Rethinking Healthcare: It’s Time for a New Health System

The COVID-19 pandemic has demonstrated how interdependent health systems are around the world and that they face the same, universal health challenges. It has revealed inequities when measured against social determinants of health, confirming the suspicion that health solutions first and foremost benefit the rich. It has also shone a light on the pressures and inadequacies in even the most advanced and celebrated health systems, and demonstrated once and for all that modern healthcare delivery is not fit for purpose.

Speculation on the future of health has been a topic for discussion for over 2,500 years, with the creation of the Hippocratic Oath signalling early understanding of medical ethics and consideration of the doctor-patient relationship, which has continued to evolve over time. Growing populations and alarmingly high rates of chronic disease create significant global burden. Now, more than ever, a new approach must be developed. The approach must put patients at the centre of decision-making, and it must work throughout the world. Good health is crucial not just for the individual, but for the success and prosperity of society, and right now we are not doing it very well.

At the centre of any health system is the individual, a human being with the same basic needs regardless of politics, culture, religion, values. With these basic needs in common, so too will there be commonalities in the needs of a system of healthcare that supports each individual, to achieve their highest health potential. Ideally a system that draws on cutting-edge technology and advances in research and development and focuses on health and wellbeing rather than being organised to manage disease. Most systems have evolved over the years, in response to new methods, advances in our understanding of biology and the development of different pricing models--health information and technology in the most sophisticated systems is a good demonstration of this development. Take the U.K.’s National Health System as an example: although often described as a single system, one hospital in England may use several hundred different IT packages, with several different EHR systems that do not talk to each other. This is not by design, but as a result of years of adaptations, editions and mutations to the process, as short-term funding is applied to long-term challenges.

Watch Jörg Debatin, chairman of the Health Innovation Hub, talk with HIMSS TV about how digital infrastructure and interoperability have been key to Germany making significant progress in digital health and digitizing the patient journey.

The individual at the centre of this conundrum is even more complex. Every aspect of their lives is relevant for their health—where they live, what job they do, who they spend their time with, their hobbies and their good and bad habits. In an increasingly digital world they are accumulating data in all their interactions with society that could be of relevance to their healthcare, and help determine how they need to be supported, or which services they need access to, to reach their health potential. This individual-level data, with the individual in the driving seat for how it is gathered, shared and used (and by whom) will be the missing piece in realising future health, while gaining population-level insights that will be relevant on a global scale. Considering how to shape the health system such that the individual is truly at the centre is the biggest challenge of all.

In this series, we will explore this need for a new health system in greater detail, considering the current trends in the forecast for future health, the likely direction of travel as systems readjust in light of the COVID-19 pandemic, and the challenges and opportunities that will be met along the way. The discussion will include:

1. Why the current system in most developed countries isn’t able to support everyone (and what the pandemic has revealed)
2. Reflection on the huge disparities between the top 10% and bottom 90% in their experiences of health
3. The need to shift focus from disease management to realising health potential
4. The need and opportunity to align public health and personalised medicine
5. How to usefully support translation of innovation into healthcare, and how to identify which innovations are worth pursuing

This series is the product of several years of collaboration, bringing together our different disciplinary and geographical perspectives to examine the challenges that healthcare faces, and the potential solutions it will need to commandeer to improve health outcomes and create a sustainable future.

By Bogi Eliasen, Director of Health, Copenhagen Institute for Future Studies, a HIMSS Future50 Leader; Harriet Teare, DPhil, Consultant, Copenhagen Institute for Future Studies, Research Leader, RAND Europe; Terry Vrihenhoek, PhD, Consultant, Copenhagen Institute for Future Studies, Staff/Faculty Advisor, University Medical Center Utrecht; HIMSS Members

The views and opinions expressed in this content or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.