academia

As ‘thinking season’ kicks off, the focus is on how technology and big data can deliver better value healthcare to more people than ever before. January is a time for reflection, planning and predicting what lies ahead. It’s the season for assessing the mega-trends that will shape our future and working out how we will respond. Perhaps the most prestigious venue for future-gazing is Davos where world leaders from politics and business gather on 17-20 January for the World Economic Forum . Here, global influencers will look at how prevailing economic, social and political forces present challenges and opportunities for all of us. Last year, the key phrase from Davos was the ‘ 4 th Industrial Revolution’ . The WEF set the tone for thousands of conversations on the topic last year, including at the MedTech Forum in Brussels last December. This year – with the convergence of technologies that blur the lines between the physical, digital and biological systems still very much in view – the theme will be Responsive and Responsible Leadership . But what can healthcare leaders expect from 2017? When it comes to healthcare , the WEF frames the conversation with some key demographic statistics: - By 2050, the world’s population will have risen to 9.7 billion - 2 billion people will be over the age of 60 To continue to meet the (growing) demands of healthcare consumers without blowing up healthcare budgets, new ways of delivery services will be required. Smarter, more efficient, technologies and systems will be essential. This brings us to the concept at the heart of many new-year health policy forecasts: value . Value-based healthcare has been something of a buzzword since it was coined by Harvard’s Michael Porter . Most of us have an intuitive sense of value. In healthcare, Porter...
What is your day-to-day work like? I’m the head of a busy Department in a University Hospital in Bratislava and I’m also the Secretary General of IFOS - the International Federation of Otorhinolaryngological Societies. My department is dealing with both inpatient and outpatient care. We are also a teaching hospital so aside from dealing with patients with ear, nose and throat disorders, I’m kept busy upskilling students and providing young doctors with specialised training in Otorhinolaryngology –head and neck practice (ORL). I’m also involved in different research initiatives so when there’s a deadline for a research grant in my field of business this can be quite demanding on my time, finalising research submission with my team. How do you help improve or save people's lives through your work? Rhinology conditions - nose and sinus diseases, infections, inflammatory conditions and tumours - affect a huge segment of the population, particularly if you consider the amount of people affected by allergies. We carry out a number of surgical procedures relieving patients of their sinus problems. One of the most challenging areas of our work is treating those patients with head and neck tumours. We work with a multidisciplinary team to carry out sophisticated and highly complex surgeries. Another area is helping patients with congenital hearing loss. This is another very complicated area, particularly for children with hearing impairments. To be able to carry out life-changing surgery and provide patients with an implant and thus the opportunity to hear again: it’s hugely rewarding. Indeed, by implanting a cochlear implant in the ear of a child, you are forever connected to that child and their family, right through to their adult lives. You can see them grow and develop and enjoy a happy and successful life as they return for check-ups, not impaired or...
Representatives of Health Authorities and Payers seem to have mixed feelings about orthopaedic implants. They all know someone in their immediate environment who has had a new knee or a new hip and who is very satisfied with it. They also know that these people have regained their quality of life after a long period of pain and reduced mobility. Yet, when they look at their budgets, they get cold sweat. There are indeed good reasons to be worried. A simple look at demographic predictions reveals that 21% of the EU population will be over 65 in just 5 years from now - a 4% jump from 2010. Predictions for 2060 are even more worrying, with 1 out of 3 citizens over 65. All over Europe, budgetary measures have been taken to try to make our generous social systems sustainable and orthopaedic implants have not been overlooked. Unfortunately for manufacturers, but most importantly for patients, implants do appear very prominently on the bill, making them an easy target when it comes to budget cuts. After all, it is much easier for any authority to ask for a discount than to implement complex in-house structural reforms. In addition, in some countries, such as Germany, public opinion has been given the impression that use of implants is too high, only because the number of hip and knee implants is one of the highest in Europe. But before answering the question of overuse in Germany or underuse in other countries, one should answer the question of when the appropriate time for surgery in the care pathways is, and what is the economic impact of implementing this. We need solid scientific background to demonstrate that timely surgery is beneficial for both patients and health systems -in Germany and elsewhere-, and not a waste of...
At W.L. Gore we took the decision to review our educational strategy well before the recommendation of the EDMA and Eucomed Boards to phase-out direct sponsorship of Healthcare Professionals (HCPs) to third party organised educational events was announced. We did this as our business leaders were getting increasingly concerned about the complexities of doing business across regions worldwide and being aware of all the issues that could arise. In our company, fairness is one of the core values, and we consider fairness to our customers as part of our ethos. Discussions around medical education were originally business led, with representatives from all parts of the business of our company contributing. Then compliance and legal professionals joined the conversation. As we talked and talked, we realised we had to answer the question - why do we support the medical education of Healthcare Professionals and for what reason? This helped us come up with a new, refocused educational strategy that took into account the changing environment and the modern world in which we operate. As a result we did reconfirm our intention to provide education, but we reviewed the best and most efficient way in which this could be done. The debate led us to introduce a shift from direct sponsoring of HCPs to third party organised educational events to grants. Was this tough? Yes, particularly as in some areas W.L. Gore was the first to introduce this concept. Both internally and externally some struggled with the concept. However with clear explanation and our conviction that this was the right way forward we started to see a change in attitude. We now find a system based on grants allows more forward planning, as we provide grants for a period of up to a year. Generally a broader group within the chosen institution...
Public and private healthcare payers around the world face substantial and evolving challenges in making good decisions on behalf of their ultimate clients—their beneficiaries or subscribers, i.e., people who are at risk of becoming patients. As agents for these potential patients, payers and providers must make prudent clinical and economic recommendations on how to obtain value for money when allocating the scarce funds they manage to obtain better health for their clients. One of the major challenges payers and providers face today is assessing the value of rapidly evolving medical technology. I use the word “evolution” here because they must choose the winners in a complex and competitive environment where some new technologies will succeed and others will fail - indeed, this is “survival of the fittest”. However, how do we, or more importantly, how should we determine which technologies are the fittest? Or, in other words, the most “fit-for-purpose”? Economists have long recognized the unique nature of the market for medical products and services. Back in 1963, American economist and Nobel laureate Kenneth Arrow published a landmark paper in which he identified the pervasiveness of uncertainty as one of the key characteristics of this market. How does the healthcare market address this uncertainty? The short answer is: by providing information or goods that reduce uncertainty. For example, regulatory agencies exist to certify the quality of medical technologies. Professional licensing aims to guarantee the competence of medical providers. Insurance schemes are regulated to define benefit packages and fair competition among them. Medical innovation introduces new competitors on the healthcare market, and by definition, there is very limited information available when a medical technology is launched regarding what could be its ultimate value in a healthcare system. How do we deal with this uncertainty? One of the key tools or processes...
In linguistics, describing a word as a false friend implies that despite similarity in spelling or pronunciation, it actually has distinct – sometimes even contradictory – meanings in different languages. Describing rare diseases as ‘rare’ creates a similarly false association, one which implies they have a limited impact and scarcely occur. Drawing such a parallel does not reflect the reality for the approximately 30 million European citizens who have received a rare disease diagnosis. For them, a rare disease is anything but rare. Instead, it is an often long and terrifying crossing into largely unchartered waters that are characterised by a lack of information, specialists’ know-how and effective treatment.