The Health Care Toolbox is Complete — Now we Need to Make it Work
Last part of an article series on ‘Growing the Collective 5P Value Pie in Health Care’
What does it take to scale a collaborative, value-based health care system akin to the 21st century?
This is the daunting question that is plaguing our systems and societies.
Today, we are writing the 31st of October 2020. In any other year, many of us would be celebrating a joyful Halloween party. This year, everything is different.
Soon, we will be reaching the one-year mark of the global Covid19 public health crisis. Over this past year, we have witnessed hundreds of thousands losing their lives to this novel virus, millions of long-term disabled patients surviving the disease, and too many families surviving the crisis with destroyed livelihoods.
We know that our health care systems & infrastructure had long been broken before this pandemic hit. Now, several months into it, the ailings of our systems have become even more obvious. It somehow seems as if not much has improved as we are gliding full speed again into the next wave of exponential viral growth.
“We should be doing better. A lot better.” writes Julie Kliger today in her newsletter on health care ‘real insights, real stories.’
In her article, Julie compares the daily death toll to a frightening picture of several jumbo jets falling from the sky, crashing every day in America alone. She wonders why there is not more of a public debate on the root causes of why a communicable disease is leading to such an outgrowth of mortality in a developed country. Conversely, the public debate seems to be arguing around basic public health measures whilst numbers of cases, hospitalizations & ICU occupancy keep skyrocketing and health care workers are fast approaching a second wave of burn-out.
Nevertheless, admits all this chaos and despair, there is some light sparking on the horizon as we are also watching a crisis catalyzing change.
Many countries have been able to seize this moment of disruption and accelerate what the toolbox of digitization & modern technology holds for health care. Public spaces such as schooling & public health offices have been upgraded with digital solutions & communication platforms, often enabling the roll-out of contact tracing & large scale testing capacities (Korea, Taiwan, Germany to name only a few). The use of telemedicine has seen an all-time high, and payers across the world have started finally reimbursing this channel of interaction between patients & providers.
Further, exceptional progress has occurred on the research front with many examples of collaborative projects initiated across continents & research teams. Crowd sourcing, open access data sharing & virtual scientific meetings have ignited an unprecedented exchange & acceleration of insights. The science around the virus and the clinical experience of dealing with the disease have helped us learn on how to best contain the virus in public spread, and how to best treat and take care of individual infected patients.
In the search of novel treatments & vaccines against Covid19, numerous public-private partnerships have rapidly been pulled off the ground. Broadly spanning coalitions involving pharmaceutical companies, academic institutions, regulators such as FDA & EMA as well as institutions like the WHO & the NIH have enabled a risk-sharing approach on cost and drug discovery. In normal times — this is worth remembering — developing a drug-to-market can easily take up to ten years and cost several billion dollars. An effort that is traditionally carried out by the private sector.
Working now across public & private sectors on a novel vaccine within less than 18 months is readily close to spectacular.
In this present article series of Growing the Collective Value Pie in Health Care, I have written about the Tango for Five as the quandary in health care and explored the toolbox that we hold at our fingertips to fix it.
If health care would be one organization, there would one joint accountability. However in reality, there is a set of five independent networks who are taking decisions on a daily basis, yet being rarely aware of their tight interdependency of decision-making: patients — providers — pharma — payers — policymakers. After many years as a physician & business leader working across a variety of networks in this ecosystem, I came to conclude that:
only once these ‘5Ps’ rally behind a common purpose and break down barriers to collaboration, will we effectively be moving forward with the much-needed transformation in health care.
The question of the moment is: how can we potentially leverage & perpetuate the positives that this pandemic ignited and grow them into the future? Over and over again, history has shown us that major crises and their disruptive power can propel long-lasting change. There is no reason why we could not harness this disruptive moment for health care. Over the past four articles, I have reviewed the following key ingredients that scholars and practitioners in the field consider important for a successful journey towards redesigning a humanistic and patient-centered system of health:
- WHY MUST WE CHANGE? — because of a broken balance between progress in medicine and affordability of that innovation;
- WHAT NEEDS TO CHANGE? — incentivizing quality of health outcomes instead of volumes of services, and hence eliminating inefficiencies and delivering value to all stakeholders in the ecosystem;
- WHO NEEDS TO RALLY? — behind a common purpose to make that change a reality: patients-providers-pharma-payers-policymakers;
- HOW CAN HEALTH CARE LEADERS ACCELERATE this change? — through building bridges among the top five decision-makers, coupled with harnessing the potential of digitization, artificial intelligence and machine learning.
In brief, the toolbox to fix the quandary of health care is all here. It is full and it is complete. It contains all the systems-, organizational & individual components. We know now what we have to do. But, how to make it happen?
It starts with creating a consistent awareness of the underlying dilemma. In our broken health care systems, not one problem nor one solution can be found within one single actor. All share the responsibility. Collectively. In the private as much as in the public sector. We need to stop singling out villains as this will only further deepen the disparities and competing interests. What we need instead is a holistic approach with integrators — a path forward addressing both organizational and personal needs for change.
Individually, as health care leaders, it starts with realizing that most of the solutions to our problems may actually lie outside of our own area of expertise or constituency network.
In the future, leaders who are able to display empathy to problem-solving as well as resilience to the discomfort of change will be leading the way. They will be forging novel, cross-sector partnerships among patients with providers with pharma with payers with policymakers, such as we have seen them emerge during this pandemic.
Somehow, the peculiar challenge we are facing in this health care crisis is to repair a plane while flying it, and even having to make it a better & more innovative one for when we arrive. Hence, whenever something feels similarly herculean & chaotic — just like our health care systems and the world we live in — it is important to remember to break it down into smaller parts and pieces; taking a step back; advancing step by step; taking on what is in our control as individual leaders.
In review of this entire series on how to Collectively Grow the Value Pie in Health Care, I am concluding with this roadmap of steps that as a starting point we can collectively discuss and attempt to implement :
- APPLYING the principles of value-based care by measuring outcomes in well-defined patient populations and within a clear time frame;
- ADOPTING the playbook of collaborative, interest-based principles;
- ACQUIRING a digital footprint to simplify the complexity of health care.
Be the change you want to see in the world, said Mahatma Gandhi. Adapted here— be the change you want to see in the world of health care.
I would like to sincerely thank all my readers and fellow health care leaders who have provided me with great inspiration along the way of these past six months. I feel encouraged to continue on that path together with you, hopefully landing many innovative new health care planes, akin to the 21st century.
