AUSTRALIAN INSTITUTE OF HEALTH INNOVATION Faculty of Medicine and Health Sciences Healthcare Systems: Future Predictions for Global Care Towards progress, avoiding pitfalls and achieving sustainability October 12, 2018 Brisbane Convention & Exhibition Centre, Australia JeffreyJeffrey Braithwaite, Braithwaite, PhD, PhD, FIML, FCHSM, FFPHRCP, FAcSS, Hon FRACMA, FAHMS FAIM, FCHSM, FFPHRCP, FAcSS, Hon FRACMA Professor and Director Professor and Director Australian Institute of Health Innovation AustralianDirector Institute of Health Innovation DirectorCentre for Healthcare Resilience and Implementation Science CentrePresident for Elect Healthcare Resilience and ImplementationInternational Society Science for Quality in Health Care [ISQua} Australian Institute of Health Innovation Our mission is to enhance local, institutional and international health system decision-making through evidence; and use systems sciences and translational approaches to provide innovative, evidence- based solutions to specified health care delivery problems. www.aihi.mq.edu.au Australian Institute of Health Innovation PIONEERING | STRATEGIC | IMPACT Australian Institute of Health Innovation •Professor Jeffrey Braithwaite • Founding Director, AIHI; Director, Centre for Healthcare Resilience and Implementation Science •Professor Enrico Coiera Director, Centre for Health Informatics •Professor Johanna Westbrook Director, Centre for Health Systems and Safety Research Thank you Amongst all the things we publish, this talk is based on a book To the editors, authors and support teams around the world who helped us with it. We dedicate this talk and all our work in health systems improvement to them. Acknowledgements: Yukihiro Matsuyama Canada: Wolfgang Hoffmann Stuart Whittaker Chapter authors Paul G. Shekelle Anne W. Snowdon Angelika Beyer Samir Al-Adawi Stuart Whittaker Charles Alessi Holger Pfaff Kristiana Ludlow Samir Al-Adawi Africa: John Van Aerde Neeltje van den Berg Wendy James Kristiana Ludlow Jacqui Stewart Karin Schnarr Greenland: Iran: Wendy James Shivani Ranchod Central and Eastern Europe: Tine Aagaard Ali Mohammad Elise McPherson Argentina: Wendy James Lise Hounsgaard Mosadeghrad England: Hugo Arce Kristiana Ludlow Guyana: Italy: Martin Powell Ezequiel García-Elorrio Russell Mannion William Adu-Krow Americo Cicchetti Russell Mannion Viviana Rodríguez Central Asia: Vasha Elizabeth Bachan Valentina Iacopino Estonia: Australia: Wendy James Jorge J. Rodríguez Sánchez Silvia Coretti Kaja Põlluste Ken Hillman Kristiana Ludlow Ganesh Tatkan Marcella Marletta Ruth Kalda Fakhri Athari Yukihiro Matsuyama Paul Edwards Japan: Margus Lember Steven Frost Chile: Hong Kong: Yukihiro Matsuyama Finland: Austria: Oscar Artega Hong Fung Jordan: Persephone Doupi Maria M. Hofmarcher-Holzhacker China: Eliza Lai-Yi Wong Reem-Al-Ajlouni France: Nataša Perić Hao Zheng Patsy Yuen-Kwan Chau Edward Chappy René Amalberti Thomas E. Dorner Denmark: Eng-Kiong Yeoh Lebanon: Catherine Grenier Brazil: Liv Dørflinger India: Nasser Yassin Laetitia May- Walter Mendes Janne Lehmann Knudsen Girdhar Gyani Rawya Khodor Michelangeli Ana Luiza Pavão Carsten Engel Intro: Maysa Baroud Anne-Marie Armanteras- Victor Grabois Jesper Eriksen Russell Mannion Malaysia: de-Saxcé Margareth Crisóstomo Portela Discussion and Concl: Yukihiro Matsuyama Ravindran Jegasothy Germany: Russell Mannion Paul G. Shekelle Ravichandran Jeganathan Acknowledgements: Chapter authors cont. Christine S. Gordon Papua New Guinea: South Africa: Wui-Chiang Lee Ndapewa Hamunime Paulinus Lingani Ncube Stuart Whittaker Min-Huei (Marc) Hsu Julie Taleni Neidel Sikosana Lizo Mazwai Usman Iqbal Malta: New Zealand: Portugal: Grace Labadarios The Netherlands Sandra C. Buttigieg Jacqueline Cumming José-Artur Paiva Bafana Msibi Madelon Kroneman Kenneth Grech Nigeria: Paulo André Fernandes SEA: Cordula Wagner Natasha Azzopardi-Muscat Emmanuel Aiyenigba Paulo Sousa Wendy James Roland Bal Mexico: Northern Ireland: Preface: Kristiana Ludlow The United Arab Emirates: Jafet Arrieta Gavin G. Lavery Clifford G. Hughes Yukihiro Matsuyama Subashnie Devkaran Enrique Valdespino Cathy McCusker Wendy Nicklin Spain: Unites States of America: Mercedes Aguerrebere Charlotte McArdle Qatar: Laura Fernández- Robert H. Brook MENA: Norway: Yousuf Al Maslamani Maldonado Mary E. Vaiana Wendy James Ånen Ringard Noora Alkaabi Sergi Blancafort Alias Trinidad and Tobago: Kristiana Ludlow Ellen Tveter Deilkås Nagah Abdelaziz Selim Marta Ballester Santiago Claudine Richardson- Subashnie Devkaran Oman: Russia: Lilisbeth Perestelo-Pérez Sheppard Mongolia: Ahmed Al-Mandhari Vasiliy V. Vlassov Antoni Salvà Casanovas Turkey: Tumurbat Byamba Huda Alsiyabi Mark Swaim Sweden: Mustafa Berktaş Tsolmongerel Tsilaajav Samia Al Rabhi Rwanda: John Øvretveit İbrahim H. Kayral Namibia: Sara S.H. Al-Adawi Roger Bayingana Camilla Björk Venezuela: Bruce Agins Samir Al-Adawi Edward Chappy Switzerland: Pedro Delgado Joshua Bardfield Pakistan: Scotland: Anthony Staines Luis Azpurua Margaret K. Brown Syed Shahabuddin Richard Norris Andriana Degiorgi Tomás J. Sanabria Daniel Tietz Usman Iqbal Andrew Thompson Taiwan: Apollo Basenero David R. Steel Yu-Chuan (Jack) Li Acknowledgements: Chapter authors cont. Editorial, statistical, logistical and project staff Wales: Andrew Carson-Stevens Wendy James Jamie Hayes Kristiana Ludlow Andrew Hayes Louise Ellis Sir Liam Donaldson Kate Churruca Yemen: Gina Lamprell Khaled Al-Surimi Elise McPherson Hsuen P. Ting Regional editors Jessica Herkes Jackie Mullins Jeffrey Braithwaite Sue Christian-Hayes Russell Mannion Chiara Pomare Yukihiro Matsuyama Claire Boyling Paul G. Shekelle Stuart Whittaker Samir Al-Adawi Fighting an invisible foe The story of John Snow • Three major outbreaks of cholera in London during the 1800s • In 1854, over 10,000 died from cholera in London and Newcastle • The germ theory of disease had not been accepted yet • … a disease of the poor • There was one water pump in the Soho area, in Broad Street • Within 250 yards of the spot where Cambridge Street joins Broad Street there were upwards of 500 fatal attacks of cholera in 10 days … • The answer was in the water! The message? Sometimes, look in the places you least expect to find the answer A series on international health reform Healthcare Systems: Future Predictions for Global Care ISBN: 978-1-138-05260-4 Website: https://www.amazon.com/Healthcare- Systems-Future-Predictions- Global/dp/1138052604/ref=sr_1_1?s=boo ks&ie=UTF8&qid=1527203715&sr=1- 1&keywords=Health+care+systems+futur e+predictions+for+global+care Healthcare Systems: Future Predictions for Global Care What will health systems look like in 5-15 years? Regions: Americas, Africa, Europe, Eastern Mediterranean, South-East Asia and the Western Pacific. Synthesises perspectives from 152 countries and territories around the world. Contributors • 148 contributing authors covering 152 countries and territories. • 28 low-income, 40 lower-middle-income, 33 upper- middle-income, 46 high-income and five currently unclassified countries and territories. • The authors’ task were to: Provide a case Identify the Derive possible study, issue, main changes solutions to big challenge or needed to health system problem in their secure lasting challenges to health system improvements 2030 Lessons? What lessons can be taken from this global outlook on the future? Five main trends • The trends shaping health systems of the future: • Sustainable health systems • The genomics revolution • Emerging technologies • Global demographic dynamics • New models of care The chapters The world in context through the eyes of our authors … The chapters’ nine themes 1. Integration of healthcare services 2. Financing, economics and insurance 3. Patient-based care and empowering the patient 4. Universal healthcare 5. Clinical information technology 6. Aging populations 7. Preventative care 8. Accreditation, standards and policy 9. Human development, education and training 1. Integration of healthcare services • Important step in creating coordinated care delivery and reducing waste • Eight chapters • 14% of total + Region: Central and Eastern Europe 2. Financing, economics and insurance • Affordability of care and resource allocation in healthcare is a global issue • Five chapters • 9% of cohort + Region: Africa 3. Patient-based case and empowering the patient • Educating and empowering patients to be involved in their own care • Eight chapters • 14% of total 4. Universal healthcare • Strong support globally for the greatest care in the most cost-efficient way • Three chapters • 5% of total + Region: Central Asia 5. Clinical and information technology • To improve efficiency and timeliness of care delivery, and patient access to services and information • Ten chapters • 18% of total 6. Aging populations • The need for care for older patients including their comorbidities, fragility and cognitive decline • Four chapters • 7% of total 7. Preventative care • An ounce of prevention is worth a pound of cure • Three chapters • 5% of total + Region: South-East Asia 8. Accreditation, standards and policy • Shared goal of improving patient safety and strengthening the health system through one or all of these methods • Nine chapters • 16% of total + Region: Middle East and North Africa 9. Human development, education and training • Human development is crucial; from workforce recruitment to professional development and supporting leadership roles • Seven chapters • 12% of total The result … Case study: Australia and aging • CriSTAL tool developed to identify