Health management embodies the complete health ecosystem. Apart from working alongside patients, researchers and more, health managers must engage with policymakers and regulators to help forge governance structures that will centre around equity, efficiency and effectiveness. Only together can we pave the path that will invite better health outcomes for the community at the individual, organisational and systemic levels.
This section provides a quick guide to the current policy landscape regarding health management and what stance EHMA will hold on priority topics in the field.
Person-centred care empowers people to take charge of their own health. It always ensures that patients judge and determine the final value. From decision-making and planning to developing and monitoring, patients co-create and co-deliver their care according to their own wants and needs.
Whilst person-centred care and patient-centred care are often used interchangeably, person-centred care goes beyond an individual seeking healthcare. It extends the concept of patient-centred care to individuals, families, communities and society. Person-centred care focuses its attention on people’s health within their communities and its role in shaping health policy and health services.
Where Positive Impact Could Occur
- Foster relationships and networks around patients than focusing on organising a health system structure could ensure that practitioners listen to patients and include them when designing treatment plans.
- Patient-centred care and personalised medicine could contribute to improving care outcomes, enhancing patients’ quality of life and experiences, and reaching goals of efficiency, effectiveness and quality care and treatment.
- Adopting integrated and person-centred models which recognise and identify the needs, preferences and values of every individual could address the fragmented and discontinuous care that takes place for individuals with multiple and complex health needs.
- Digital health (from training and tools to implementing healthcare technologies) could play an integral role in delivering and adopting person-centred, integrated care.
- Patient-centred care could be the viable and holistic approach for higher patient satisfaction and value and improved health outcomes.
- Patient involvement could ensure that sustainable reforms occur in a health system and treatments are correct and in line with patients’ needs and expectations.
- Some methods to guarantee that patients’ needs and preferences are being met could include changing current health practices; developing new measurements to capture patient preferences; showing more interest in population health; adjusting payment mechanisms; aligning regulation and non-financial incentives; undertaking different approaches to strategic purchasing to help support the aforementioned actions.
- Leadership roles could include the introduction and integration of soft skills to fully implement an integrated, person-centred healthcare system.
HEALTH TECHNOLOGY AND DIGITAL TRANSFORMATION
Increased adoption of digital innovation is essential for higher-quality patient care and will occur in the coming future. The COVID-19 pandemic highlighted the need for digital solutions, given that such technologies could help health systems be more responsive, resilient, person-centred and financially and environmentally sustainable.
On 3 May 2022, the European Commission presented a proposal for a regulation on the European Health Data Space (EHDS) to reconcile the regulation of the primary use of health data by European Union citizens/health professionals and the secondary use of such data by researchers, innovators and policymakers. The EHDS is the next step in collecting and using a large amount of high-quality, standardised and real-world health data to develop novel treatments and more personalised medicine and inform decision-making processes.
In the same vein, the Digital Europe Programme (2021-2027) is a 7.5bn-€ programme funded by the European Union that supports projects in supercomputing, artificial intelligence, cybersecurity, advanced digital skills, and the use of digital technologies. Its ultimate aim is to drive digital transformation in Europe and foster European Data Spaces in each sector. For health, this will mean creating an interoperable data system and governance structure that brings together the currently fragmented data from both the public and private sectors.
Where Positive Impact Could Occur
- Artificial intelligence (AI) could be employed for managing medical records and data to save time for health professionals, e.g., nurses spend approximately 25% of their time on administrative tasks.
- Countries could ensure that health workers hold a high level of digital literacy by delivering proper digital health education/training sessions that equip them with the skills, trust, knowledge, and acceptance needed to maximise the use of digital technologies.
- Data used in AI technologies must be accessible and transparent, use clear language and have an ethical use. Building trust in AI could translate into investing in research, designing, and testing of such technologies; guaranteeing the quality of the data; raising awareness and knowledge of AI and how it works; and ensuring that liability regimes are in place.
- Digitalisation could be successful and harmonised if all stakeholders could capture total value via improvements in quality of and access to care; reimbursement regulation; network-based organisational benefits such as efficiency gains, learning or knowledge transfer; and legitimacy gains due to institutional isomorphism.
- Medication in hospitals is the highest spending chapter for health budgets according to OECD data, which suggests that a lack of digitalisation of medication management in European hospitals poses a significant weakness for health systems.
- Digital tools and advanced logistic systems could address issues of resource waste due to poor drug management systems, given that they could provide accurate quantification of stock supply and information on consumption data and prescription patterns. An annual cost of 22.22€ per hospital bed from expired medication is associated with manual medication management.
- Digital tools could prevent and improve the management of medicine shortages (which is at a crisis level) and provide accurate, real-time data to support the reallocation of medicines.
- When implementing new digital systems, safety cultures should be created to ensure benefits from new digital systems are maximised, and safe working environments are created. Consultation and co-design with healthcare professionals could prove helpful in this context to deliver the sustainable, effective and positive impact of digital medicine management platforms.
- The implementation and scale-up of digital tools and electronic medication management systems in healthcare facilities and antimicrobial stewardship programs could improve the prudent use of antibiotic prescriptions and reduce antibiotic consumption. Inappropriate antimicrobial consumption and prescribing may reach 90% and 75%, respectively, in hospitals and long-term care facilities.
- Digital transformation of healthcare services could be framed in the guiding principles of universal health coverage to close the digital gap and leave no citizen behind in terms of digital literacy.
- Digital tools could connect and serve both patients and healthcare professionals, but medicine should not lose sight of the social and human element in favour of digitalisation.
- Upscaling healthcare IT systems help support European objectives related to the sharing of patient data for research and development in evidence-based decision-making processes.
The workforce of the future
The COVID-19 pandemic has highlighted the centrality of the health workforce in the sustainability of health systems. Any transformation that would aim to make health systems resilient and innovative, whilst ensuring patients’ safety and quality of care, must start with healthcare professionals, their educations and continual learning. Whilst the demand for more health professionals, especially those specialised, is increasing, Europe is experiencing shortages of healthcare workers. Common issues among European countries include staff recruitment and retention, mobility and migration of health professionals, and a balance of apt skills in the right areas.
WHERE POSITIVE IMPACT COULD OCCUR
- Developing new skills, including those that are digital, via a revamping of training and education programmess and new approaches to workforce planning could address the evolving and increasing needs of citizens; the digitalisation of health services; and general trends toward more co-creation of health and care with patients.
- A rise in retention rates could occur if health systems invest in and protect their existing health workforce whilst providing incentives to increase recruitment of new generations of health workers.
- Priority areas where digital transformation could be applicable include strengthening primary care; improving the digital skills of the health workforce; providing digital mental health services for the public and the health workforce; and enhancing data governance.
- Psychological safety has a direct influence on improving patient safety. Interventions that improve psychological safety could support a culture in which teams would know how to engage in functional and constructive conflict, uphold inclusive behaviours and carry out proactive inquiry.
- Health workforce planners could estimate the future by focusing on the importance and significance of digital transformation and telemedicine, and the technical development needed among the health workforce.
- Updating training of the future European workforce whilst upskilling and re-skilling the current workforce could help meet the demands of a transitioning society that is beginning to adopt green and digital solutions.
Sustainable and resilient health systems
The COVID-19 pandemic disrupted health systems, highlighting the need for more sustainable approaches. A system that is sustainable in both structure and management in hospitals can promote optimal well-being and health for people. In particular, the lessons learned from this pandemic must be used to increase the resilience of health systems for future crises, so responsiveness can continue meeting patients’ needs.
The World Health Organization defines a sustainable health system as a “system that improves, maintains or restores health, whilst minimising negative impacts on the environment and leveraging opportunities to restore and improve it, to the benefit of the health and well-being of current and future generations.” Providing sustainable health services is only possible if healthcare is available, adequate, accessible, affordable and appropriate for everyone.
Where positive impact could occur
- Health systems could adopt a wide understanding of sustainability that encompasses economic, environmental and social aspects to support a sustainability transformation.
- Focus could be placed on health promotion and disease prevention, given that these are considered key factors for the long-term sustainability of health systems.
- Funding could be prioritised for prevention and epidemic preparedness. Investing more in prevention could mean saving more on treatments in the future and having more funds for more health services.
- Health systems could benefit from experience less cuts in prevention budgets and adopting a forward-looking approach. Short-term savings can lead to long-term drawbacks.
- Further funding and investments could help transition towards sustainable care models and health facilities, thereby positively impacting well-being and supporting economic growth in the long term.
- Sharing knowledge and empirical experience could contribute to accelerating the rate of breakthrough, sustainable reforms in health systems.
- Professionals could be made further aware of the reasons for sustainable changes and the need to improve efficiency in healthcare.
Healthcare access, delivery and outcomes
Access to healthcare is an essential objective of health systems, as it represents one of the most important determinants of life expectancy and quality of life. Evidence suggests that healthcare access is socially biased to the disadvantage of the most vulnerable, underpinning a negative impact on health inequalities. Facilitating access to healthcare implies improving the affordability, accessibility, acceptability, availability and adequacy of care services. Many subgroups of the population still face considerable barriers that impede them from reaching the necessary healthcare resources.
For health systems to respond to ongoing and emerging health challenges, they must better address existing disparities in access to health services and ensure that they are not exacerbating or promoting discrimination that could leave certain populations behind.
Where positive impact could occur
- Fostering multi-stakeholder collaboration could successfully increase access to medicines and therapies. This could include improving health literacy among patients and boosting patient engagement and involvement. It could also imply the active sharing of good practices among the scientific community and intensifying cooperation between health systems.
- Through Universal Health Care (UHC), every citizen could access the health system without facing severe financial consequences. The COVID-19 pandemic has shown that UHC increases the resilience of health systems and re-emphasises the importance.
- Solutions to improving access to appropriate treatment could include making technological advances more accessible, cheaper and straightforward around the globe; expanding digital portability; increasing the opportunity for patients from around the world to participate in health trials that could save lives; and enabling the dissemination of health knowledge.
- Further efforts could be taken to improve literacy on health rights and access in the migrant population, especially among those who recently arrived or undocumented.
- Equal access to healthcare addressing economic, language difficulties and health access barriers could be promoted.
- Patients could be co-creators in disease management plans to improve health outcomes and reduce avoidable complications.
- Digital health could improve person-centred healthcare and help build more resilient health systems if pursued further.
- Member States could prioritise the implementation of a “health” model as a main pathway to guarantee all European Union citizens access to high-quality, effective and efficient health systems that increase the quality of life; reduce disability and productivity loss; and deliver long-term economic development.