any new healthcare organization capable to substitute the individual medical visits and the hospitals as predominant ways of healthcare provision New complementary ways of provision: • On line healthcare services • E-visits • Telemedicine • Focused factories
- 43. 43PricewatershouseCoPricewaterhouseCoopers September 2005 8. Change of the paradigm of the biomedical model Biomedical model Future Episodic care Management of chronic diseases Objective: cure Control and adaptation to the disease, when there is no cure Fee for services Subscription Process leaded by the provider Process leaded by the consumer Curative medicine Predictive medicine
- 44. 44PricewatershouseCoPricewaterhouseCoopers September 2005 9. The emerging health economy Cosmetics Food and Supplements Fashion Security Building Supplies Wellness Traditional Health Care
- 45. 45PricewatershouseCoPricewaterhouseCoopers September 2005 10. A place for new global players? USA, Hong Kong, India, Malaysia, The Philippinnes, Portugal Sweden, Denmark, Finland, Norway, France, Germay, United Kingdom, Spain United Kingdom, Australia, Ireland, Saudi Arabia, Spain, Thailand, Hong Kong Germany, Belgium, The Netherlands, Luxemburg, Portugal, Check Republic, Norway, Sweden, Spain and China (representation office)
- 46. *connectedthinking To Download the Executive Summary www.pwc.com/healthcare Thank you Ignacio Riesgo Ignacio.riesgo@es.pwc.com + 34 629 12 86 58
Notas do Editor
- Good morning. Thank you very much, Luis and Fernando, for inviting me to share with you in my rusty English some ideas about the main trends in the Healthcare industry.
- I will start by saying that PwC has published three main reports on the trends of the healthcare industry. The first one in 1999, the second in 2001 and the last one in 2005. This last report deals with the sustainability of the healthcare system. Sustainability has been a great concern for politicians and managers of the system everywhere. The question is: Are our healthcare systems sustainable? In other words, will our healthcare systems be able, such as we know them, of being operational and useful for future generations? The common answer, particularly among the politicians, is that because the healthcare expenses are growing more than the general growth of the economy, healthcare systems will be unsustainable if this trend is maintained.
- Nevertheless, healthcare expenses have been growing in the last decades, and will continue to grow in the future. According to the OECD and other estimates, that will be the percentage of GDP devoted to healthcare in the US in the year 2020: 21% (they are now at about 15%). And this will be the percentage in the rest of the OECD countries, except the US: 16% (they are now at about 9%). In other words, a huge growth of healthcare expenses. And, what are the reasons explaining this fantastic growth of the healthcare expenses?. Well, the main reason is the real avalanche of new knowledge in biomedicine (more that 30,000 articles per month in the Medline, the scientific database of the US). This new knowledge is quickly transformed in new diagnostic and therapeutic technologies, which permit to handle some problems until now impossible to handle for human beings. Apart from that, the aging of the population, consumerism and so on. But the main reason is technological advances.
- Despite high spending, patients don’t get the care they need. This graph is taken from a paper published recently in the NEJM, a prestigious medical magazine. What that shows is that adult patients receive on average 55% of the recommended care in some very common conditions: breast cancer, depression, diabetes, etc.
- The expenses are growing, we don’t received the recommended care, and, also, healthcare system could be dangerous. This is the result of a very well known report published in the US: there are more deaths in the US in hospitals by medical errors that deaths for traffic accidents, and much more than for very popular diseases as breast cancer and HIV. This report produced a great impact in the US.
- Another observation is that the healthcare system that, until very recently, regarded as a local industry, is becoming global as well. Here are some examples of global influences in the healthcare industry: companies in South Africa contract with the NHS for elective surgery, The Philippines export nurses around the globe, the US turns to Indian and Australian companies for outsourcing radiology readings, … If we come to Spain, CAPIO a Swedish company has recently bought a hospital chain in Spain, Spain is exporting medical doctors and nurses, at the same time we are importing doctors from East European countries,…
- Reaching this point, we should ask this question. Is healthcare spending worth it? There area a lot of articles saying that the introduction of the new technology is worth in terms of quality of life, avoiding mortality and prolonging life. This is just an example: this is the death rate per 100,000 population in heart attacks with the therapeutic approach of the 80’, 90’ and in this century. We can see the reduction of the mortality.
- Well, the importance of this report of PwC is that face this problem of the sustainability of the healthcare system, not in terms of analysis of the growth of the expenses, but in a much more holistic approach. The report identifies 7 attributes of sustainable systems and healthcare organizations. Quest for common ground Digital backbone Climate of innovation Quality and safety standards Realignment of incentives Strategic resource deployment Adaptable delivery roles and structures What the report does is to explain these attributes and to present examples of initiatives on this line in several countries. I am going to present very quickly some of these examples.
- Common ground. That means that the healthcare system is not already the relationship between a medical doctor and a patient. It is a complex industry with many public and private institutions and companies, sometimes competing. Nevertheless, a common vision and a balance of public and private interests, in a context of societal priorities, are necessary to have a sustainable system.
- For example, some public Administrations are making efforts to encourage competition in the healthcare system. Germany is privatizing some public hospitals, in The Netherlands insurance companies contract with providers independently, in England the NHS is outsourcing some of the elective surgery,..
- Those are some transferable lessons: Collaborations across traditional sectors Use regulation to encourage competition Access to new sources of capital, for example in Spain there are some initiatives for the private financing of public infrastructures, as is the case in the UK
- Digital backbone. Everything related with the digital transformation of the healthcare system
- Do you remember Newt Gingrich, Bill Clinton’s friend?. He is now devoted to IT in healthcare. And to quote him: Paper kills. Why paper kills?
- This is the core activity of the healthcare system. The relationship between a doctor and a patient. It is supposed that a patient goes to see a doctor looking for information and clinical decisions. What are the traditional tools used by doctors for this relationship: First, the clinical record, normally in paper. But if the clinical record is in paper and is here, it can’t be in another hospital, or in a surgery, or in the car, or at the home of the patient,… all places where this clinical information could be needed. And if we don’t have this information will go to the anonymous medicine which is dangerous and very expensive. Second tool, medical knowledge, which is in the brain of the doctor. How is this brain fed? Contacts with come colleagues, attendance to some clinical sessions, occasional reading of some articles,… but we are speaking of more than 60,000 new references per month in the Medline on biomedicine. To diffuse this new knowledge is a fantastic logistic challenge of knowledge management that can’t be solved reading sometimes some magazines. So “paper kills”. In other words, it is impossible a medicine of quality based on papers. The whole health system needs a digital transformation.
- In this transformation, the clinical record plays a central role. But not a traditional clinical record, understood as a mere repository of clinical information, but as a place receiving manually or automatically a lot of information from several sources, and used by the doctor and the patient.
- This is the vision of the future medical/patient relationship. Both receiving information from many sources and establishing relationships (not only in one direction, as was the traditional approach), through a smart clinical software. This is the EHR.
- There are a lot of examples of digital transformation. Perhaps the most notorious example is the great project in the NHS, the biggest non-military project of IT in the world.
- Incentives realignment. For the consumers, for healthcare professionals and medical institutions.
- Some examples
- It is supposed that we can avoid unnecessary demand, combining copayment and physician incentives.
- Those are the effects of the copayment in Germany on the reduction of the activity
- Incentives for healthy lifestyles. This is the prevalence of some diseases, comparing obese and normal people.
- Quality and safety standards. Until now, because the information was hailed in paper, it was difficult to measure quality. But it is supposed that the digital transformation of the healthcare system is going to facilitate the establishment of quality and safety standards.
- Some lessons
- &lt;number&gt; 07/04/16 There is a movement now to introduce the Six Sigma method in healthcare. If you are at the level 6, that means that it will be less than 3.4 defects per million; if you are a 5 Sigma, 230 defects per million, and so on.
- &lt;number&gt; 07/04/16 We can compare now the quality level for these three conditions: airline deaths, problems with the airline baggage handling or errors in the diagnosis of heart attack in the emergency area of a hospital.
- &lt;number&gt; 07/04/16 Well, those are the results. You have more possibilities of being badly diagnosed in a hospital if you have a heart attack than to lose your baggage in an airport
- Strategic resource deployment. Obviously, nothing to see the deployment of resources now than before having the possibilities given by the telemedicine.
- Some lessons
- Climate of innovation. It is impossible to improve care, efficiency and outcomes, if we don’t introduce continuously innovations in technology and processes
- Some examples
- And lastly, adaptable roles and structures. In other words, not fixed professional roles and care facilities, but flexible roles for professionals and for institutions
- Some examples
- Following this report, and directly inspired by Moses, we would like to share with you some comments on these megatrends of the healthcare system Healthcare is the industry growing most in the economy Demographic changes and changes in the patterns of diseases Great impact of the new medical technologies Great impact of the innovation, mainly related to IT Concern about quality Appearance of the “new consumer” Changes, but not radical ones, in the way of providing services Change of the paradigm of the biomedical model The emerging health economy A place for new global players?
- We have already seen this point. This is the % of GDP devoted to healthcare in the US in the year 2013
- Demographic changes and changes in the patterns of diseases: Ageing of the population More importance placed on of the chronic diseases More importance placed on mental diseases
- Great impact of the new medical technologies According to the Institute for the Future, those are the technologies that will have the greatest impact in this decade: Rational drug design Advances in imaging Minimally invasive surgery Genetic mapping and testing and pharmacogenomics Gene therapy Vaccines Artificial blood Xenotransplantation Stem cell technologies
- Victor Fuchs, probably the most prestigious health economist in the world, did a survey a few years ago among a lot of medical doctors in the US, asking for the 10 technologies of higher impact in the last times. And this is the result: 1.MRI and CT 2.ACE inhibitors to treat high blood pressure 3.Balloon angioplasty to open blocked blood vessels of the heart 4.Statins to improve lipid metabolism and reduce risk for coronary heart disease and other vascular diseases 5.Mammography 6.Coronary artery bypass graft 7.Proton pump inhibitors and H2 blockers to treat gastro-esophageal reflux disease 8.Selective serotonin reuptake inhibitors and new non-SSRI anti-depressants 9.Cataract extraction and lens implant 10. Hip and knee replacement
- Great impact of the innovation
- Concern about quality. We have already spoken about that
- Appearance of the “new consumer”. This new consumer has more the mentality of client than the mentality of patient. It could be defined as people with as least two of these three characteristics: In a household with a income above 53,000 $ At least 1 year of college education Experience with IT, as having a PC As you can see, more that 50% of the population could be classified as “new consumers”
- Changes, but not radical ones, in the way of providing services
- Changes in the paradigm of the biomedical model
- The emerging health economy. The people who defend this concept say that a health economy is one in which the value of health becomes a key driver for the growth of the whole economy, not just the health care sector. In such an economy, traditional health care continues its very strong expansion. But more important, a broad set of health values- including physical, emotional and spiritual well-being- drive innovation and growth in markets for a wide range of products and services not traditionally associated with health These include such disparate things as cosmetics, fashion, security, building supplies, wellness and food Some people say that the frontier in economic growth is not wireless communication, or biotechnology or even nanotechnology, but that the real growth opportunity for the end of this decade is the emerging health economy Several phenomena: People use the traditional healthcare services using the traditional payors People use the new products with money from the pocket Traditional healthcare companies are exploring new products, apart from the traditional ones Non healthcare companies are exploring products related with health
- In the healthcare industry there have been always global players, but in the field of pharmaceutical or medical devices companies, but not in the field of payors (insurance companies) or providers. It was considered that the payors and providers were local markets, where the aspects of specific regulations were so strong that there was no place for a global company adding value. Is this situation changing? The other day we had an interesting discussion on this topic with Luis and Fernando. The people who defend the place for global companies in this field say that the main competitive differentiation of this companies is the introduction of the innovation (in IT, imaging, biomarkers, genetic tests,…) and that this innovation would be easily introduced by global companies. I don’t know if these companies could be defined as global healthcare companies, but, at least, they have international operations.
- Thank you for your patience with my English