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Health in the 21st Century - Launch presentation

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Health in the 21st Century - Putting Data to Work for Stronger Health Systems.
This report explores how data and digital technology can help achieve policy objectives and drive positive transformation in the health sector while managing new risks such as privacy, equity and implementation costs. It examines the following topics: improving service delivery models; empowering people to take an active role in their health and their care; improving public health; managing biomedical technologies; enabling better collaboration across borders; and improving health system governance and stewardship. It also examines how health workforces should be equipped to make the most of digital technology. The report contains findings from surveys of OECD countries and shares a range of examples that illustrate the potential benefits as well as challenges of the digital transformation in the health sector. Findings and recommendations are relevant for policymakers, health care providers, payers, industry as well as patients, citizens and civil society.

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Health in the 21st Century - Launch presentation

  1. 1. HEALTH IN THE 21ST CENTURY Putting data to work for stronger health systems
  2. 2. The health sector faces a changing landscape and new challenges
  3. 3. Health spending is projected to continue to outgrow national incomes Health expenditure as a share of GDP, projection to 2030 4.6% 5.5% 6.2% 6.7% 6.7% 7.0% 7.0% 7.4% 7.5% 8.0% 8.1% 8.3% 8.8% 8.9% 9.1% 9.5% 9.7% 9.7% 9.9% 9.9% 10.2% 10.4% 11.3% 11.3% 11.4% 11.6% 11.7% 12.0% 12.0% 12.1% 12.2% 12.3% 13.0% 13.0% 13.1% 13.3% 14.5% 20.2% 0% 5% 10% 15% 20% 2015 2030 % GDP Source: OECD Health Division projections, 2019. StatLink 2 https://doi.org/10.1787/888934017196
  4. 4. But a fifth of this spending is, at best, ineffective and, at worst, harmful Source: OECD (2017) Tackling Wasteful; Spending in Health Care • 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
  5. 5. 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
  6. 6. And people (rightly) expect a health system designed around their needs & preferences … but health system are slow to change…
  7. 7. 7 People want to take control of their own health Source: Health in the 21st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm
  8. 8. Intelligent use of data and digital technology can help 8
  9. 9. Many sectors have transformed themselves to harness digital opportunities This has resulted in:  Better products  Better services  More efficient  Big consumer surpluses
  10. 10. 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
  11. 11. Health care is rapidly ‘digitising’ … which is good Source: Health in the 21st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm
  12. 12. But health systems remain “data rich - information poor”
  13. 13. Data are available but not linked regularly, missing important opportunities Source: Health in the 21st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2013 % of key national health datasets available 2019 % of key national health datasets available 2013 % of datasets regularly linked 2019 % of datasets regularly linked Percentage of key data sets (a) available and (b) regularly linked, 2013 and 2019
  14. 14. Only a few countries are ready to re-deploy EHR data for research and other purposes Source: Health in the 21st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm Technical, operational and governance readiness to use EHR data, 2016
  15. 15. Routine health data are under-used in managing medical technologies Source: Health in the 21st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm Use of routine health data in pharmaceutical policy, 2018
  16. 16. 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 Too seldom people can interact with their own records
  17. 17. And the health workforce is not ready 30 to 70% of health professionals* report knowledge and skills shortages relating to digital tools and data analytics Outdated day-to-day work processes do not enable the digital technology to add value A digital tool is often a “black box” to a health worker or is not informed by workers’ and their patients’ needs Skills mismatch Inadequate work processes Lack of involvement * depending on category and country
  18. 18. 18 ICT expertise is short supply compared to other sectors Source: Health in the 21st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm
  19. 19. Investment in software and databases as a % of GFCF Unweighted mean across 12 OECD countries More generally, health systems appear to under- invest in information management 0 10 20 30 40 50 60 Software & databases % GFCF 0 0.5 1 1.5 2 2.5 3 ICT services % output Non-residential gross fixed capital formation (GFCF) is a measure of spending on fixed assets. Countries covered: Australia, Austria, Denmark, Finland, France, Italy, Japan, the Netherlands, Norway, Sweden, the United Kingdom, and the United States. Purchases of ICT services as a % of output Unweighted mean across 12 OECD countries 19 Source: Health in the 21st Century www.oecd.org/health/health-in-the-21st-century-e3b23f8e-en.htm
  20. 20. A DIGITAL TRANSFORMATION RELIES ON A POLICY TRANSFORMATION 20
  21. 21. Digital transformation requires fundamental institutional reform …. and investment • Overarching, cross-sector digital strategy with a consolidated vision, plan and policy-framework1. Strategy • A legal and policy framework that enables data to be used and shared for agreed purposes but ensuring that individual privacy and data security 2. Governance • Operational - workforce and the public to make the most from digital technology • Institutional – data can be put to work to generate knowledge and action 3. Capacity
  22. 22. Efficiency waste = 400B Additional health = $200B Direct benefits = $600B ~GDP of Poland ~8% OECD health expenditure This can deliver considerable health and economic dividends across OECD countries
  23. 23. Doubling what OECD countries invest in their information systems would still deliver a 3-fold return $ $$$x2
  24. 24. “The key barriers to building a 21st 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 Barriers are not technological ….
  25. 25. More on OECD work related to health Contact us health.contact@oecd.org @OECD_socialFollow us on Twitter www.oecd.org/healthVisit our website

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