Published 12 October 2020
Some of the biggest challenges facing our world today are about health and in particular, healthcare. These include ensuring health systems can handle major shocks like pandemics or climate change, overcoming diseases like cancer and heart disease, and ensuring equality of health coverage for all.
In order to overcome these global public health problems, our healthcare systems need to change, to evolve so that they are ready to handle whatever the future may hold.
Fortunately, the tools we need to build resilient, equitable and future-proofed healthcare provision for everyone, are available today. Some of these are already transforming the world's potential to capture and analyse vast amounts of medical data, the application of rapidly advancing digital technology and our greatly improved understanding of human biology and genomics. But unfortunately, not all are being harnessed when it comes to health care.
That is why it is so important to bring together organisations and individuals from different sectors, private and public, to drive change. Because only by working collaboratively to embrace the potential of, for example, data to drive healthcare and policy decision-making, will we be able to harness the power of these forces to deliver for patients. Only by leveraging the innovations we already have at hand, will we be able to deliver health care personalised to the needs of each and every individual.
Technology can drive efficiency in healthcare
This idea of the future healthcare system with the individual at the centre is, of course, something which patients, and the organisations which represent them, welcome. Leanne Raven, CEO of Crohn’s and Colitis Australia, believes two of the biggest issues facing patient advocacy groups are access and affordable care. Health systems built around digital technology and our new-found capacity for collecting and analysing massive amounts of data (combined with our enhanced understanding of human biology), are a way to overcome both of those challenges.
“Better use of technology will improve access for many people, as they will no longer have to travel long distances to receive healthcare. In many cases they can receive care in their homes, leaving hospitals to become more like critical care units,” Leanne believes. “Leveraging new diagnostics like genetic screening and new treatments will cut waste and bring efficiencies in healthcare. That frees up budget and resources to drive affordability and access to high-quality team-based care. Affordability and access are the two biggest issues that patient organisations deal with on an advocacy level, and driving change to reduce these health inequities could be life-changing.”
Smaller countries may lead the way
Stanimir Hasardzhiev, Founder of the National Patients’ Organisation, Bulgaria, also believes that health systems which maximise the use of innovative technology and data solutions are more equitable. “Medical costs in smaller countries are often higher because they lack the purchasing power of their larger neighbours. Now, though, they can leapfrog decades of development and take the learnings from larger countries to create health systems which are driven by data and supported by technology”.
“The perfect health system is one which is constantly evolving according to the needs of patients, as those needs change over time,” adds Stanimir. But all too often he sees that even the technology that we have in our hands now is not used as widely as it could be. So patients do not benefit from today’s technology let alone tomorrow’s: “technology is developing faster than health policies. To protect citizens from health inequality and enable them to benefit from advances in technology, policies need to keep pace with innovation”. This is something which Leanne also recognises. “Those who provide health services or develop health policy must invest in the consumer (patient) experience,” she says, “particularly if they want to drive change and reduce health inequalities.”
The pandemic has shown the urgent need for change
The issue of making health systems fit for purpose now and in the future is not only about making them better for patients and society. During the COVID-19 pandemic, most countries struggled to cope with the surge in the numbers of often seriously ill patients. In many parts of the world, routine clinical care for conditions including cancer and heart disease was put on hold as health facilities and staff were overwhelmed by the coronavirus.
Medical organisations across the globe have raised the alarm about the serious consequences of pressing “pause” for so-called routine care. They have suggested that this may leave us with an enormous public health burden for years to come. That is in addition to the human toll in terms of premature mortality and delayed diagnosis. This crisis has highlighted like never before the need to ensure health systems are robust and sustainable in the longer-term, and better placed to manage the next pandemic that emerges.
But how can this be done? Bogi Eliasen, Director of Health at the Copenhagen Institute for Future Studies says that to begin with, health budgets must be viewed as an investment rather than a cost. “This incentivises prevention and moves the focus to longer-term outcomes rather than simply whether a clinical service has been delivered,” he says. “We must also shift the basis of decision-making in health from one based on perception to one based on facts.” It always takes time to change established practice and update established understanding and beliefs. “If you want to convince people that there is a different, better way to do something, you need to show them the evidence, give them the data,” Bogi added.
We will only succeed if we work together
Providing the data to facilitate this critical change is exactly what FutureProofing Healthcare is designed to do. The project has convened independent experts from a range of relevant fields including patient organisations, health systems, think tanks and academia, to evaluate today’s health systems and their readiness for tomorrow. This group of experts have identified measures used to evaluate how healthcare in different countries of the world is progressing towards becoming more sustainable, personalised, integrated and, importantly, digital.
As Stanimir Hasardzhiev says: “COVID-19 has shown the opportunities offered when systems are driven by data and supported by technology.” Bogi seconds that line of thinking and adds that “Health systems were made for an analogue world, not the new digital and biological world. FutureProofing Healthcare aims to facilitate that change through the provision of centralised resources and expertly curated information.” But the programme will not only provide invaluable information in an accessible way, as Bogi adds: “By comparing countries and regions it helps us identify and export best practice. Learning from each other we can bridge boundaries and help foster more collaborative working across geographies.”
At the heart of any ideal future-proofed health system should, of course, sit the needs of the patient. The evidence base upon which health policy decisions are made must include an understanding of what works best for patients and healthcare professionals. For Leanne, a key element of this will be “creating a system where consumers (patients) have more control.” She sees FutureProofing Healthcare as a way to “show how things could be and what the path is to get us there, paving the way for change.”
That path to change should help to ensure the health systems of the world are more resilient, sustainable and ready to withstand the next global health crisis (be that caused by another pandemic, climate change, or something entirely unforeseen). It may also accelerate progress towards some of society’s most cherished goals including universal health coverage by 2030.
As Professor Tikki Pangestu, former director of WHO Research Policy and visiting Professor at Yong Loo Lin School of Medicine, National University of Singapore, comments: “The FutureProofing Healthcare initiative will be an important catalyst and driver for data and science-driven decision making, policy reform and strengthening of health systems, so that such systems are affordable, accessible, responsive, sustainable and resilient, and therefore ready to deal with known and unknown threats to human wellbeing and security. Beyond effectively dealing with health crises, the final ultimate goal of a future-proofed health system is equity, social justice and health for all people.”
Nobody has all the answers, but together we can find them
Roche has always been committed to tackling some of the biggest challenges in healthcare. FutureProofing Healthcare offers an opportunity to explore some of these challenges with experts from different sectors, industries and countries, to create a shared sense of what is working and where greater focus is required. And to hopefully prompt action for the future.
FutureProofing Healthcare brings together core elements of Roche’s vision for a better future for healthcare. The sweet spot where innovation in treatment, advances in technology, understanding of the human genome and our ability to analyse (using AI) data, is where the long-held promise of personalised healthcare becomes a reality. For us, personalised healthcare is not only about prevention and treatment for individuals, it is also about providing us with the capability to re-imagine what health systems will look like for future generations to come.
Padraic Ward, Head of International at Roche Pharma, believes that governments and healthcare policy makers need to keep that future in mind when they make decisions today. “Personalised care is an important advance for patients, and can eliminate waste and deliver efficiencies that can keep health systems sustainable, even in the face of growing populations and rising costs. But for that to happen, the systems need to evolve. We look forward to collaborating with our partners to help shape a more robust and patient-oriented global health ecosystem.”