Insights from the EHMA Conference in Italy

Innovation and early intervention among key drivers for strengthening health systems

Finding sustainable solutions for complex health systems was the focus of the European Health Management Association (EHMA) 2023 Annual Conference, held from June 5th to 7th in Rome, Italy. A Focus Session was held at the conference in which Professor Americo Cicchetti, Director of ALTEMS – Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Italy facilitated an esteemed panel of experts*. Together they explored key insights from the multi-national research commissioned by the Partnership for Health System Sustainability and Resilience (PHSSR), that shed light on potential solutions. The research identified innovation and early intervention among key drivers for strengthening health system sustainability and resilience across countries. The panel, however, highlighted, that there are multiple challenges that affect the ability to act on such insights.


These challenges and suggested solutions are highlighted below:


Establishing consensus on how we identify and measure the sustainability and resilience of health systems

With shared indicators, data collected can be more powerful, as it can be aggregated and compared across countries and regions. The research commissioned by the PHSSR offers a vision for what these indicators could be having utilised seven core domains affecting health systems (as defined by a London School of Economics research framework) – they are; governance, financing, workforce, medicines and technology, health service delivery, population health and environmental sustainability.


Securing much needed investment in healthcare systems and identifying where it is most needed 

For too long health expenditure has been seen as an increasing cost burden. What’s more, short-termism often results in healthcare spend being dictated by electoral cycles. A longer-term investment approach is needed. To achieve this, policy makers and politicians need to be on board. By identifying the indicators of success for policy makers and transforming their view of healthcare to align with these indicators, increased investment in health systems could be secured. But investment is not effective unless it is wisely spent. We saw during the COVID-19 pandemic that some areas were left severely under-resourced with serious consequences – such as late diagnoses and missed treatments for those with non-communicable diseases. The essential role of measuring shared indicators is again critical, as the data collected can identify the areas of greatest need and direct investment accordingly. It is by following such an approach that the PHSSR research identified innovation and early intervention as important areas of focus for investment.


Establishing innovation and early intervention to support sustainability

The fostering of a culture of innovation has been found to increase chances of adaptability and scalability. These attributes will be vital to maintain an agile health system that can transform to meet the needs of future populations. Prevention and early intervention are widely under-emphasised in many national policies but are of critical importance for a strong health system. Investment is needed in population-based screening and early diagnosis that are measured against specific objectives and outcomes. Furthermore, robust plans should be developed for maintaining essential care, including vital screening services, during crisis scenarios.

 

Collaborating to develop and implement sustainable solutions 

There is a diverse ecosystem of organisations that contribute towards the running of health systems, each lending its specific areas of expertise. This is why a collaborative approach is key to success. The private sector is often the driver of innovation, but it needs the insights from patients, health professionals and policy makers to understand the nuances of the health systems they are innovating for and to ensure solutions developed are feasible and can be implemented. Public-private partnerships harness these capabilities of both sectors, but such partnerships can only develop if there is political support for such an approach, with policies and initiatives that enable these more flexible ways of collaborating. 


Identifying changes to governance structures to support health system strengthening

Shared governance between a country’s national and regional systems was also found to be a more sustainable model. A study in the Lombardy region of Italy is researching this concept further with a view to developing a policy framework that could be rolled out elsewhere. It is looking at how the 250 private health companies in the region communicate with the public sector to identify need and direct resources. It also uses the PHSSR research framework at a local level to measure indicators of health system strength and correlate inputs to quantitative and qualitative measures of these indicators.


From the latest EHMA session, it is clear that to ensure the sustainability and resilience of health systems around the world, a new approach is needed. With so many great minds focused on creating solutions, all we need now is the collective will and commitment to make it happen.


* The expert panel included: Dr Kostas Athanasakis, Assistant Professor of Health Economics and HTA, Laboratory for HTA, University of West Attica, Greece, Professor Scott L. Greer, Professor at Michigan University and Senior Expert Advisor, European Observatory on Health Systems and Policies, U.S., Marco Marchetti, MD, Director, AGENAS, Italy, Francesca Patarnello, VP Market Access and Government Affairs, AstraZeneca, Italy and Emmanouil Tsiasiotis, Research Project Manger, ALTEMS, – Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Greece.