In 2015, global healthcare (HC) spending represented almost €7.5 trillion (11% of the world’s GDP), expected to grow almost 6% in the 3 years to come. National Health Care Systems and Care Providers, worldwide, are migrating to some level of integrated care. MedTech companies want to follow, but wonder which direction will generate the highest value.
Trends in healthcare worldwide
In the U.S. and Europe, the number of patients continues to increase because of an aging population and increasing numbers of chronic patients. By 2020, HC is expected to represent almost 20% of GDP in the US and close to 13% in most W-European countries.
Governmental cost reduction programs and privatization of HC insurance are putting pressure on hospital operations and inflating the non-clinical (mainly administrative) costs of the HC systems simultaneously. They represent over 15% of hospital budget in the US, Holland, Germany and England; a counterproductive effect that doesn’t help to cope with increasing needs for health care.
In emerging economies, there is a continuous effort to make HC accessible for a larger part of the population, which is not always supported by the required increase in public funding.
At the same time there is an increase in quality of care, more skilled personnel and state of the art facilities, all involving rising costs of diagnoses and therapies.
To deal with the cost and volume pressure, care providers worldwide move to value based health care and to various types of integrated care provision models.
Chronic disease patients play and important role in this equation. In the US and Europe, 60 to 70% of the deaths are related to chronic disease.
Value-based delivery models
In order to better understand how hospitals want to improve value-based delivery models for chronic disease patients, TforG surveyed 250 hospitals in the big-5 West-European countries and in a number of emerging economies (Turkey, Russia, Brazil, China). The models under analysis are pertinent to Patient Care Pathways for:
- Cardiology (Hear failure, AP, AVD)
- Neurology (Stroke)
- Orthopaedics (Arthritis)
- Endocrinology (Diabetes)
- Oncology (lung, liver, prostate)
Clinical and non-clinical stakeholders were interviewed about the priorities, challenges, bottlenecks and opportunities related to these clinical pathways. The table below summarizes the main outcomes of the exercise.
3 important outcomes:
- Hospitals believe that factors in the pre- and post-acute phase of care provision substantially impact their efficiency and profitability.
- Criteria linked to volumes of patients represent a bigger challenge for hospital management and physicians than the quality of care.
- Eventual solutions to the above often do not fall under the authority or budget of the hospital organization, unless they move into vertical integration
Hospital-based and integrated solutions
Looking at the MedTech industry, all providers address one or more of the priorities listed above by offering different levels of solutions.
- Increasing connectivity/interfacing/data processing between departments and modalities
- Addressing the need for better multidisciplinary management of the patient, etc.
e.g. Philips (HealthSuite)
Facilitating integrated solutions:
- Consulting services to improve care processes and patient throughput
- New technologies facilitating home-based care, connecting patients at home with care providers of different types
e.g. Medtronic (Integrated Health Solutions)
Clinical assistance or full care provision:
- External partners offering care provision services and clinical processes that are traditionally performed by hospitals, physicians, etc.
e.g. Fresenius – Helios (private hospital services) and Medtronic-Diabeter (young type I diabetes patients)
Context and pathology rule the care path
Very different models are required to handle the challenges within a particular national context.
The role of the national healthcare system is crucial. Finland, for example, chose for small hospitals enhanced by outsourcing, and created an important role for private providers within their public healthcare management. In the French model, regional reference centres and departmental HC agencies take the lead in care integration.
The specific needs and contexts of the respective pathologies and clinical pathways are another parameter impacting the potential integration models, e.g. patients with cardiac implants can be monitored through tele-health solutions. In this case, monitoring services would be an obvious opportunity to reduce the workload for the hospital.
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About Bart Van den Mooter
Bart is the founder of TforG and works closely together with over 50 global companies such as Abbott, Baxter, GE, J&J, Medtronic, Philips, Stryker and Covidien. In this function, he spends a lot time with Key Opinion Leaders and Health Policy makers in Europe and in Emerging Markets. He graduated at the Polytechnic University of Leuven with a Master of Engineering and has an MBA (Flanders Business School).