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Global views on healthcare in 2018

Global views on healthcare in 2018 | Health Care Business |

In the new Ipsos Global Advisor survey, Britons are most positive globally about their healthcare system and - with Spain - have the highest confidence that they get the best treatment.


Some of the remarkable findings:

  1. "Consumers’ assessment of the quality of their healthcare varies widely across the 28 countries covered in an Ipsos Global Advisor survey of more than 23,000 adults. Globally, 45% rate the quality of the healthcare they have access to in their country as good, 33% rate it as neither good nor poor and 23% as poor.
  2. Among problems facing healthcare systems, access to treatment/long waiting times is the one consumers around the world are most likely to view as a major concern (selected by 40%), most of all in Poland (70%), Serbia (68%), Hungary (65%) and Chile (64%). Insufficient staffing is the second most cited major problem globally (by 36%), most of all in Sweden (68%), France (67%), Hungary (63%) and Germany (61%). Cost of accessing treatment third most cited problem worldwide (by 32%) – but ranks at #1 in the U.S. (64%), Malaysia (49%), India (44%), Saudi Arabia (32%), and in a statistical tie with other issues in Australia (38%).
  3. Views about the future of healthcare differ widely across countries as optimism prevails in emerging countries (especially China, India, Saudi Arabia, Malaysia and throughout Latin America) while pessimism dominates in many developed countries (especially in Western Europe).
  4. Globally, less than half of all participants agree that the provider they last saw know them as a person (36%), or that they know that doctor very well (37%), or that the doctor showed them emotional support (40%).
  5. Globally, one half (49%) agree they get all the medical care they need while one quarter (24%) disagree and another quarter (27%) neither agree nor disagree.
  6. Globally, cancer ranks as the #1 public health concern with obesity a far second.

Thinking about Telemedicine

  • Globally, only 10% report having ever used telemedicine. Generally speaking, reported experience is far more common in emerging countries of Asia and the Middle East and in the United States than it is in Europe. Among the 10% who have used it, about two thirds say they would use it again and one third say they wouldn’t. Globally, 44% say they haven’t used it but would try it.
  • Globally, 12% say they currently use a connected health device or tool to manage their health, 15% say they have used one, but are not using any now, and 68% say they have never used one – the other 6% do not know. The five countries where usage is highest are the same as with telemedicine: China (28%), India (23%), Saudi Arabia (22%), Malaysia (18%) and the U.S. (15%).
rob halkes's insight:

In the perspective on patients/consumers there is still alot to do in getting healthcare right! A conclusion from the recent (2018) global survey of health by Ipsos
"Views about the future of healthcare differ widely across countries as optimism prevails in emerging countries (especially China, India, Saudi Arabia, Malaysia and throughout Latin America) while pessimism dominates in many developed countries (especially in Western Europe)."

Interesting is to see how patients' responses do tell more about their beleifs, then about figures. Where is the global survey that really compare data like from GHO/WHO, EU, IFPMA, OECD, and Global Health 50/50?

More disturbing for scholars on healthcare is the disappointing percentage of people having experience with telemedicine!  

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What Healthcare Can Learn From Finance About Data Sharing

Both financial data and health data require the highest levels of security and privacy. Heavy regulation ensures that this type of information is as secure as possible. In principle, that’s a good thing. No one wants their medical profile out there for all to see.

But the experience of that safe and secure data exchange, between healthcare and finance, is dramatically (and we do mean dramatically) different. Banks, credit card companies and other financial institutions are able to navigate these barriers to talk to one another, making it easier for customers to coordinate payments and understand their overall financial wellbeing. So why can’t patients, doctors, payers and insurance providers do the same for health data?

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was passed with the good intentions of keeping personal identifiable information out of the wrong hands. However, these same regulations also block health information from being shared within the right hands, at the right time. Extended care ecosystems — consisting of family, caregivers, payers, doctors, institutions and providers — would benefit from access to this data to better coordinate care for patients. Instead, this burden often falls to a patient and, if they have one, a family member or friend helping to care for them.


From products that would alleviate the burden of coordinating care, to advancements in health research, here are just a few ways designers can look to finance as a model to help bring the healthcare sector up to date.


In order for patients to be good advocates for their own care, they need to be provided with the right tools. However, for those navigating the system right now, the tools are not evolving at the same pace as the financial or consumer markets. This leaves patients stuck in endless paperwork and outdated systems, responsible for recording, remembering and communicating their full medical history. This may not seem like such a big deal for healthy people that don’t interact with the system much, but it can become overwhelming for those with chronic illness who have to become their own advocates. When the healthcare sector embraces secure, but open, data sharing, it will unlock a spectrum of new health service opportunities.

Much like healthcare, the finance industry has a vast trove of complex data spread across countless interactions overtime. Nevertheless, finance has found ways to both protect and simplify the aggregation and consumption of data through a series of consumer-facing tools. The credit score is perhaps the most ubiquitous. By calculating data from consumer credit reports, the FICO score puts a number to individual’s credit worthiness, allowing users to quickly prove to those they interact with that they will responsibly service their debt or stay current on their financial obligations. With the use of this score, consumers are able to purchase or rent homes or automobiles, open up credit cards, or finance the purchase of other big ticket items like laptops, televisions or furniture.


Since the credit score was first established in 1989, many more user-friendly financial tools have arisen to help people take control of their financial data. One such example is ClarityMoney, an app that tracks spending habits and offers recommendations on how to best manage personal spending. The app recommends credit cards that can save the user money, and even highlights all recurring subscriptions, allowing the user to cancel any they may not be using with a simple click of a button. Few tools like these, powered by comprehensive personal data, exist in the healthcare space today.


Banks have been utilizing image-recognition technology software for mobile check deposit and secure routing to ensure efficient access and distribution of funds for years now. In addition, advancements in blockchain technology are also opening up many different possibilities for the exchange of protected information in fields beyond finance. Take a look at what’s happening in home security. When the healthcare sector embraces these new and emerging technologies, we will see real advancements in sharing, maintaining and utilizing personal health data, through to making leaps and bounds in broad-based medical research.

Not all patient data needs to be personal in order to be valuable. For years, the finance industry has collected anonymized data to track patterns and provide targeted offerings to consumers, even before the customer realizes what they need. And with the rise of emerging technology, there are unprecedented opportunities to learn from new sources of data. Noting the rise of digital banking and social mediaLending Club adjusts their risk-worthiness of consumers in part by how quickly users fill out their online application, what time they fill it out, and the makeup of the social media networks. When larger pools of anonymized data around diagnosis and symptoms are made available in the same way, we will see real opportunities for tangible medical breakthroughs. The sharing or crowd sourcing of diagnoses and symptoms will most certainly be useful for those dealing with chronic illness. Activating this data will inevitably open up new possibilities for treatment advancements.


Today, the free flow of personal financial data is so seamless that purchases can be made from almost anywhere in the world with just a thumbprint or tap of an app. But in the healthcare sector, getting medical records from one physician to another may require a patient drive to the facility, provide proof of identity, pay a service fee, fill out paperwork, physically pick up the data and bring it to their next appointment. If it were this cumbersome to share financial data, the entire economy would be paralyzed.

When we open up communication, clinicians are able to collaborate by seeing notes from other doctors, cross-referencing medications, reviewing lab and test results, and observing changes in symptoms over time, delivering true, coordinated care. Patients will no longer be burdened with recording and describing health histories across multiple providers and (often) over long periods of time. PicnicHealth is one company already offering medical record management using an e-signature to request permission to access health records, including all doctor’s notes, prescriptions, lab results, X-Rays etc. Let’s take it one step further by incorporating data from patient’s own health or fitness trackers as well to create a fully connected care ecosystem.


For both patients and providers, knowledge is power. This means that as designers and strategists, it is crucial to find a way to optimize access to health data, while maintaining the highest levels of security and privacy. Using human-centered design for complex healthcare challenges can lead to data solutions that securely flow from one entity to the next, increasing convenience, advancing medical knowledge, improving (and saving) lives and, most certainly, our sanity.

Via Plus91
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A majority of the French people favors the use of Artificial Intelligence for their health

A majority of the French people favors the use of Artificial Intelligence for their health | Health Care Business |

PARIS (TICpharma Mazars)
"Physical well-being, weight control, sleep, nutrition, -
Discover the good resolutions of the French for 2018."


A large majority of French (76%) believe that artificial intelligence (AI) and new technologies in the health field can be useful for people who are fragile or suffering from a particular condition, according to the results of a poll OpinionWay for Mazars cabinet unveiled on March 6th.


This is one of the remarkable findings of a survey held among the French people by Mazars (see here).


  • The French report that with the perspective on prevention to  health, they also are:
    in favor of the transmission of data collected through connected devices to healthcare professionals (70%);
  • for the transmission to healthcare professionals of data collected via connected objects (53%);
  • ready to use Artificial Intelligence software to interpret their medical data (50%);
  • ready to visit commercial websites for teleconsultation (33%)!

Howeveer, they do think there's need for accompaniment and more and more individualization! One in two French people even express a need for tailor-made support.

Who should take care of health prevention?

  • Family doctors (51%);
  • Healthcare professionals (39%);
  • Public Institutions (38%);
  • Everyone for him/herself (35%);
  • Health institution (20%);
  • The family (13%).


Via Denise Silber
rob halkes's insight:

French people are quite conscious of what they need or should do to stay healthy.

Interesting is how they value their own awareness of health risks, like: tabacco: about 90% think they are well-informed

and effects of alcohol on health (88% wel informed).

They think that public messages about prevention of health are sufficient in number (74%) and do attract attention (70%)!

how would this survey come out in the other EU countries?


Denise Silber's curator insight, March 7, 2018 5:20 AM
Evolution des moeurs lorsqu'on prend un échantillon représentatif de la population. Les médecins ne représentent pas, sur le plan démographique, un miroir de la population. Donc leur avis sur l'e-santé, depuis le départ est différent.
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Americans' Views Health Insurance End of Turbulent Year - The Commonwealth Fund

Americans' Views Health Insurance End of Turbulent Year - The Commonwealth Fund | Health Care Business |
Learn more about a Commonwealth Fund survey that reports about three in 10 marketplace and Medicaid enrollees are concerned about losing their health coverage.


Adults were asked about:

  • INSURANCE COVERAGE 14 percent of working age adults were uninsured at the end of 2017, unchanged from March–June 2017.
  • AWARENESS OF THE MARKETPLACES 35 percent of uninsured adults were not aware of the marketplaces.
  • REASONS FOR NOT GETTING COVERED Among uninsured adults who were aware of the marketplaces but did not plan to visit them, 71 percent said they didn’t think they could afford health insurance, while 23 percent thought the ACA was going to be repealed.
  • CONFIDENCE ABOUT STAYING COVERED About three in 10 people with marketplace coverage or Medicaid said they were not confident they would be able to keep their coverage in the future. Of those, 47 percent said they felt this way because either the Trump administration would not carry out the law (32%) or Congress would repeal it (15%).
  • SHOULD AFFORDABLE HEALTH CARE BE A RIGHT? 92 percent of working-age adults think that all Americans should have the right to affordable health care, including 99 percent of Democrats, 82 percent of Republicans, and 92 percent of independents.


The Affordable Care Act’s 2018 open enrollment period came at the end of a turbulent year in health care. The Trump administration took several steps to weaken the ACA’s insurance marketplaces. Meanwhile, congressional Republicans engaged in a nine-month effort to repeal and replace the law’s coverage expansions and roll back Medicaid.

Nevertheless, 11.8 million people had selected plans through the marketplaces by the end of January, about 3.7 percent fewer than the prior year.1 There was an overall increase in enrollment this year in states that run their own marketplaces and a decrease in those states that rely on the federal marketplace.

To gauge the perspectives of Americans on the marketplaces, Medicaid, and other health insurance issues, the Commonwealth Fund Affordable Care Act Tracking Survey interviewed a random, nationally representative sample of 2,410 adults ages 19 to 64 between November 2 and December 27, 2017, including 541 people who have marketplace or Medicaid coverage. The findings are compared to prior ACA tracking surveys, the most recent of which was fielded between March and June 2017. The survey research firm SSRS conducted the survey, which has an overall margin of error is +/– 2.7 percentage points at the 95 percent confidence level. See How We Conducted This Study to learn more about the survey methods.


rob halkes's insight:

Amazing how the US government cannot act upon the righteous wishes from the people for an affordable health care. Wouldn't they all stand up and do what is needed?
See this survey: Americans’ Views on Health Insurance at the End of a Turbulent Year, - The Commonwealth Fund

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The Top 10 risks to the global economy -                     Cause for Concern? The Economist

The Top 10 risks to the global economy -                     Cause for Concern? The Economist | Health Care Business |
In an age of increased unpredictability and event risk, firms and governments are more than ever seeking to insulate themselves from the consequences. Despite encouraging headline growth figures, the global economy is facing the highest level of risk in years.
In this report, The Economist Intelligence Unit examines the top 10 risks to the global political and economic order. It evaluates not only the potential impact these risks could have, but also the likelihood of their occurrence.

Please register to download this report

rob halkes's insight:

It's now that we enjoy the highest level of risks around the globe. Health care will have to deal with that. But several factors will influence its success. Let's be aware that the current status on the globe is not a certainty. See Global Access to Healthcare Index website

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The Seventh Annual Global Media Intelligence Report

The Global Media Intelligence Report is eMarketer’s largest and most comprehensive snapshot of the state of media usage and spending worldwide. The report covers 36 countries in six major regions—Asia-Pacific, Western Europe, Central and Eastern Europe, Middle East and Africa, North America and Latin America.

eMarketer PRO subscribers can access the report here

The Executive Summary of the report highlights: 

  • Audience data
  • International media usage 
  • Trends by demographic


rob halkes's insight:

Backgrpound information for anyone using social media for health care:
The report covers 36 countries in six major regions—Asia-Pacific, Western Europe, Central and Eastern Europe, Middle East and Africa, North America and Latin America.

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Publications Archive - Health Consumer Powerhouse

Publications Archive - Health Consumer Powerhouse | Health Care Business |

Sweden tops Europe for preventing re-occurring heart disease -
New extended EU heart study: Secondary Prevention of CVD


The Health Consumer Powerhouse published an extension of the 2016 Euro Heart Index (EHI), focussing on Secondary Prevention of CVD, on August 26, 2017 at the European Society of Cardiology Congress in Barcelona. Sweden tops the ranking of the 31 countries included, scoring 956 points out of a maximum 1000, followed by France (champions of the full EHI 2016) at 911. This is very much due to a strong Swedish tradition of healthcare quality registries, in this case manifest by the very solid Swedeheart registry.
General conclusions from the Secondary Prevention study:

  • There is a need to understand the specifics of secondary prevention vs. disease prevention for the general population, outside cardiologist professional circles: it is essential to increase awareness about secondary prevention among primary physicians, people working in national bodies and policy makers.
  • Most European countries lack a comprehensive national CVD action plan with targets for secondary prevention of CVD.
  • There are significant gaps between evidence-based measures for secondary prevention and actual practice.
  • Heart conditions are chronic and frequently associated with long-term patterns of unhealthy lifestyles. Patient benefits are not necessarily attained through advanced interventions and the most sophisticated drugs. Regular follow ups, patient education to teach patients and families how to manage the situation can improve outcomes, life styles, reduce fear and depression and improve medication compliance.
  • Systematic gathering of quality data on cardiac care is essential to improve outcomes.

“Very unequal access to cardiac rehabilitation in Europe and between cities and rural areas. The focus on outpatient care should be increased, to reach all patients. Assuring timely access to quality rehabilitation for all those who need it, or follow ups for those who do not, should be top priorities for secondary prevention” says Dr. Beatriz Cebolla, Project Director of the Euro Heart Index.
Professor Arne Björnberg, the HCP Chairman, explains the larger picture: “In heart care, there is a remarkable lack of a joint pan-European standard how to treat patients. More consistent deployment of inexpensive generic drug therapies such as statins and clopidogrel would save thousands of lives!"

About the EHI
The Euro Heart 2nd-ary Prevention Index provides a ranking of cardiovascular healthcare systems in 31 countries across five key areas: "1. Risk assessment and control, 2. Cardiac rehabilitation (CR), 3. Access to treatment, 4. On-going prevention and 5. Data quality, measured on 17 indicators. The Index is constructed from public statistics and independent research. The producer of the EHI is the Health Consumer Powerhouse Ltd, which has been analysing performance of European national healthcare systems in around 50 index publications since 2004. The production of the EHI 2016 - 2017 was supported by an unrestricted grant from Amgen Europe GmbH.
The report on the Secondary Prevention extension is freely available on

Full EHI report with data and methodology explained, matrix and media releases are available on:

For further information, please contact:

EHI Project Director: Dr. Beatriz Cebolla (,
+49 152 2371 9856

rob halkes's insight:

The conclusion about secondary prevention of Cardiovascular events is hard:
Not only is there a need to understand the specifics of secondary prevention outside the cardiologists professionals, but most European countries lack (!) a comprehensive national CVD action plan!

Recent research of the Euro Heart Index (EHI) alerts to increase awareness about secondary prevention among primary physicians, people working in national bodies and policy makers.!

See here

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Does more education for health professionals equal better patient care?

Does more education for health professionals equal better patient care? | Health Care Business |
Many aspiring health providers require advanced degrees to enter practice. But does more medical education actually improve patient care?


In recent years, nurses, physiotherapists, audiologists, speech therapists, and pharmacists have all increased their entry-to-practice requirements, with registered nurses needing at least a bachelor degree, and physio and other therapists obligated to obtain a master’s degree to be considered for licensing.

By 2020, all pharmacy schools in Canada will move to a doctorate degree, adding a year to their training and bringing the total time in school to at least eight years. In the meantime, physician assistants are feeling the pressure to move, as their American counterparts have begun to do, from a master’s to a doctorate as the first step to practice.

These ever-advancing requirements to enter into practice are known as “degree creep.” But does the drive for more time in the classroom actually improve patient care?


And what does this actually do for patient care? The literature is scarce....



Roussel says there’s no push to bump up nursing entry-to-practice credentials to a master’s. Instead, she says there’s more discussion on how to integrate a practical doctorate in Canada, and how to enhance the PhD-level degrees that already exist...

Sunita Mathur, a physiotherapist and assistant professor in the Department of Physical Therapy at the University of Toronto, wrote a 2011 editorial in Physiotherapy Canada asking whether it was time to consider a more advanced degree. The answer was a firm no.

“We didn’t want it to just be ‘creeping credentialism.’ We didn’t want to say, they’re going to basically get the same education but we’ll call it a doctorate and increase it by a few months,” Mathur says.

“What we’re doing instead is working on curriculum renewal to change how we teach, how we deliver information to help students be creative and critical thinkers,” Mathur says. “We’re keeping the same structure, but working on the curriculum to help learners prepare for the environment.”

O’Connor says the view needs to be wider than just the start of one’s career.

“Entry to practice is just the beginning,” she says. “We need to have a map for the whole career pathway.”

rob halkes's insight:

IN respoinse to the blog:

Does more education for health professionals equal better patient care?
Date: July 6, 2017

Is "Quality of care" directly related with level and quality of medical education?  The complicated relation between personal ability, motivation, quality of educational school, conditions of entry into real care etc. etc. is an issue of study for as long as medical education exists. Putting it in the way this blog is stating, is a rather tiny perspective on the matter. WHy not just turn the question around: "What should medical education do and how would they need to do that", to ensure that medical education improves health care practices!

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The Netherlands best healthcare of Europe 2016 - European Health Care Consumer Index 2016

The annual 35 country ranking of healthcare by Health Consumer Powerhouse. Read the full Euro Health Consumer Index (EHCI) at

Netherlands scores again as first!


What can Europe  learn from The Netherlands?

  • ”Chaos” systems, where patients can choose where to seek care, do better than ”planned” systems;
  • but ”chaos” needs to be managed, and the NL does that very well!
  • Choice and competition! (and remember that this has to have a ”grandfather” function managing the system!)


See here


rob halkes's insight:

Netherlands first again in the EHCI: best healthcare 2016
"there is no stopping the Dutch!

Information, not only for others but also relevant to the Dutch as well - Don't go back to planned care, nor to Sickfunds!

Paul Thomas Ricci's curator insight, March 1, 2017 10:55 AM

Netherlands first again in the EHCI: best healthcare 2016
"there is no stopping the Dutch!

Information, not only for others but also relevant to the Dutch as well - Don't go back to planned care, nor to Sickfunds!

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Infographic: Can Pharma Stuff EHRs with Coupon Offers, Free Samples & Other Stuff Doctors Say They Want?

Infographic: Can Pharma Stuff EHRs with Coupon Offers, Free Samples & Other Stuff Doctors Say They Want? | Health Care Business |

Physicians do not like EHRs. That much is clear. But the vast majority have to use electronic record systems on a daily basis. What can pharma do to better give doctors what they want?

Via Pharma Guy
rob halkes's insight:

There's more to the question whether #pharma can give doctors what they want: to begin with, wouldn't it be good to discuss what goods are necessary.. Doctors would learn that it takes more to tango.. Pharma would learn that docotors have good idea for value added services :-)

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Donald Trump triggers political earthquake

Donald Trump triggers political earthquake | Health Care Business |

From The Economist Intelligence Unit - Nov.9th, 2016


At the election on November 8th the Republican presidential candidate, Donald Trump, defeated his Democratic rival, Hillary Clinton, in one of the biggest upsets in US political history. The Republican Party maintained its majorities in the House of Representatives (the lower house) and the Senate (the upper house), giving it a clean sweep of the executive and legislature.


The presidential election result is a shock. ...

In the Congressional elections, the Republicans also had a strong night. .... in the chamber.... The House also remained in Republican hands, as was widely expected. A clean sweep gives the Republican party, and its president-elect, powers that will exceed that of his predecessor, Barack Obama, and will enable smoother passage of legislation. It also dramatically alters the outlook for the Supreme Court, which is currently one justice down and equally balanced between liberals and conservatives.

Mr Trump's election victory will cause widespread alarm across the global economy, given his loose grasp of economic policy, unabashed political populism and tendency for contradiction. We expect to see wild gyrations in bond, stock and currency markets until Mr Trump provides some clarity on his policy agenda. Given this volatility, it is unlikely that the Federal Reserve (the central bank) will raise interest rates in December, as we had previously expected.

Impact on the forecast

Our US political and economic forecasts are under review following Mr Trump's election victory. A new outlook will be published in the coming days.


FROM Modern HealthCare: Trump Upset will force healthcare leaders to rethink the future

Republican Donald Trump's shocking victory Tuesday will force a major shift in the healthcare industry's thinking about its future. Combined with the GOP's retention of control of the Senate and the House, a Trump presidency enables conservatives to repeal or roll back the Affordable Care Act and implement at least some of the proposals outlined in the GOP party platform and the recent House Republican leadership white paper on healthcare.

But the assumption of Republican control over both the White House and Congress most likely means an end to the expansion of Medicaid to the 19 states that have not yet implemented it, and puts the expansion in the other 31 states in serious jeopardy.
But there are divisions even among conservatives over issues such as Medicare restructuring and how to help Americans afford health insurance. And Senate Democrats almost certainly would try to use their filibuster power to block major ACA changes....

Healthcare leaders were not prepared or eager for the healthcare changes a Trump victory would bring about. Modern Healthcare's second-quarter CEO Power Panel, a survey of 86 healthcare CEOs, found that the chief executives overwhelmingly backed the Affordable Care Act and supported its goal of pushing providers away from fee-for-service medicine and toward delivering value-based care.
The overwhelming message from the survey was that the next president and Congress should stay the course set by President Barack Obama and the ACA.

But last week, Trump promised to immediately repeal and replace the ACA if elected. “When we win on Nov. 8 and elect a Republican Congress, we will be able to immediately repeal and replace Obamacare. We have to do it,” Trump said.....

From MedCity news: ..the ramifications for healthcare?
After shocker election, what are the ramifications for healthcare?

... Beyond efforts to legalize recreational use of marijuana and raise taxes on cigarettes and soft drinks in multiple states, several jurisdictions had ballot initiatives that could fundamentally change aspects of the healthcare delivery system


E.g.: Colorado: Assisted Suicide
Colorado voters ..., appear to approve Proposition 106, to legalize physician-assisted suicide for adults with terminal illnesses.

Should the margin go up, Colorado will become the fifth state with a medicak aid-in-dying-law, along with Washington, Vermont, Montana and California.


E.G.: Colorado Single Payer health Insurance

... voters overwhelmingly rejected Amendment 69, a ballot initiative that would have set up a single-payer system called ColoradoCare. ...At 11:30 pm Mountain time Tuesday, 68 percent of precincts had reported, and 80 percent of votes counted were against the measure.

According to the Colorado Independent, the amendment would have taxed employees, employers and income from capital gains and other nonwage sources. That revenue was to fund a statewide healthcare plan called ColoradoCare.

Predictably, the measure had powerful opponents in the business community — especially from commercial insurers, who would have effectively been put out of business in the state

E.g. California: State Agency Drug prices..

..The votes are also clocking in for California’s Proposition 61.. the initiative sought to cap state spending on prescription drugs Despite the ballot rejection, debates about medical costs and drug price manipulation will continue to swirl in the public domain.
No none is more aware of this than PhMRA, the main lobbying group for pharmaceutical companies, which reportedly increased its dues by $100 million in anticipation of a post-election pricing storm.



rob halkes's insight:

The American election will have its impact on the American Health Care System, on its economy and on the world's geopolitical problems. Reason enough to rethink healthcare and the dominant current democratic "representative election systems in the Western world" ..
HealthCare embodies values that are central to the community. But I fear the worst for all people with serious conditions when the Republicans have the say about it.. Patients of America: Unite!

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CORPORATE REPUTATION OF PHARMA 2015 with re. to Respiratory Conditions low!

CORPORATE REPUTATION OF PHARMA 2015 with re. to Respiratory Conditions low! | Health Care Business |
Reports published in 2016 on the Corporate Reputation of Pharma, as viwed by over 1,000 patient groups


  • Patient centricity.
  • Provision of patient information.
  • Patient safety.
  • Usefulness of products.
  • Record of transparency.
  • Integrity.

COMPANIES assessed: AbbVie I Amgen I AstraZeneca I Bayer I Boehringer Ingelheim I Eli Lilly (Lilly) I GSK I Janssen I Merck & Co I Novartis I Pfizer I Roche I Sandoz I Sanofi I Teva

About the report:

London, Thursday 27th October 2016. This report is based on the findings of a PatientView November 2015-January 2016 survey exploring the views of 118 patient groups with an interest in respiratory conditions. These respiratory patient groups came from 57 countries (28 of the 118 were based in the USA). The report provides feedback (from the perspective of  these patient groups) on the corporate reputation of the entire pharma industry during 2015, as well as on the individual performance of 15 pharma companies at six key indicators that influence corporate reputation. The 2015 respiratory results are compared with those provided by patient groups from across all therapy areas in 2015.
For the purposes of this report, the phrase ‘corporate reputation’ is defined as the extent to which pharma companies are meeting the expectations of patients and patient groups.


Industry Wide Findings:

The 118 patient groups with an interest in respiratory conditions and responding to the 2015 ‘Corporate Reputation of Pharma’ survey were less positive about the pharma industry’s corporate reputation than patient groups in 2015 from almost any other therapy area (except patient groups specialising in mental health, or in gastrointestinal conditions). See table ...
Patient groups with an interest in respiratory conditions ranked the pharma industry 7th out of 8 healthcare-industry sectors for corporate reputation in 2015 (ahead only of for-profit health insurers). Pharma was ranked 5th in 2015 by patient groups of all therapy areas.
Why is pharma’s corporate reputation poorer among respiratory patient groups?
Several reasons account for pharma’s lower approval ratings among respiratory patient groups. Only 67% of 2015's respondent respiratory patient groups believe the industry to be capable of creating high-quality products. Although this figure might seem high, the equivalent 2015 figure among patient groups of all therapy areas was 72%.
Examples of comments made to the 2015 survey by respiratory patient groups echo such sentiments:
[Question to respondents: Which companies have the best record for supplying high-quality, useful products?] “Probably smaller biotechs. Everybody else just imitates, or buys products and companies.” — National Canada-based patient group specialising in rare diseases, including respiratory conditions
“Most information on adverse affects or clinical trials is not open source in India, and patients have very little access to such information.” — National India-based patient group specialising in chronic disease in general, including respiratory conditions
According to 18.6% of respiratory patient groups, the most-important strategies a pharma company could adopt to improve its corporate reputation are: a fair pricing policy; and also a patient-centred strategy.


If you would like more information, or would like to get hold of this report, please use contact details below.
Contact: Alex Wyke     Email:  


rob halkes's insight:

Pharma is doing less on Respiratory conditions than on other diseases in the perspective of patients and patient groups, except for 'mental health' and 'gastrointestinal' conditions.

Percentage of patient groups of different therapy areas worldwide  stating that pharma industry has an "excellent" or "good" corporate reputation in 2015 was highest for 'Urinary' conditions' (57.7%) and 'diabetes' (53.7%). For 'Respiratory' 'only' 38%. There is a way to go for the respective Brands.!!

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Research consortium building scaffolding for Precision Medicine Initiative’s All of Us

Research consortium building scaffolding for Precision Medicine Initiative’s All of Us | Health Care Business |

Last week, the National Institutes of Health, which is heading the initiative, rebranded the Precision Medicine Initiative's cohort program as "All of Us."

On Jan. 20, 2015, about 30 minutes into his State of the Union Address, President Barack Obama said the words that would set in motion a health research initiative that could exceed the scope of any that has come before it.

Obama told listeners that he was green-lighting the launch of the Precision Medicine Initiative, a program two decades in the making that would begin where the groundbreaking Human Genome Project left off.

“I want the country that eliminated polio and mapped the human genome to lead a new era of medicine — one that delivers the right treatment at the right time,” Obama said, between his remarks about trade and net neutrality. 

Obama called for $215 million in fiscal year 2016 to breathe life into the Precision Medicine Initiative, which supporters say promises to dramatically transform the way healthcare is delivered and received by looking at the nature and nurture sides of the health of 1 million Americans over decades. Last week, the National Institutes of Health, which is heading the initiative, rebranded the Precision Medicine Initiative’s cohort program as “All of Us.”

“It’s sort of uncharted waters,” said Christine Cole Johnson, chair of Henry Ford Health System‘s Department of Public Health Sciences. Detroit-based Henry Ford is coordinating a five-member research consortium that is building the early scaffolding of the All of Us project by recruiting 10,000 participants from across seven states.

Ford and the other four members are operating under the umbrella of the Trans-American Consortium for the Health Care System Research Network, which encompasses more than 9 million people from Michigan to Texas. The consortium also includes scientists from Baylor Scott & White Research Institute in Texas, Essentia Health in Minnesota, Spectrum Health in Michigan and the University of Massachusetts Medical School.

Some of the participants had already submitted proposals to NIH during an earlier round of site selections. But this time around, they banded together at the invitation of Henry Ford and received a round of Year One funding to be divided among the members, which will each aim to recruit at least 2,500 participants.

All were quick to call the research initiative a “game changer” and “revolutionary.” Giovanni Filardo, director of epidemiology and a principal investigator at Baylor Scott & White, said All of Us could be a model for future studies.

The Precision Medicine Initiative is an extension of a focus in medicine that came out of the NIH’s Human Genome Project of tailoring treatment to the individual, genetic level. It’s particularly evident in oncology studies that are now grouping trial participants together by tumor mutations rather than types of cancer.

The Trans-American Consortium builds on the new depth of genetic understanding by adding lifestyle and other information, Filardo said.

First, he and his fellow consortium members have to build the infrastructure of the study before their 12-month deadline hits. Just figuring out how to get the sites configured to share data — including patient records — will be a challenge.

If that sounds straightforward, consider that Baylor, for example, will be pulling from five sites in Texas. Research cohorts in Dallas and Waco are vastly different in ethnicity, age, gender, religion and education, Filardo explained.

Now do that same calculation for the other sites and factor in the difficulty of collecting diet and lifestyle information, electronic health records, samples of blood and urine and real-time data from smartphone apps and wearable devices from 10,000 people.

Some are are healthy, others are sick, have a mental illness, have developmental delays or cognitive impairments. Many people in a hurry, speak Spanish as their primary language or don’t speak at all. The consortium also has to hire staff to wrangle that many people into a cohort that will sign up and stay signed up for years.

That said, a cohort of this size has the statistical power to detect associations between genetic and environmental factors and how they affect health, according to NIH.

Very few studies deal with so many variables, said Dave Chesla, manager of the Spectrum Health Universal Biorepository“We’re looking at people in a way we have never done before,” Chesla said.

The caveat is that because this round of funding is limited, the consortium partners may not reach underrepresented groups, including Native American tribes and rural communities, if these populations aren’t near the initial sites. That should change over time as the number of sites expand.

That is, if they do. Expansion and future funding of the Precision Medicine Initiative may depend on the presidential election on Nov. 8.


The initiative’s goal is to be inclusive, but because of the longitudinal nature of the study, the most desirable participants are young adults. Chesla described them as the 18-year-olds getting a physical before they leave for college. Finding such people and keeping in touch over time entails adjusting to reaching out by social media, text messages or whatever new digital communication tools develop in the future. 

Young or old, gaining buy-in will require applying the same principles of precision medicine to people: personalizing the study to fit the individual, not the other way around. Researchers have to if they want to tap the possibly unparalleled diversity of the United States, which is where the Precision Medicine Initiative started. 

The consortium plans to set up patient advisory committees to help with the patient-centered design. That is why Henry Ford reached out to Kathleen Mazor, a professor of medicine at UMass Medical School who specializes in understanding how to bridge the gap between patients and medical professionals.

She will be advising the consortium on things like how to write model consent forms that are clear to people of different groups so that they fully understand what is being asked of them and what to expect. Participants will likely be motivated by immediate practical benefits to their health. That’s not so easy with a study of this duration.

“I don’t know what those answers are, but they’ll be interesting,” Mazor said.

Answers may not even arrive within the lifetime of some of the participants. But the big picture, as Johnson and the other members of the consortium see it, is what people who sign on will be adding to our understanding of ourselves.

“It’s for your relatives, it’s for your grandchildren. It’s for people,” Johnson said. “That’s why it’s called All of Us,” she said.


rob halkes's insight:

Great challenges ahead for partnership in care, working and even co-creating with all stakeholders to only design but also to conduct the needed research and big data mining for the purpose of "precision medicine"! I only hope that the next president of the US will see the relevance of it for all (American) people. It will be a historic research and development route.

Specifically in line with the intention to include patient panels, I want to pinpoint the fact that "co-creation" is more than "just working together". In this way the project has a process challenge too!

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Partnerships key to success of value-based care in medtech

Partnerships key to success of value-based care in medtech | Health Care Business |
Partnerships between insurers, health systems and medtech companies as well as insight gleaned from Big Data are going to key to the success of value-based care in the medical devices industry.

Insights from Big data and partnerships among medtech companies, insurers and health systems will drive the success of value-based care.

That was the message from industry executives gathered at the annual conference of the medtech industry — AdvaMed 2016 — in Minneapolis that concluded Wednesday.

Those partnerships are already leading to better clinical outcomes, said Dr. Richard Migliori, chief medical officer of UnitedHealthcare. Medtronic became the preferred provider of insulin pumps for UnitedHealth Group’s commercial and Medicaid patients in July in an initiative to reduce hypoglycemia incidents that frequently send patients to the emergency room.

“It’s just a great way of linking back from a desired outcome to a delivery system that’s focused on that outcome,” Migliori said.

Migliori and executives from Medtronic, Mayo Clinic, and IBM Watson Health agreed that the move toward value-based care will continue, despite the impending change in U.S. political administrations.

“The move to value-based payment is pretty important but it’s also undefined at the moment,” said Dr. John Noseworthy, CEO of Mayo Clinic.

Mayo is focused on understanding the value that its system provides by quickly getting the answers to helping patients with complex conditions, and bringing in technology early in the process to advance that effort, Noseworthy said. Mayo is looking for strategic partners to help in those efforts, he added.

Those partners for hospitals and medtech companies needn’t be as large as a Medtronic to get new technology to market, according to Noseworthy and Medtronic CEO Omar Ishrak. Smaller medtech companies can move more quickly to develop products because they don’t have to contend with the layers of bureaucracy that exist at a large corporation, Ishrak explained. If the healthcare industry values outcomes over products, whoever finds an effective solution to a healthcare problem will get credit for that, he said.

Stifling the creativity of small companies would be a “huge mistake,” added Noseworthy. “There are some advantages in being small. You don’t have to ask for permission. You just ask for forgiveness later on.”

The rapid evolution of artificial intelligence is also expected to help drive health systems as well as medtech companies to improve patient outcomes and value-based care. Experts said AI resembles the Internet of the mid 1990s and will expand into a variety of products and services, according to a report in the New York Times.

Applying cognitive value to data from a variety of sources will help lead to the best patient outcomes for the best value, said Deborah DiSanzo,  general manager of IBM Watson Health. IBM Watson Health is working with Mayo by funneling clinical trial information directly to oncologists so they may determine which patients might be eligible to participate, she said.

The U.S. healthcare system would be wise to look toward the Netherlands and some of the Scandinavian countries for leadership in executing value-based models, Medtronic’s Ishrak noted. Those countries have good healthcare data and have worked in different conditions to execute value-based models, although they haven’t been scaled across any one particular country yet, he said. The Netherlands instituted a bundled-payment model for diabetes in 2007, in which insurers pay a care delivery group to cover diabetes care services for one year, according to a report in Harvard Business Review.

“One thing is for certain,” Ishrak declared. “The move is going to happen and everybody is going to have to change. I can’t change my business model without everybody here changing their business model.”

rob halkes's insight:

I can only quote doing right to the substance of the blog:

Applying cognitive value to data from a variety of sources will help lead to the best patient outcomes for the best value, said Deborah DiSanzo,  general manager of IBM Watson Health. IBM Watson Health is working with Mayo by funneling clinical trial information directly to oncologists so they may determine which patients might be eligible to participate, she said.

The U.S. healthcare system would be wise to look toward the Netherlands and some of the Scandinavian countries for leadership in executing value-based models, Medtronic’s Ishrak noted. Those countries have good healthcare data and have worked in different conditions to execute value-based models, although they haven’t been scaled across any one particular country yet, he said. The Netherlands instituted a bundled-payment model for diabetes in 2007, in which insurers pay a care delivery group to cover diabetes care services for one year, according to a report in Harvard Business Review.

“One thing is for certain,” Ishrak declared. “The move is going to happen and everybody is going to have to change. I can’t change my business model without everybody here changing their business model.”

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The Awful U.S. Life Expectancy Despite Awesome Dollars Spent on Healthcare!

The Awful U.S. Life Expectancy Despite Awesome Dollars Spent on Healthcare! | Health Care Business |

The US stands out as an outlier: the US spends far more on health than any other country, yet the life expectancy of the American population is not longer but actually shorter than in other countries that spend far less.

If we look at the time trend for each country we first notice that all countries have followed an upward trajectory – the population lives increasingly longer as health expenditure increased. But again the US stands out as the the country is following a much flatter trajectory; gains in life expectancy from additional health spending in the U.S. were much smaller than in the other high-income countries, particularly since the mid-1980s.

This development led to a large inequality between the US and other rich countries: In the US health spending per capita is often more than three-times higher than in other rich countries, yet the populations of countries with much lower health spending than the US enjoy considerably longer lives. In the most extreme case we see that Americans spend 5-times more than Chileans, but the population of Chile actually lives longer than Americans. The table at the end of this post shows the latest data for all countries so that you can study the data directly.

Via Pharma Guy, Lionel Reichardt / le Pharmageek
rob halkes's insight:

Creating Healthcare systems is more than just about money..

Stephanie Felix's curator insight, April 2, 2017 11:43 PM

The Article that I have chosen as a part of my curation explains the link between health spending and life expectancy in the United States. The United States spends far more on health than any other country in this world, but the life expectancy of the American population is no longer but shorter than any other country that spends far less money on health. Studies have found that administrative costs in the health sector are higher in the United States. There have been price comparisons between countries and it is pointed out that these comparisons compare violence rates in the Unites States as being higher than other rich countries. One of these reasons for the underachievement is the large inequality in health spending.  

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Editorial: A mixed picture on public health

Editorial: A mixed picture on public health | Health Care Business |

Life expectancy for white women took a small but unexpected dip in 2014, the Centers for Disease Control and Prevention reported last April. And nearly a year ago, a paper from two leading economists revealed that life expectancy for whites has been declining for nearly two decades, with almost all of the decrease concentrated among men and women without a college education.
The causes, they reported, had nothing to do with increased rates of heart disease or cancer. Rather, the data revealed sharp increases in suicides and drug-related deaths among less-educated whites.
The social decay in some areas that are driving those numbers helps explain the anger shaping this year's presidential election. But legitimate concern for the economic status of those left behind by deindustrialization has overshadowed the somewhat brighter picture of overall health painted by the latest CDC National Health Interview Survey of 35,000 Americans, which was released last week. On virtually every indicator—with the sole exceptions of the related issues of obesity and diabetes—the U.S. is better off or the same today as we were 10 or 20 years ago.
On this annual self-evaluation of health, exactly two-thirds of Americans reported that they are in either excellent or very good health. That measure has increased by nearly a full percentage point over the past decade. Obviously, we still have work to do. It remains nearly 2 points below where we were in the late 1990s. The number of uninsured has declined sharply because of the Affordable Care Act. The CDC reports that in January to March of this year, that number fell to 8.6% of the population, down from 9.1% the previous year and 16% in 2010.
As a result, access to healthcare continues to improve for most Americans. This year, 87.5% of respondents indicated they had a regular place to go for medical care, statistically unchanged from the previous year but up from 85.4% in 2010—the year the ACA passed. In addition, the number of people reporting they didn't obtain needed care for financial reasons, which increased from 4.3% in 1999 to 6.9% in 2010, was back to 4.3% this year. [..]

The one area where the survey revealed worsening conditions was in the related rates of obesity and diabetes. Nearly 31% of respondents said they were obese, slightly higher than the year before and significantly higher than the 20% self-reported rate in 1997.

rob halkes's insight:

It is going better, but is it going good, or , even, for the best? ..

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The solutions to America's drug cost dilemma (and why they won't happen) - Modern Healthcare

The solutions to America's drug cost dilemma (and why they won't happen) - Modern Healthcare | Health Care Business |

By Harris Meyer  | October 1, 2016

Patients are complaining their drugs are unaffordable. Insurers are protesting that specialty drug costs are forcing them to jack up premiums. State Medicaid directors say spiking pharmacy costs are forcing them to make painful coverage trade-offs.
Congress has been grilling drug company executives over their big price hikes.[..]

Yet the issue of how to make drugs more affordable for individual patients and society is so complex and sensitive—and drug industry opposition so formidable—that a comprehensive, politically viable approach to solving the problem has yet to emerge.
The impasse has left patients, insurers and healthcare provider groups pushing for immediate relief from the most egregious price spikes, like Mylan's 550% list price increases over eight years on EpiPen epinephrine auto-injectors, a must-have product for counteracting allergic reactions. [..]

Public opinion clearly backs quick action. A Kaiser Family Foundation survey last month found 77% of Americans say prescription drug costs are unreasonable, with 82% backing giving Medicare the power to negotiate drug prices.
And the mounting public pressure has produced some results. One drugmaker, Allergan, recently promised to voluntarily limit price hikes on its products to once a year and keep them to single-digit percentage increases.
But those are the exceptions—not the rule. Other drug companies are shifting the blame to insurers, arguing that health plans are pushing excessive costs on members through high deductibles and copayments.[..]

Making policy action tricky is that rising prices for generic, brand-name and biologic products each have different causes, and each requires a different set of policies to bring under control. And each category has its own set of stakeholders ready to thwart decisive action that would bring down prices.
With brand-name drugs, many stakeholders have bought into the idea that lower prices will reduce the financial incentives for developing new breakthrough products. With biologics, patient and physician groups worry that potentially cheaper biosimilars may not have the same efficacy as the brand-name biologics they replace. [..]

Despite all the talk about the need for action, when someone proposes or implements even relatively modest measures to address drug costs, there's often a furious backlash. [...]

Emotional criticisms like this suggest that the American public may be unprepared for explicit efforts to evaluate whether a drug or other type of treatment is worth the cost—unlike in other advanced countries such as Great Britain that openly weigh costs versus benefits in making coverage decisions. [...}

While strengthening generic competition could be the low-hanging fruit in tackling drug costs, ICER's Pearson cautioned that in pharmacy policy and politics, nothing is ever simple. “Even the no-brainers end up being more complicated than we think they are,” he said.

rob halkes's insight:

A good view on America's drug cost dilemma!

It shows the complexity and the inability of current stakeholders in the health care system to solve an issue like drug pricing.

This has not only to do with the costs of creating the drug themselves, but also with an array of opposing interests in the process. Imagine the opposing interests between investors in pharma and patients (in)directly paying for it. Also imagine the complexities of decision making in their respective institutional contexts. Yet, only if stakeholders recognize their dependence of each other and seeking ways to balance their interests, a substantial solution is possible. Power exertion of one group over another is a dead end in the long run here!

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Who truly represents the patient perspective? – Cancerworld

Who truly represents the patient perspective? – Cancerworld | Health Care Business |

Who truly represents the patient perspective?

By Simon Crompton

In CancerWorld September / October 2016 2016, 18-21.


As researchers, regulatory bodies and health systems give patients more of a voice in consultation and decision making, advocacy groups are questioning what it really means to represent the patient view.

Nothing about us without us. So goes the mantra of patient organisations around the world, asserting their right to have a say in health decision-making.

Five words that make patient involvement sound so simple. But a growing body of patient and cancer organisations are asserting that it’s anything but simple: the whole idea of ‘patient representation’ is flawed and needs a re-think, they say.

Conventional models of patient representation bring risks. For some committees, companies and organisations, having a patient on the panel simply means they can tick the patient involvement box and move on. At least that’s the view of Deb Maskens, founder of Kidney Cancer Canada and Vice Chair of the International Kidney Cancer Coalition (IKCC).

“It’s far too easy for health technology assessment organisations or pharmaceutical companies to say that they have a patient on their committee and therefore they have had patient input,” she says. [..]

And then there’s the question of how ‘representative’ patient ‘representatives’ can actually be. Several European patient organisations have become concerned about the number of committees where one or two firmly established patients are there to represent all cancer patients – even in discussions that relate to a type or stage of cancer entirely different from their own. That situation, says Maskens, is “absolutely ludicrous”. 

Bettina Ryll, founder of the Melanoma Patient Network Europe, Chair of ESMO’s patient advocacy working group and a patient representative on many committees, agrees. As long as patients on committees are expected to represent the views of hundreds of people whose experiences may be entirely different from their own, they are in a very vulnerable and ineffective position.

“It’s very very difficult to be representative. I’m fed up with being challenged about this wherever I go. People say: ‘Yes, but how representative are you anyway?’ and this is a very easy way to take out the patient perspective if it’s not convenient. It’s an especially pressing issue because not everyone in health systems is happy with patient voices becoming more integrated into health decision-making. Undermining difficult patient views happens very frequently, and in the end, just the ‘yes-sayers’ are left over. That’s not sufficient.”

Those who represent patient interests in complex technical discussions are also vulnerable to criticism. Discussions on the relative risks and benefits of specific drugs, for example, may require some expert knowledge from the patient representative. But people with that degree of understanding are then accused of no longer being representative of most patients. “It’s a double bind,” says Ryll. “You can’t win.”
Evidence-based advocacy

But there may be a way forward. A growing number of patient advocacy groups are adopting the idea of ‘evidence-based advocacy’ to replace conventional ideas of ‘representation’. It involves letting go of any expectation that one patient should be able to represent everyone. Instead, patients on groups or committees gather, filter and convey information about the patient perspective on a particular issue from a variety of sources. They become a conduit for evidence from the relevant patient community, not a narrator of personal experience or opinion.

“I don’t in any way want to take away from the value of people conveying their personal narratives,” says Maskens. “But patient representatives now need to be equipped with a new skill set.

“Those on established committees should have to have an ear to the ground of what is happening in that disease space. There are thousands of people online in some form, and so before a review decision comes up, patient representatives can take a deeper dive into that patient community – listening to them, asking open-ended questions.

Read on... ! HERE




rob halkes's insight:

From "ePatient" up to "evidence-based patient advocacy: Progress is seen in how patient are (getting) represented. Ever since 2009/10 some patients made themselves known as "epatients" on social media to indicate their willingness and drive to speak as representative of patients with a specific condition.

Patient Advocacy groups took up this idea and forwarded patients among their midst. "Patients Inside" became a certificate for conferences in which participation of patients was organised and guaranteed. The idea is now introduced to use the term "evidence based" patient advocacy in which "representatives" "hear" their peers about some issue of interest and then forward the "data" to meaningful information for whoever wants to know.. It is a positive add on to the skills and channels patients have to forward their opinions, experiences and preferences!

rob halkes's curator insight, October 5, 2016 9:39 AM

From "ePatient" up to "evidence-based patient advocacy: Progress is seen in how patient are (getting) represented. Ever since 2009/10 some patients made themselves known as "epatients" on social media to indicate their willingness and drive to speak as representative of patients with a specific condition.

Patient Advocacy groups took up this idea and forwarded patients among their midst. "Patients Inside" became a certificate for conferences in which participation of patients was organised and guaranteed. The idea is now introduced to use the term "evidence based" patient advocacy in which "representatives" "hear" their peers about some issue of interest and then forward the "data" to meaningful information for whoever wants to know.. It is a positive add on to the skills and channels patients have to forward their opinions, experiences and preferences!

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Ziekenhuisfusies leiden niet tot aantoonbaar betere kwaliteit zorg | Hospital Merger do not effect improvement of healthcare itself (Dutch research)

Ziekenhuisfusies leiden niet tot aantoonbaar betere kwaliteit zorg | Hospital Merger do not effect improvement of healthcare itself (Dutch research) | Health Care Business |

"Fusies tussen ziekenhuizen hebben niet aantoonbaar bijgedragen aan een verbetering van de kwaliteit van de zorg, Dit concludeert ACM na onderzoek."
Mergers of hospitals do not effectively contribute to an improvement of quality of care. the Dutch Authority for Consumers and Markets (ACM) published a Dutch study in which they researched quality effects of 14 mergers of hospitals  in the period 2007 -2013.

Based on this research, the ACM recommends:

  • Do specify expected quality improvements specific and up front before the merger activities start, also with its expected drivers, in order to create this focus in the process of the merger;
  • It appears to be necessary to (further) develop the currently used 97 indicators of quality, into clear, comprehensible and accessible ones;
  • It would often be better to consider focused collaboration between hospitals, which would be less intrusive and be more clearly, instead of pursuing a complete merger.

See here and the download of the study itself (in Dutch).


rob halkes's insight:

Merging hospitals is a completely different process than "improving" or innovation of hospitals. Mergers are about organizational and financial values. Improvement and innovation should be more about medical outcome values and patient values. Mergers aim at increase of volume of care and hence return of business, whereas innovations of care deal with improvement of health outcomes and patient satisfaction. There is no automatic co-realization of each focused values. The recent study if the ACM does verify this obvious fact.

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Better Ways to Pay for Health Care - en - OECD

Better Ways to Pay for Health Care - en - OECD | Health Care Business |

Data and research on health including biotechnology, cancer, health care, health spending, health insurance, fitness, dementia, disability, obesity, smoking, genetics and mortality.,


Payers for health care are pursuing a variety of policies as part of broader efforts to improve the quality and efficiency of care. 
Payment reform is but one policy tool to improve health system performance that requires supportive measures in place such as policies with well-developed stakeholder involvement, information on quality, clear criteria for tariff setting, and embedding evaluation as part of the policy process.

Countries should not, however, underestimate the significant data challenges when looking at price setting processes. Data access and ways to overcome its fragmentation require well-developed infrastructures. Policy efforts highlight a trend towards aligning payer and provider incentives by using evidence-based clinical guidelines and outcomes to inform price setting.

There are signs of increasing policy focus on outcomes to inform price setting. These efforts could bring about system-wide effects of using evidence along with a patient-centred focus to improve health care delivery and performance in the long-run.

See also Here:


rob halkes's insight:

The payment model for healthcare is still very much a pay for intervention or for means to help you care for your health. Health outcomes however depend on an integrated whole of expertise, means, medication, therapeutic action and the lot.
If these do not add up in concert with each other to a sound outcome, why pay then for the sum of them? Integrated pay models of care drive payers to a position where they don't want to be: negotiation about the value of each (small) part of the whole of care without any view on the effect of it all.
Should we think "integrated care starts with the model of pay for care?"

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Medtech Companies Need to Transform While Times Are Still Good

Medtech Companies Need to Transform While Times Are Still Good | Health Care Business |
Times are still good for the medical technology sector. Most companies still have strong gross margins, healthy growth in sales, and high valuation multiples. But the health care industry is undergoing a period of significant change. Medtech companies can take six actions to manage this transition and position themselves for long-term success.

In the first few years of the 2000s—the golden age for medtech—sales grew by double digits. But sales growth has leveled off considerably in recent years and now hovers at around 4%. (See Exhibit 1.) There are many reasons for this, including the pressure to reduce health care costs, the increasing power of economic stakeholders in purchasing decisions, more consolidated and sophisticated health systems, new low-cost competitors, and the ubiquity of information with which to assess value. [...]
Times are still good for medtech—but the health care industry as a whole is undergoing a period of significant change. These changes could create a downward spiral for companies that cling tightly to business as usual. But those that build their capabilities and adapt their business models will find enormous opportunities to grow and thrive. In this report, we identify the major forces that are reshaping the industry and outline the transformative actions that medtech companies should take in response to them. We also describe how to manage such a transformational effort. By leveraging BCG’s proven transformation framework, medtech companies can improve their financial positions, close performance gaps, and establish a winning position.

rob halkes's insight:

Times are still good for business in med tech.. for pharma and healthcare provision as well. But the large BUT is indeed health care as a whole is undergoing significant changes. When these (market) and system changes are not paralleled by internal changes in the health industry companies, I guess it will get tricky before 2020. See here how you can cope

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Get ready for exponential growth in telemedicine in 2017

Get ready for exponential growth in telemedicine in 2017 | Health Care Business |
As hospitals expand to serve patients at the national and international level, as payment models require more home care/wellness care and as consumers demand the same kind of convenience from healthcare that they get from other industries, telemedicine will expand and mature.
rob halkes's insight:

#telemedicine is on its way now, but there are enough barriers that don't  make that development a smoothy one!

A well defined patient pathway, wise integration of intervention by different disciplines, accommodation for different stakeholders, are the kind of conditions to which an adequate development and implementation should adhere.

It is better to create a road map first than just try to install it.
See here for the core meaning of ehealth.


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Vital Signs | Deloitte | Life Sciences and Health Care

Vital Signs | Deloitte | Life Sciences and Health Care | Health Care Business |
This report by the Deloitte UK Centre for Health Solutions identifies 7 markers of a strong healthcare system and explores how these can be used to transform healthcare delivery across Europe.
rob halkes's insight:

PatientView - See here:

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Home Page Top Stories

Home Page Top Stories | Health Care Business |

NPR delivers breaking national and world news. Also top stories from business, politics, health, science,close technology, music, arts and culture. Subscribe to podcasts and RSS feeds.

She was a mother in rural Ghana. She only wanted four children. But she had seven.

That's a story that Faustina Fynn-Nyame told at the Women Deliver conference this week in Copenhagen, Denmark. Fynn-Nyame works with the reproductive health care nonprofit Marie Stopes International. [...]

In the global health care sector, a number of drone delivery projects have been popping up — including one jointly funded by the United Nations Population Fund and the Dutch government. A group of public health experts, local health authorities and private-sector partners dreamed up the idea in 2014 when trying to figure out ways to improve access to contraception for women in the hardest-to-reach areas of sub-Saharan Africa.

Access to birth control, reproductive health information and other services for women of childbearing age is a massive problem in this region, where fewer than 20 percent of women use modern contraceptives. The World Health Organization estimates that 225 million women in developing countries would like to delay or stop having children but lack access to reliable birth control methods.

Cue the drone. In late November of last year, an unmanned, automated machine with a wingspan of about 50 inches carried about 4.5 pounds of supplies like condoms and birth control pills, as well as life-saving drugs like oxytocin, which prevents hemorrhaging during childbirth, to parts of Ghana. [...]


rob halkes's insight:

Health Tech is readily deployable in logistic areas of care. Still, it needs alignment with health care providers to accompany their actions to serve their patients with the new condition in logistics. Health care innovation is not a one off issue.

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6 Recent Digital Health Innovations to Watch- HIT Consultant

6 Recent Digital Health Innovations to Watch- HIT Consultant | Health Care Business |

Compiled a list of digital health innovations that have the potential to create greater change when it comes to the application and practice of healthcare.
At HIT Consultant, we are always thinking about how digital innovation is impacting healthcare. As a result, we’ve compiled a list of innovations that have the potential to create greater change when it comes to the application and practice of healthcare in our series: HIT Consultant’s Selected Six Digital Health Innovations.

1 GeNemo Search Engine ...the genomic search engine partially named after the fishy tale is already here. GeNemo—the “Ge” part stands for the word gene— is a Google-like search engine for functional genomics data that was created by University of California San Diego bioengineers and led by Professor Sheng Zhong. It’s arguably the first genomic search engine of its kind, designed to solve a very pressing and complex pain point for researchers: effectively searching functional genomic data from online data repositories. [..]
2 Google’s Cardboard Google Cardboard packs some serious capability inside of its paper-light frame for healthcare. In fact, it has already saved a baby’s life—a twin girl named Teegan—who was born with half a heart and one lung.

Dr. Juan Carlos Muniz, a pediatric cardiologist at Nicklaus Children’s Hospital (NCH) in Miami, FL, used the device to make a 3D model of the little girl’s heart in preparation for the complex surgery to amend her life-threatening condition. In collaboration with an iPhone app called Sketchfab, the cardiac team was able to see Teegan’s heart in 3D from a variety of angles quite easily and elegantly with Cardboard. This allowed Dr. Redmond Burke, chief of cardiovascular surgery at NCH, and his team to carefully plan the complex procedure, including the safest and most effective points of incision.[..]
3. SkinTrack Smartwatch Turns Your Skin Into A Touchscreen

Students of the Future Inferences Group (FIG) at Carnegie Mellon University did apparently, as they have created just that with SkinTrack. It’s a system that uses embedded electrodes from a smartwatch band in conjunction with a ring on your finger, which generates an electric signal upon touching your arm. The approach even works when the skin is covered with clothing.

To be fair, this is not the first skin touchpad ever created, but the researchers at FIG think it’s certainly a more functional one.[...]

4. STAR—Surgical Robot...The Children’s National Medical Center and John Hopkins University recently tested a Smart Tissue Autonomous Robot (STAR) during an experimental surgery on anesthetized pigs. The robot was only tasked with suturing during the procedure, but it was reported to have performed very well, having sewed more consistent than veteran doctors or other robotic assistants. [..]

5 DNA Thermometer... a thermometer 20,000 times smaller than a single human hair. How do you build a device that small? You can’t—but it turns out, you can create one out genetic material.

Researchers from the Laboratory of Biosensors and Nanomachines at the University of Montreal developed the tiny thermometer by creating various DNA structures than can fold and unfold at specifically defined temperatures.[..]

6. True North- IBM’s Fake Brain..

At IBM’s Lab in Australia, researcher Stefan Harrer and his colleagues are building a system that analyzes brain waves in the hopes of recognizing epileptic seizures.

The system uses a neural network to analyze the data, which mimics the systems of neurons within a person’s brain. This system is similar to the neural networks that recognize photos on Facebook. This neural network is running on an experimental IBM chip called True North.[..]

rob halkes's insight:

I don't know how you experience these ever renewing lists of new technology for care applications. Fine that is, but then what?

Apart from thinking: "Let thousands of flowers bloom", I always heave a sigh: "Djee, I wished people would invest as much in redesigning care in collaboration to create coherent care paths for patients as in prompting new technology to care". Without intentional cooperation to implement new services all tech is useless to begin with..

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