Health systems across the planet are fighting similar battles. One upcoming fight is that rising life expectancies will eventually put cost pressure on governments, patients, and caregivers as chronic and degenerative diseases become more commonplace in the general population. This may coincide with a global lack of clinical resources, as is currently foreseen.
Policymakers, economists, and healthcare professionals are naturally hard at work to solve this looming problem. But, as has been the case in other industries, technologists want to contribute too—and with their unique and futuristic digital tools are seeking different ways of taking care of patients (read our Healthcare Reimagined report).
For instance, telemedicine platforms and connected objects can enable people to monitor and support themselves, which could help reduce congestion at clinics, promote more cost-effective homecare, and increase patient accountability. At its simplest, remote access to advice can connect patients in "medical deserts" (whether in terms of their location or other systemic failings) to doctors. These examples all represent improvements for healthcare providers, but at their core serve the most important factor of all: a more positive and more comfortable outcome for patients.
Big data and data analysis tools are also being employed in the name of prevention, a concept central to healthcare: it's cheaper and more effective to prevent than to react. (This is as true for healthcare professionals as it is for patients). Educational apps now exist to train patients on their own wellbeing, and wearable technologies help people understand their own bodies so as to live healthier lifestyles.
Finally, inside hospitals, artificial intelligence and process automation are also improving work environments by freeing up caregivers to focus more on patients.
Luxembourg has great circulation through its circuits
Across the EU, only 4% of hospitals dedicate a twentieth (or more) of their budgets to the digital world, whereas in Luxembourg that percentage is a much healthier 33%.1 Despite the country's smallness probably affecting this number, it nevertheless indicates the positive direction that the Grand Duchy is taking.
This is no accident: here in the Grand Duchy there are frameworks and initiatives promoting innovation and public/private partnerships. Several organisations like LuxInnovatoin additionally work to attract startups.
Take the Luxembourgish electronic health record (Dossier de soins partagés) as an example of interoperability amongst healthcare actors, or DPIs (Dossier patient informatisé) like the Dop@min project as an example of internal digitalisation. The idea with such initiatives is to create a more secure and better coordinated environment for carers, with the ultimate goal of course of optimising patient care.
Luxembourg is also widely known for its advanced expertise in computer data security, storage, and processing (driven by and developed largely in the financial sector). In recent years this expertise has been applied to personalised medicine, alongside big data and analytics. Personalised medicine, which seems to have a bright future in Luxembourg, is a niche sector that fragments patients into different groups, enabling more targeted care.
All these elements, combined with top-notch fixed and mobile infrastructures, make for a vibrant and creative health sector.
Turning aches and pains into stakes and gains
Luxembourg's health sector is certainly improving its ability to pump data and technology through itself, but these are still the early stages. Three observations we have made, and which we presented at the recent Healthcare Summit, regard collaboration, data transparency, and patient empowerment.
In looking to other systems for inspiration, Israel jumps out as exemplary in how its actors collaborate. The Israeli health system, essentially state-owned, is organised around four health maintenance organisations (HMOs) that provide integrated care packages based on a lump-sum funding per member. Clalit, one such HMO, offers its members access to general practitioners, general and specialised hospitals, laboratories, radiology offices, pharmacies, and homecare—all under one roof. These various providers work in systems that are totally interoperable.
Luxembourg, being so petite, may have an advantage in enabling collaboration of this kind. But together with that must come more transparency of healthcare data, an area on which several studies2 have singled out Luxembourg as low-scoring. Giving patients more access to their own data will empower them to understand their situations and make more informed choices, which ultimately benefits all parties.
And thirdly, data sharing, data privacy, data acquisition—these phenomena, along with the capabilities and drawbacks that come with them, are still relatively new. The public has certain conceptions and misconceptions about them, and governments are still putting effective regulation into place (recent example: the GDPR) aiming to keep data safe.
In terms of healthcare apps and connected devices, security remains a major concern. With fewer than half of the EU Member States having frameworks for assessing such gadgetry, a gap emerges between professional medical devices and health-related tools of unverified quality. For example, imagine a personal scale with online functionality: it may be very useful for someone tracking weight loss, but if it's used to monitor changes related to more serious issues then an error in its calculations could have severe consequences. Stronger policy is the answer to this, to ensure that the right technologies are leveraged and that medical devices are used appropriately.
Technologists working in the health sector have the scope and audacity to wholly change how care is supplied, accessed, sourced, paid for, and more. Health professionals are at the centre of this change, naturally, and their voices represent a gigantic resource. They understand the needs and challenges of caregiving best, yet also stand to have their roles potentially risked or altered. In this context, extra reflection must be given to the transitions happening in hospitals everywhere, since digital transformations cannot succeed without cultural transformations.
In Luxembourg, this means several challenges that will crop up as forward-looking health systems gradually replace legacy ones. And our final conclusion: it will be patient empowerment that sculpts the future of healthcare in Luxembourg.
1ESPON, March 2018
2EC study on the state of health in Europe; KPMG's 2017 study on the transparency of the results of global health systems
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