The digital future of healthcare: Using data to FutureProof health systems (F3)

Are we prepared for the digital future of healthcare?

In the interactive session: The digital future of healthcare, we were building for the future of digital healthcare, not just with Lego but also with bold ideas.

It is hardly news to the participants of this convention that a digital healthcare revolution is upon us. In this session, moderated by Bogi Eliasen (Copenhagen Institute of Future Studies) and Jörg-Michael Rupp (Roche), seven important themes regarding the future of healthcare were discussed in small groups:

  • Prevention and Early detection
  • Genomics
  • Tech and AI
  • Data sharing and Governance
  • Person and Patient Empowerment
  • Personalized Care
  • Connecting Health Data Across Europe

Challenges surrounding these themes are many and some common issues appeared in the groups. One of theme is highly relevant for young professionals and future health care workers and policy makers: digital literacy.

It is obvious that the level of digital literacy needs to be addressed. More specifically, the level of (or lack of) AI literacy needs to be addressed on all levels; patients and citizens, healthcare workers and policy makers. Health education is lacking behind. There is an urgent need to incorporate AI (and other digital technologies) in the curriculum for all health educations. As the popular saying goes: AI will not replace doctors but doctors who use AI will replace doctors who don’t. Nurses that use AI will replace doctors that use AI. Patients that use AI will replace all of the above.

With the use of very analog tools (Lego, post-its and voting tokens) the future of digital health was explored in a room full of European healthcare leaders. It is clear that we are standing in front of a lot of new opportunities. But a lot of challenges need to be addressed. The overall impression is that leaders and policy makers are not up to speed with the fast evolving digital future of healthcare

The take away message: If we impose new technologies on a broken system, we will only create more problems. We need to prepare the system for the changes that are coming (and that are already here).

This Blog was written by the Young Gasteiner Anton Hasselgren

Patient Blood Management: No need to B-negative (W4)

Mind = blown.

And that doesn’t happen to me very often anymore.  It’s disruptive.  And I like it.

Ask yourself when was the last time you had your mind blown at a health conference?  Yes, it’s true that at these kinds of events you will often have important updates, hear about unique innovations, and get caught up on interesting initiatives.  These are all critical for those of us who are actively engaged in improving health in Europe, and they are the force that draws many of us to events like European Health Forum Gastein.  Having one’s mind blown isn’t often included in a conference package.  But I’m glad I had that included in my ticket to EHFG.

We’ve all come across a slogan like, “Give blood, save lives!”  We may even have experienced the individual and collective pride associated with participating in a blood drive.  And for good reason!  But what if there was a better way than blood transfusions to deal with patients who are anaemic and need blood – a better way for patients, and a better way for the health system?  This is the question we explored in Wednesday’s session “Save blood, save lives”, where we were introduced to the concept and practice of Patient Blood Management (PBM).  For about half of us in the room (including medical doctors), this was the first time we’d ever heard of PBM, but we came out of the discussion inspired and fascinated by the prospects and promises of PBM being accepted and practiced at a larger scale.

According to keynote speaker Professor Axel Hofmann, Patient Blood Management (PBM) is an evidence-based bundle of care to optimize patient outcomes by managing and preserving a patient’s blood.  Traditionally, the question we’ve been asking is “how much anaemia and blood loss can a patient tolerate before having a transfusion?”  But what if instead we asked“what can be done to minimize and eliminate the causes of anaemia and blood loss?”  It turns out, that in answering this question with PBM, you get an improvement in key patient outcomes, including a decrease in in-hospital mortality, length of hospital stay, rates of infection, decreased risk of acute myocardial infarction/stroke, and readmission.  These improved patient outcomes have the knock-on effect of creating significant savings within the health system.[1]  Sounds great, right?  The problem is that PBM practices are not widespread, and awareness among healthcare workers and patients seems to be low.

What to do about this? How do we get the message to the right people and advocate for implementation of PBM?  That’s the wicked question we discussed together during the session.  It turns out that we had more questions than easy answers.  But a clear outcome of this session was that, even though many of us had never even heard of PBM before, we all recognized and were excited by the significant benefits promised by adopting PBM strategies.  And, if after four short presentations, we can understand the concept of PBM and be convinced this is something worth working on, maybe there is hope to convince others working in health.  We need to continue this conversation in Europe, both on the macro and the micro levels, and to disrupt the status quo on blood transfusions. And, perhaps, because we all had our minds a little bit blown, there are now new advocates for PBM among the session participants.


This Blog was written by the Young Gateiner Brenna Deckert

STEERING, NOT ROWING: How to reform a health system, fail at it, and try again (W1)

Of course, health systems vary wildly across countries, so is there anything we can learn from one another? Are there any consistent themes when it comes to good governance? We discover that though each country is different, there are many similarities. In our successes and in our failures.

The TAPIC framework defines five domains of governance:
Policy Capacity

This tool identifies and assesses some of the tangible areas for success or explanations of our failures within our health systems. In addition to these domains, three less tangible but just as crucial features of successful healthcare reform emerged from the discussion:

1. Tackling reactionary mindsets
What if the reform requires a change in constitutional law? To get support for something that was considered by some to be impossible, Austria put legally-binding targets at the centre of their reforms, and the resulting data provided the justification they needed to persuade others that inaction wasn’t an option.

2. Trust
For me, this speaks to wider societal issues around public trust in authorities, experts and information sources (‘fake news’), which as we are too aware, can have severe consequences for governance. In order to lead successful reform, you need trust from decision-makers and civil servants, but equally from citizens and civil society (which relates to participation).

3. Learn from your failures and keep trying
Finland has made numerous attempts to reform their health system, and they are determined to learn from past attempts and try again. Health systems across Europe are commonly fragmented, complex and dynamic. Change takes time, so don’t expect to reform everything all at once!

In health reforms we see successes (planned or unplanned), failures (sometimes with surprisingly good outcomes) and most of all effort from those people who care. Persisting, because: “if we don’t find solutions for the people, we are betraying the people.” (quote: Clemens Auer)

This Blog was written by the Young Gasteiner Ellen Bloomer

Transforming HIV responses in Europe: Focus on disruptive community actions (W5)

The advancements in HIV diagnosis and treatment, specifically the introduction of pre-exposure and post-exposure prophylaxis, have turned the way we (should) see HIV upside-down. But do we? Contradictive to technological advancements, HIV incidence rates are locally increasing in Europe. HIV can now be considered a chronic disease, but in our societies, many remain censured. If we want to meet our Sustainable Development Goals, we need to act.

Robbie Lawlor, HIV activist for Act-Up Ireland and co-founder of Access to medicine Ireland, is still actively fighting for subsidies for PrEP medication, despite its proven impact. Stigma is still firmly present in our society. In this situation, the role of civil society organisations is straightforward. “We need to be activists.” In Europe, there still are extremely conservative practices concerning HIV care. In this context, peer support provided for example in Serbia by POTENT has not only human impact but has been proven to be crucial in the acceptation of the diagnosis as well as beneficial in the adherence to life-saving treatment.

Many advancements have been made in Europe, but the gap between the East and the West, the stigma and prejudice still censuring our brothers and sisters and the lack of resources to make treatments accessible to everyone are still present. Why do we allow society to be our enemy?

This Blog was written by the Young Gasteiner Damiano Cerasuolo

Changing the game on health inequalities: why it matters and what we can do (F2)

Towards equity in Europe – is the time ripe for change?

“Equity” is the new buzz word in public health land and has really gathered momentum at the European Health Forum Gastein (EHFG) 2019. According to the World Health Organization (WHO), health inequities are systematic differences in the health status of different population groups. It can relate to the differences in our education, housing, environment and many other indicators that determine our health on the short or longer term.

The EHFG 2019 dedicated an entire session to equity in Europe entitled “Changing the game on health inequalities”. The session was truly inspiring and showed the huge potential gains in improving equity in terms of life expectancy, quality of life and sustainable economic growth. Most remarkable or ”disruptive”, to stick to the theme of this year’s conference,  was evidence presented by Chris Brown Head of Office of the WHO European Office Investment for Health and Development in Venice. She highlighted several findings from the recently published Health Equity Status Report (HESR) for Europe. The report contains an extensive policy and data analysis from all WHO European Region Member Countries for the period 2005 – 2016. It not only identifies the main trends and status of inequity in health in Europe, but also presents concrete measures for politicians and policy makers that could immediately lead to positive effects on the ground. The latter must sound especially appealing to the politicians among us whom are often hesitant to invest in policies and services that they believe will only deliver results a long way in the future, in someone else’s political mandate.

The unique shape and format of the report could therefore be a real landmark in addressing inequities in Europe and perhaps finally lead to the change we need. It is crucial that our, mostly, democratically elected governments in Europe realise that much of the daily challenges their ministries, police forces and other civil servants face are a direct consequence of their own poor policy choices. For example, the HESR for Europe shows a 0.1% GDP investment in 3 policies (social protection, housing and community facilities and labour market policies) would result in a reduction of inequities in illness that limits daily life between those in the top and bottom 20% incomes. The HESR shows this equates to 250,000 lives improves in 4 years in a country with a population of 60 million. However, across Europe there has been an average 50% disinvestment in policies for social protection and housing and while there has been an increase in jobs. More than 50% insecure and the bottom 20% income groups occupy most of these insecure jobs.

With 84% of the Europeans believing that reducing inequities should be on the top of their Government agenda, it is perhaps high time we elect a Government that aspires the same. Otherwise these continuous poor policy choices could on the short or long lead to some real disruption on the ground, something far beyond the disruption we are seeking this year in Gastein.

This Blog was written by the Young Gasteiners Anna Stielke & Mischa van Eimeren