CENTURY Putting data to work for stronger health systems The health - PowerPoint PPT Presentation

HEALTH IN THE 21 ST CENTURY Putting data to work for stronger health systems

The health sector faces a changing landscape and new challenges

Health spending is projected to continue to outgrow national incomes Health expenditure as a share of GDP, projection to 2030 2015 2030 % GDP 20% 14.5% 13.3% 20.2% 13.1% 13.0% 13.0% 12.3% 12.1% 12.2% 12.0% 12.0% 11.7% 11.6% 11.4% 11.3% 11.3% 10.4% 10.2% 9.9% 9.9% 9.7% 9.7% 15% 9.5% 9.1% 8.8% 8.9% 8.3% 8.0% 8.1% 7.5% 7.4% 7.0% 7.0% 6.7% 6.7% 6.2% 5.5% 10% 4.6% 5% 0% Source: OECD Health Division projections, 2019. StatLink 2 https://doi.org/10.1787/888934017196

But a fifth of this spending is, at best, ineffective and, at worst, harmful • Adverse events occur in 1/10 hospitalisations, add between 13 and 17% to hospital costs and up to 70% could be avoided • Geographic variations in rates of cardiac procedures (x3) and knee replacements (x5) are for a large part unwarranted • Up to 50% of antimicrobial prescriptions are unnecessary • 12% to 56% of emergency department visits are inappropriate • Administrative expenditure on health varies more than six- fold , with no obvious correlation with performance Source: OECD (2017) Tackling Wasteful; Spending in Health Care

Ageing populations and rising NCD rates mean that health and care needs are changing Source: Barnett K, Mercer S, Norbury M et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012; 380 (9836): 37 – 43

And people (rightly) expect a health system designed around their needs & preferences … but health system are slow to change…

People want to take control of their own health Source: Health in the 21 st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm 7

Intelligent use of data and digital technology can help 8

Many sectors have transformed themselves to harness digital opportunities This has resulted in:  Better products Better services  More efficient   Big consumer surpluses

In health, the opportunities are clear Effective, efficient and people-centered services • Faster access to critical information – effective, efficient care • More patient involvement, a better care experience • Clinical process optimisation (e.g. data-driven machine learning) Better system management • Monitor performance • Allocate resources better • Ensure better planning and access to care More accurate surveillance • Evaluate public health interventions • Faster detection and response to public health emergency • Inform policy Power up research & innovation • Statistical power Vast and varied datasets • • ‘Real world evidence’ for assessing and developing better treatments

Health care is rapidly ‘digitising’ … which is good Source: Health in the 21 st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm

But health systems remain “data rich - information poor”

Data are available but not linked regularly, missing important opportunities Percentage of key data sets (a) available and (b) regularly linked, 2013 and 2019 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2013 % of key national health datasets available 2019 % of key national health datasets available 2013 % of datasets regularly linked 2019 % of datasets regularly linked Source: Health in the 21 st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm

Only a few countries are ready to re-deploy EHR data for research and other purposes Technical, operational and governance readiness to use EHR data, 2016 Source: Health in the 21 st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm

Routine health data are under-used in managing medical technologies Use of routine health data in pharmaceutical policy, 2018 Source: Health in the 21 st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm

Too seldom people can interact with their own records 70% of countries planning to allow people to access their electronic medical record 43% of countries say that people will be able to interact with their record

And the health workforce is not ready Skills 30 to 70% of health professionals* report knowledge and mismatch skills shortages relating to digital tools and data analytics Inadequate Outdated day-to-day work processes do not enable the work digital technology to add value processes A digital tool is often a “black box” to a health worker or Lack of involvement is not informed by workers’ and their patients’ needs * depending on category and country

ICT expertise is short supply compared to other sectors Source: Health in the 21 st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm 18

More generally, health systems appear to under- invest in information management Investment in software and databases Purchases of ICT services as a % of as a % of GFCF output Unweighted mean across 12 OECD countries Unweighted mean across 12 OECD countries 3 60 Software & databases % GFCF ICT services % output 50 2.5 40 2 30 1.5 20 1 10 0.5 0 0 Non-residential gross fixed capital formation (GFCF) is a measure of spending on fixed assets. 19 Countries covered: Australia, Austria, Denmark, Finland, France, Italy, Japan, the Netherlands, Norway, Sweden, the United Kingdom, and the United States. Source: Health in the 21 st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm

A DIGITAL TRANSFORMATION RELIES ON A POLICY TRANSFORMATION 20

Digital transformation requires fundamental institutional reform …. and investment 1. Strategy • Overarching, cross-sector digital strategy with a consolidated vision, plan and policy-framework • A legal and policy framework that enables data 2. Governance to be used and shared for agreed purposes but ensuring that individual privacy and data security • Operational - workforce and the public to make the most from digital technology 3. Capacity • Institutional – data can be put to work to generate knowledge and action

This can deliver considerable health and economic dividends across OECD countries  Efficiency  waste = 400B Direct benefits = $600B ~GDP of Poland ~8% OECD health expenditure Additional health = $200B

Doubling what OECD countries invest in their information systems would still deliver a 3-fold return $ $$$ x 2

Barriers are not technological …. “The key barriers to building a 21 st century health system are not technological. They are found in the institutions, processes and workflows forged long before the digital era.” http://www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm

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