Person-centred Care Is A Path Worth Exploring

Group Photo

Group Photo – Young Expert Panel and Invited Experts and Organisers

Young Expert Panel on Person-Centred Care

Brussels, 20th June 2014

Imagine that your recommendations could have an impact on the lives of 500 million people. Imagine that the governments of countries across Europe rely on your scientific expertise to advise them on the toughest questions about the present and the future of health care. Well, that group of experts already exists and it is called the Expert Panel on Effective ways of Investing in Health (1).

The European Union seeks modern, responsive and sustainable heath care systems but the challenges to achieve these goals are enormous due to ageing populations, a shift to chronic diseases and the consequent incremental costs. Additionally, better informed and demanding European citizens demand health systems that fulfil all their individual needs. All of these things are intrinsically positive, however health systems as they were constructed in the second half of the 20th century are not necessarily prepared to respond to these new challenges.

The gap between the expectations of citizens and stakeholders in terms of what comprises a modern health care system and reality seems to be narrowed at least partially by a transition to person-centred care, but what it consists of and how it will be achieved remain questions to be answered. That was the motto for a Brussels gathering of seventeen Young Forum Gasteiners comprising young health professionals from different countries and backgrounds, to reflect, discuss and propose disruptive ideas that could change the way we currently organise health care to make it more developed, responsive, sustainable and person-centred.

The workshop was supported by MSD and hosted at Microsoft Headquarters where we were surrounded by the latest technology available in an inspiring building, and thus in the perfect environment to have fruitful discussions about person-centred care. We were warmly welcomed by Elena Bonfiglioli (Senior Director, Europe, Middle East and Africa from Microsoft) who told us that 80% of health workers have mobile based tasks but only 10% have access to mobile technology in their work place. Elena asserted that with rising health costs, cloud computing and seamless access to technology (single sign-on) are absolute preconditions to realising efficiencies. She moved on to explaining the concept of the quantified self (the use of technology to gather data about yourself) that holds interesting prospects for the future of healthcare delivery.

Then, the workshop began, moderated by Nick Fahy, who guided us expertly through the different activities. Firstly representatives from the European Commission´s DG Sanco (Tapani Piha, Head of Unit, e Health and Health Technology Assessment) and Jan Muyldermans (Secretariat, Expert Panel on effective ways of investing in health) were invited to give us overview presentations of how the Expert Panel on Effective Ways of Investing in Health works, namely, its purpose, strategic objectives, composition, mandates and working procedures.

You can imagine that such an expert panel is subjected to heavy scrutiny from all the health stakeholders in Brussels. Therefore ensuring transparency and disclosing potential conflicts of interest are key considerations for the European Commission. The standard procedures to evaluate potential conflicts of interest of the members of the expert panel are very exhaustive and frequent. A key message was delivered: in the matter of conflicts of interest you must be transparent and evaluate each case taking into account the context of the work to be done.

After an enlightening plenary discussion highlighting a range of country examples of whether person-centred care is working or not in participants´ home countries, we were divided into four groups according to our professional background and interests (researchers, practitioners, policymakers and an mHealth interest), and faced with the first task of the day: to discuss key issues to consider on person-centred care and the lessons we could take from them, and then present these findings in plenary. Despite being background-focused, several common themes emerged from the group presentations. One of them was definitely the lack of a commonly accepted definition of person-centred care. Another consistently raised issue was the quality of the evidence that is used to shape the definition and recommendations for effective person-centred care. This evidence is often biased and lacking scientific quality. Training and education both for patients and health professionals on issues such as health literacy and person-centred approaches was another point of commonality.

During lunch, we were offered the possibility to get to know the working environment at Microsoft, as well as to obtain an insight into recent innovations aimed at improving patient care. A few Young Gasteiners tried the patient simulator, where they interacted with a virtual patient and had to decide what to do in a medical emergency, competing to see if they could stabilise the patient “against the clock”.

After a productive plenary discussion reflecting on the availability and quality of the evidence on person-centred care, we moved to the second part of the workshop. Each group focused on preparing a presentation on a set of recommendations to be made for a panel of invited experts. We were given advice on how to draft the recommendations, and how to present them to an expert panel. And what an expert panel we were presenting for: Boris Azais (Director of Public Policy Europe and Canada of Merck Sharp and Dohme), Josep Figueras (Director, European Observatory of Health Systems and Policies), Stephen Leyshon (Deputy Programme Director – Principal Advisor in Patient Safety, DNV GL), Bernard Merkel (Formerly Directorate General Health Consumer Affairs, European Commission) and Peter O’Donnell (Associate Editor, European Voice).

After such an intense day of discussion we came back home with the idea that person-centred care is a path worth exploring, although work is needed to reach a consensual definition and gather more sound evidence about the effectiveness of the interventions aimed at centring the care at the person in question.

There are no “silver bullets” to solve the problems of today´s health care systems but person-centred care might be the best way to integrate an approach incorporating the social determinants of health in health systems.

André Peralta Santos, Young Forum Gastein
Sofia Ribeiro, Young Forum Gastein

Acknowledgements
We would like to acknowledge Louise Boyle from the International Forum Gastein for organising the workshop and for reviewing this text, MSD for providing financial support, Microsoft for hosting the workshop, Nick Fahy who guided us through the programme and the invited experts, who kindly agreed to evaluate our presentations and give us feedback.

References
1) Commission Decision 2012/C 198/06 – Creation of the Expert Panel

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Introducing Theresa

My name is Theresa Gschwandtner and I will support the European Health Forum GasteiNeues Bildn as an assistant during my summer holidays until the beginning of October, when the conference takes place.

I’m studying Sociology (Master’s degree) and Pedagogy (Bachelor’s degree) at the University of Salzburg. It’s a pleasure for me to get the chance at the International Forum Gastein to gain knowledge and practical skills.

I am happy about the opportunity to get insight in the field of work of organizing an important international congress dealing with an exciting topic.I’m looking forward to the experiences in the organization and I approach the next months within the IFG-Team with great motivation!

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All I want for summer is the ECDC Summer School

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Introductory meeting with ECDC Director Dr Marc Sprenger

Stockholm, 9-12 June 2014

I don’t know about you but the moment I hear “course” I develop an autoimmune reaction. It’s not that I don’t like learning, come on, I have a six year career, two masters degrees, four years of specialty in Public Health and I’m doing a PhD while working… So no, it’s not that I don’t like learning, but I just can’t bear to sit for hours listening to someone talk the day away. Therefore if you are like me, the ECDC summer course is your thing. It starts with a very formal meeting and then the crowd is quickly divided into groups. From the moment you enter your assigned room, you know this won’t be a typical learning environment: the chairs are organised around four tables and none of them are directly facing the front of the class. You are in here to talk and discuss, not to be talked at.

ECDC and the external experts´ mission, was to help us understand how evidence becomes health policy. If you think this is easy, let me make this clear: it is not. We started by learning how to calculate the burden of disease, analysed which factors helped or limited the evidence from transforming into public health actions, and what were the determinants of decision-making. How many times do you read an abstract and don’t understand how the conclusions can lead to a public health action? Exactly! We need to publish answers to these fundamental questions: what do you want to say and why is it important? Now of course, decisions need a public health ethics framework. The ethics workshop was definitely a workshop where the level of discussion and debate was high.

Once you have your evidence and health policies ethically disposed, you should be prepared for future threats, especially the cross border ones. We learned about existing tools for risk assessment and in no time were role-playing. Suddenly Young Gasteiners had to take decisions on how to operate during an infectious outbreak in Scan Mark, a fictional very wealthy country. We solved it by creating an island where diagnosed patients were taken for care upon entering the country, to avoid provoking an epidemic (as you might imagine we also had laser swords and a throne made of syringes…). The fact that our imaginary countries were wealthy or not was not a mere detail: money, or more precisely, cost-effectiveness, makes the world go round. Therefore our last workshop was dedicated to this fascinating topic.

At the end of the course I was exhausted due to the 4am sunrise light coming through my unblinded hotel windows every day, but I felt satisfied by the fact that I had learned… while having fun. Young Gasteiners, you will be invited next year, please don’t miss this opportunity!

Yaiza Rivero Montesdeoca
Yaiza participated in the ECDC 2014 Summer School with fellow Young Gasteiners Kolia Bénié and Héðinn Svarfdal Björnsson

Young Gasteiners hard at work!

The goal of the ECDC Summer School is to strengthen mentoring and technical skills in applied epidemiology and public health microbiology. This is achieved through a series of workshops on selected topics for prevention and control of communicable diseases and by providing an opportunity for sharing best practices within the ECDC expert networks. The International Forum Gastein would like to thank the ECDC for their generous support of the Young Forum Gastein Network in offering three places on the 2014 summer school to Young Gasteiners.

 

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