Today's health technology world is fast moving and exciting - but still full of wasteful ‘reinventing the wheel’ and ‘not invented here' attitudes. Collaborations, alliances and above all effective communications are the weapons needed to overcome the obstacles.
We all know the statistics and trends, with ageing populations, the chronic disease epidemic of obesity, diabetes etc. and add the economic cost of treatment,reduction in productivity and the financial problems of many countries—it would certainly be easy to feel depressed and helpless!
Add to that, the legions of organisations and ‘Experts’ who state and restate the problems and issue stark warnings of the consequences but, with some notable exceptions, rarely offer practical solutions.
There are many well meaning announcements made that repeat the latest warnings and exhortations for all of us to exercise more and manage our health better; and for governments, payers to do more. But does anyone pay any attention?
So, before we all get depressed here are some thoughts which might cheer you up a little.
There is always a Chinese proverb for every situation and of course there is one for this too.
Wei-Jie is a term which means both crisis and opportunity and it is certainly a succinct summary of where the world finds itself now.
We often hear of the 'Crisis in Healthcare' usually prefaced with phrases such as 'Out of Control' or Global. Again, it is always easy to state and restate the problems, but there is a shortage of practical solutions.
The good news is there is also an opportunity and there are solutions.
There are success stories, there are powerful forces which if aligned can deploy solutions which will help solve the problems but the bad news is there are obstacles to effective international collaboration.
The three organisations, European Connected Health Alliance, China Connected Health Alliance and the New York eHealth Collaborative contributing to this article have experiences in three continents,with a combined population of approximately 2.4 billion citizens.
All three run multi-stakeholder organisations in their respective continents and have a helicopter view of the problems and solutions.
There are of course many differences on how healthcare is delivered in Europe, China and the USA, driven by differing reimbursement systems, payers, government policies etc. but the three organisations see many more similarities than differences.
So lets hear from all three organisations and look for hope and real solutions.
Julien Venne, Strategic Advisor & European Project Team Leader for ECHAlliance notes that the 28 Member States of the European Union have a population of almost 600million,much larger than that of the USA. Currently, about 20 per cent of Europe's population is aged 60 or over; that will rise to 30 per cent by 2030 and will include a large per centage of people over age 80.
Venne acknowledged that each country in the EU has 'different healthcare systems, different rules and different politics,' although all follow a common principle: universal healthcare coverage with general practitioners as the main gateway to care. Because the EU cannot decide strategy for its members-it can only foster research and innovation and encourage change-each member state has its own healthcare business model; generally, the model is a mix of public and private sector organisations that together make up the public health and social care systems.
Contributing to the market fragmentation is the lack of interoperability among computerised systems and laws that differ from place to place. Even so, Europe presents opportunities for companies and organisations from the US and other countries working in the e-health space, Venne emphasised. 'You need to create your own ecosystem to innovate, he said the ECHAlliance is doing its partby helping to connect innovators and their products with funders and purchasers, patients and families and health and social care providers. It has created an International Network of Permanent Connected Health Ecosystems in 25 locations across Europe, each with multi-stakeholders meeting regularly and doing business with one another.
These institutions attract, government, academia, industry start ups, small and medium enterprises, patient groups, physician and other healthcare professionals to meet regularly, listen to priorities and collaborate on solutions. More recently venture capital and private equity players are participating as they seek opportunities to invest in this fast growing market.
Successes and failures are communicated throughout the network leading to faster, more effective collaboration. The emphasis is on solving real needs rather than talking about the problems.
The European Commission provides significant funding for Research and Innovation, €80 billion in the latest plan to encourage job growth and export opportunities.
Millard Chiang, Chair of the recently formed China Connected Health Alliance (CCHAlliance) provides a snapshot of China's patient population and highlights key areas of concern.
He noted that while chronic diseases such as cancer, diabetes, heart failure and hepatitis C accounted for 19 per cent (260 million) of patients in 2013, the per centage will grow in coming years along with the ageing population. People aged 60 and over currently make up close to 20 per cent of China’s 1.4 billion population. Together, they eclipse those under age 15 (16 per cent). The dwindling younger population is due primarily to the one-child policy instituted in the 1970s, but environmental factors–notably, air and water contamination from industrial products–are largely responsible for the more than a billion cases of non-chronic diseases among all age groups.
'China needs first-rate healthcare technology, operating systems and research-and we need one million additional nurses over the next five years,' he said.
Those needs, among others, drove Chiang and his colleague Peter Chau together with Brian O’Connor (ECHAlliance) to cofound the CCHAlliance, forming 'a bridge' to Europe through collaborations with the ECHAlliance. The result is a variety of opportunities for companies involved in 'ehealth, mhealth, telecare, phealth, digital health and related technologies'.
Chiang credits networking with countries outside of China, as well as internal networking with China's ministries of health, social welfare and security, with the rapid success of the CCHAlliance's outreach efforts. ‘In eight short months, we've opened our first office in Shanghai ,recruited Members from Government,Industry and Academia and identified specific needs which provide real opportunities for European and U S players, he adds.
The determination of the authorities at central, provincial and municipal levels to dramatically improve medical and social care services to their citizens provides significant opportunities for Chinese local companies and in particular for Western companies.
That determination is being matched by additional investment at every level with amounts of additional funding that other countries can only envy.
Streamlining healthcare in the US and beyond
David Whitlinger, Executive Director of the New York eHealth Collaborative, says that the US shares the concerns of China and the EU regarding an ageing population and the costs of chronic diseases. According to the latest figures, chronic disease is responsible for
80 per cent of US healthcare spending, or US$2.3 trillion. Implementation of the Affordable Care Act could ameliorate the problem, he said, by 'putting us on track to provide healthcare to all of our citizens, thereby bringing us in line with Europe and China.'
Also similar to Europe and China, the US Centers for Medicare and Medicaid Services continue to 'shift from a hospital-centric system to healthcare delivery in ambulatory and home care settings, and from a curative approach to preventive care, 'Whitlinger said.' There's a move to pay for quality, outcomes, wellness-all opportunities for innovation if we can get healthcare ecosystems to align to a set of universal services throughout New York state and across the globe.'
Whitlinger concluded by observing that the ECHAlliance is a sister organisation of the CCHAlliance, and that the New York eHealth Collaborative is a member of the ECHAlliance. Together, he said, the organisations 'offer a window into the health status and needs of some 2.4 billion people on three continents, in markets that are spending up to four trillion US dollars. 'He stressed that the global market is ripe for 'killer apps' that can scale across countries and be delivered via a 'coordinated care/team-based approach'-for example, a 'medication-adherence app' to support care plans or an app that could make a significant impact on obesity, exercise and other lifestyle changes.
Right now, Alcoholics Anonymous and Weight Watchers are the only programs proven to work worldwide. We need killer apps that help eduacate
citizens to encourage them to take responsibility for their health and
lifestyle choices, thus giving them a better quality of life and reducing health insurance premiums for them and their families and other big health problems in New York, Europe, China and beyond.'
When you read the above and think about the sheer scale of US$4 trillion being spent, on providing healthcare and over US$1 trillion of that being spent on managing chronic diseases in over 400 million peoplethis really is both a crisis and an opportunity .
When you look at the amounts being spent currently in these three continents on health social care and public health and appreciate that even greater sums will need to be spent, the question which is often asked, but rarely answered is: What can be done?
The answer is: We can do a lot, because the knowledge and experience of solving at least some of the budgetry pressures on Governments everywhere have been tried and are working somewhere already.'
This Three Continent Coalition of the ECHAlliance, CCHAlliance and the NYEC is already sharing successes, experiences & opportunities. All three intend to intensify their collaboration by presenting their respective memberships with business deals, engagement with their opposite numbers, jointventure, licensing and distribution possibilities.
The combined efforts of these organisations will help turn the crisis into an opportunity for many.