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The reinvention of health care models

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The reinvention of health care models

Public and private providers, professionals and users, and all stakeholders will be challenged by "unprecedented changes in information technology, integrating automatic big data, image analysis, artificial intelligence, and deep learning that will radically transform health care ", says António Ferreira, president of the National Commission for Reference Centers.

It will have an impact on the changing role of doctors and other professionals in healthcare delivery, patient empowerment will grow and providers will have systems in place to turn data into information and information into knowledge.

To Francisco Rocha Gonçalves, Healthcare Technologies Management director of Luz Saúde, "Today's digital technologies, and the forms of technology that will emerge soon, will be enablers and linkages of new forms of care organization, research, prevention and financing ".

He considers that they are not merely accelerators of the current way of working, but "will be instrumental in the new models of relationship with the patient, with the actors of the health value chain and with society. That is, innovation with which people go generate innovation and thereby build a future ".

Creating value for patients

Technology is not a device, a medicine or a software in itself, it is a broader concept, it is embedded in a work process, combined with other resources and capabilities, it is a particular way of organizing production. So it doesn't matter if they are public or private or social organizations. "More than the shareholder nature, what matters is the goals and the degree of commitment to achieve them," says Francisco Rocha Gonçalves.

The advantage is "who best creates value for patients". The creation of value goes according to Francisco Rocha Gonçalves by the integration of technological options in the production of better results and optimization of the costs to which these care are offered. "Whoever best manages this technology management, which involves technology upgrades but also smart integration and an ability to change the way we work and organize pathways, will be at the forefront in creating value for patients."

For Francisco Rocha Gonçalves, "the most successful strategies will involve: identifying key technologies in connection with companies' mission / vision, seriously rethinking how they solve customer problems today, accelerating time to completion and changing corporate culture." . Emphasizes that the two key competencies are strategic leadership and the ability to manage alliances or networks.

The challenges for the NHS

Innovation, particularly in health technologies, is the major challenge, at least in terms of investment and funding from the National Health Service (NHS), which is said to have much of the obsolete equipment. This need for reinventing the care model requires investment and will necessarily increase health spending.

"The technological decline in hardware in the NHS is one of the symptoms of its failure and results from wrong choices in the use of available resources – which are now, as never before, extremely reduced", underlines the former president of Hospital de São João in Porto, where he specializes in internal medicine and assistant professor at the Faculty of Medicine of the University of Porto.

He added that "I am not sure that the private ones have better information technologies than the public ones. The development of information technologies in some public hospitals is really remarkable at national and international level", says António Ferreira.

Francisco Rocha Gonçalves considers that "investment in quality assets and the inherent expense are not even the main characters of the future health story that we are writing: this is the reinvention of the care model and the main actor is the sick, or people in general if we want to start a little further upstream. "

"The NHS is core in the provision of care in Portugal but does not exist in autarky, so surely that investment will be financial in the acquisition of own resources when justified, but also in the design of integration solutions with the rest of the value chain. that leverage innovation processes or better alternatives – with suppliers, providers, complementary industries, financiers, local or international, etc. ", concludes Francisco Rocha Gonçalves.

The digital health bubble

In the first half of 2019, start-ups focused on the digital health and wellness business raised $ 4.2 billion in 180 businesses, according to Rock Health, which only has operations of over two million. US dollars. The forecast is for it to reach 8.4 billion in 2019 against 8.1 billion in 2018. The capital invested in digital health startups since 2011 has reached 29.4 billion dollars.

António Ferreira considers that technologies will be crucial.

Health technology assessment is critical

Technologies have a value chain transformation capability, ie create value for patients, offer many options and the pace of change is very rapid.

With advances in digital health, data science, and medical technologies, it is becoming more important to evaluate health technologies and interventions, and to quickly access innovation, because this ability to evaluate "is part of the ability to successfully transform the value chain, or to create value for patients, because there are many options and the pace of change is very fast, the ability to identify and assess the impacts of health technologies is critical, "says Francisco Rocha Gonçalves, Healthcare Technologies Management director of Luz Saúde .

The traditional assessment of the era was done with established methods, constantly updated, and with good known results. The economic assessment takes into account the direct, indirect, opportunity costs of technology to which clinical outcomes are added, and in these multiple outcome attributes, patient or society preferences, or may include broader impacts on society. reported outcomes, the relevant alternatives to achieve the same end. "It is a rigorous process that helps identify good opportunities for innovation in new technologies," concludes Francisco Rocha Gonçalves.

Ethics, data protection

The technological explosion with data science, the bet on real world evidence (RWE), IoT possibilities, international collaborative R&D networks, etc. "These are now ways to make even more robust evaluations, more in line with the challenges of new therapeutic options, to update studies faster and to increase what we know of the impact of innovation," says Francisco Rocha Gonçalves.

According to António Ferreira, specialist in Internal Medicine at Hospital de São João and who is chairman of the National Commission for Reference Centers, "the entry and dissemination of these technologies in health systems raises questions from various spheres – ethical, legal. relating to data protection and access, of a technological nature, namely in terms of security, ethics, etc. However, none of them will prevent their dissemination in the coming years. it's crucial. "

It adds that "the possibility of allowing the assessment of individual and social and even epidemiological impact of interventions will enable the establishment of new financing models and the assessment of care based on the same impact and the results obtained".

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