VODI

This is the second in a two-part series. Read part one . The link between clinical and social aspects of COVID-19 raises the question of what type of data are needed to manage the COVID-19 surge and better absorb shocks that may be caused by future pandemics. We believe clinical patient level data are essential given the different ways the disease has developed for different patients. There are many questions up in the air that need to be answered in order to prepare better for future pandemics and to treat the disease. If testing and analysis is done in a harmonised way across the EU countries, data from different tests can be compared. And if these data are combined with demographic, social, health and other relevant characteristics it will bring additional value by understanding the framework for the disease and perhaps also indicate a more efficient treatment through personalisation. This will require a number of things: Developing testing in a diagnostic context linking patient data, such as registries, to additional sources of data to be able to follow up the development of the disease in the medium- and long-terms. Establishing a common framework that allows for meaningful comparison across borders – from health system to health system. If it cannot be done quickly enough at a global level, it should be possible to do it at a European level. Establishing common ways of interpreting data (preferably through a harmonised approach at EU level) in order to maximize the value of the treatment for the patient, for the health systems, and for our societies. A communication published by the European Commission in July identified EU-wide sharing of clinical, epidemiological, virological data through an EU COVID-19 data sharing platform as one of action areas to ensure the short-term EU health preparedness for...
The power of diagnostics information ( VODI ) to public health and society was a topic of keen interest even before the COVID-19 outbreak. The pandemic offers us fresh lessons on how health systems can harness this value. Many of us will recall one of the earliest recommendation from the Director General of the WHO during the pandemic: test, test, test . In our view, testing played a key role in healthcare systems’ response to COVID-19. From the earliest weeks of the pandemic, Germany and South Korea stood out in managing outbreaks relatively well. Besides having very resilient healthcare systems with high laboratory capacity and trained staff, they were also doing better than most countries because they had the resources to test widely at an early stage. As a consequence they have also suffered lower case fatality rates than comparable countries. Despite the rapid development of diagnostic tests, most countries lacked the necessary personnel, equipment, and infrastructures to be able to cover the needs caused by the surge of severe COVID-19 cases. Yet, the wide deployment of diagnostics has helped to control this surge in countries which supported appropriate reimbursement policies for diagnostics and antibody tests. Social measures, including the design of lockdown protocols and the progressive return to the “new normal”, have been informed by the effectiveness with which diagnostics were deployed. Border policy has been linked to the availability of, and free access to, rapid testing at airports. This has been facilitated in some high-income countries such as Denmark, and in some low- and middle-income countries, such as Senegal. So, how can we better harness the value of diagnostic information for more personalized care in future? The urgency of controlling the surge of COVID-19 cases has made it necessary to prioritise the immediate consequences of the tests, those...
Covid-19 has proven a seismic event for our societies, and it is easy to forget that the pandemic will not dominate the debate on healthcare forever. Yet by any rational measure, efforts to manage long-term conditions will continue to be responsible for the majority of healthcare costs into the future. Heart failure (HF) is, and will remain, one of these crunch issues. Simply put, we have very little choice but to pursue the timely prevention and care of HF, due to the sheer scale of the disease and the high price attached to failure, both human and economic. HF occurs when the heart is unable to pump enough blood to meet the body’s needs, resulting in a heavy physical and psychological burden. Outcomes are often poor, including mortality and quality of life. In fact, HF is the most common cause of hospital admissions in people over 65 and the leading contributor to unplanned hospital readmissions overall. Yet few political leaders across Europe appear to grasp that HF is a major battle ground for preventable morbidity, mortality and cost. Rapid access to effective diagnostics and the best use of diagnostic information are essential to reducing the burden of HF. Therefore, we welcome MedTech Europe’s case study exploring how the information generated by in vitro diagnostics can help to improve HF care, and in particular by cardiac biomarkers such as natriuretic peptides (NP testing). Unfortunately, the use of diagnostic information for HF is routinely suboptimal in many European countries. Poor multidisciplinary working, misdiagnosis, lack of capacity and inconsistent application frequently lead to harmful delays, meaning HF is often confirmed late, after severe damage to the heart has occurred. Bottlenecks are commonplace for echocardiography, the specialist-led ‘gold standard’ diagnostic test, and key tools such as NP testing are still not fully reimbursed or...
Prevention is better than cure. It’s cheaper too. In fact, preventing future illnesses and preventing complications from existing conditions, are vital to the future sustainability of health systems. For a vaccine that prevents measles, or a medication that prevents a heart attack, the value is obvious. But what about the value of learning that you are at risk of heart attack? This information could trigger changes in behaviour and lifestyle that reduce the chances of hospitalisation or death. What about the value of regularly monitoring your blood glucose if you have diabetes? This could prevent profoundly negative (not to mention expensive) complications such as blindness, amputation or stroke. And what about the value patients and society gets when a clinician knows whether to use an antibiotic – and which one to choose. Not only does this enhance the patient’s chances of a timely recovery, it supports responsible use of antimicrobials and makes better use of resources. Investing in prevention With many conditions, earlier intervention improves patient outcomes and spares them – and the health system – avoidable illnesses and treatments. The obvious example is cancer: effective treatment of early stage cancers can dramatically improve prognosis. That’s why screening is so important. Screening is also an example of how population-based prevention programmes can deliver for citizens across the social spectrum, regardless of income or health literacy which can otherwise exacerbate inequality of outcome. I realise this is not breaking news. Yet less than 3% of health budgets is devoted to prevention. The rest goes on cure and care. I sometimes think we should refer to healthcare as ‘sick care’ – a system focused on ‘healthcare’ would dedicate itself to preserving good health for as long as possible. As rates of diabetes, heart failure and other chronic conditions continues to rise, and...