The rate of innovation continues to outstrip what was ever thought possible, but we need to rethink and turn our way of approaching the future on its head. If we go from the current reality – shaped first by our business, then the market and finally the environment – we won’t get there, Hilary Thomas, partner at KPMG, told an audience of the Healthcare Businesswomen’s Association last month.
With 6%-9% growth in healthcare expenditure every year, the only solution is to increase quality and reduce costs, she says. But to reach this point requires a very different way of thinking.
Prior to joining KPMG, Prof Thomas spent 23 years in the NHS, from qualifying as a doctor in 1984 to becoming a professor of oncology and believes health systems now need to be fundamentally redesigned. “Organisations used to sit at the centre but now it’s the consumer,” she stresses. “We need to be conscious of the bigger picture, of how the demographics, social values and behaviours, technology, political and economic issues feed into this evolving landscape.” For example, for every drug prescribed, 75% of patients have looked it up online before taking it.
But making wholesale change involves a good dose of bravery, she noted, like the hospital that took the decision to project its feedback from iWantGreatCare onto the side of the building for all to see. Be it good, bad or downright ugly.
“Whereas inappropriate bed days caused by MRSA are less than 1%, inappropriate bed days caused by poor medicines management are nearer 10%-15%,” notes Prof Thomas. So the major trends revolve around ways to improve medicines compliance – aligning the interests of the industry with that of healthcare professionals and patients – and include the development of companion diagnostics to reduce ineffective prescribing, IT and big data, and mobile health.
But there are three critical strategies underpinning this vision of the future: understanding the customer; reshaping R&D to provide reimbursable drugs and devices that deliver shareholder value, for example by partnering with academia and using virtual clinical trials to speed drugs through to proof-of-concept; and anticipating the influencers in the wider healthcare system, be it for patients, payers or healthcare professionals.
“Life science companies will need to become better at identifying who their customers are, what they want and how they want it delivered,” says Prof Thomas. “And licensing authorities need to be educated otherwise they will always license the same drugs; we need to be smarter so we don’t lose drugs that are good and spend less time on the medicines that are bad.”
With the dawn of big data, this should be easier than in the past. But profusion does not always mean value, explains Thomas. With the amount of data growing 40 times faster than the world’s population, “the challenge is how to get the value from the opportunity. “
She concluded by saying that "we need to work out how to pick the winners; prevention has been in the too-difficult box for too long but that’s how we will support a population of 10 billion in the years to come".