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Prevent the next wave

The taboo on raising efficiency and productivity in healthcare must be broken. To stave off the next crisis in healthcare, we must invest smartly not only in innovations that improve patient outcomes, but also in those that improve efficiency. If the current trend of productivity decline continues, in 2040 the Netherlands will need three million healthcare workers to meet the growing demand for health care services: one million more than previous estimates, which do not take productivity decline into consideration, and double the current number of healthcare workers. In our new study, “Prevent the next wave”, we show that turning the tide is a dire necessity, and we make recommendations for an innovation ecosystem that befits one of the great healthcare challenges facing us in the next few decades.

The study shows that productivity in healthcare has declined over the last several decades, in stark contrast to what we see in other sectors. This puts our healthcare system under tremendous stress. Efficiency-enhancing innovations are essential to ensure that healthcare remains accessible for all patients. Moreover, these innovations are often appreciated by the patient. Think of faster recovery after surgery, earlier detection of risks by monitoring at home, or a reduction of the wait for home care for wound treatment.

The use of labour-saving innovations is not only essential to maintain our high standards of access to and quality of care, but also helps patients in the near term to receive the care that was postponed because of the Covid pandemic.

Daan Livestro (Gupta Strategists): “The Covid crisis has revealed the true consequences of having reduced access to care. Regular care was postponed or canceled, which has likely had detrimental effects on patients and led to the loss of many healthy life years. Going forward, an increasing demand for healthcare, partly caused by the aging of our population, and increasing labour shortages will put ever more strain on our health system. Through an ecosystem that stimulates labour-saving innovation, we can prevent the next crisis”.

Five recommendations for our health innovation ecosystem

If we want to be able to make do with the same number of healthcare workers in the future, they must all be able to provide 60% more care in twenty years’ time than they do now. To achieve this, it is not enough to focus on incremental improvements. An ecosystem that stimulates efficiency improvement at all links is necessary for labour-saving innovations to flourish.

By looking over the fence, and learning from sectors like car manufacturing and agriculture, we have distilled five recommendation to improve our health innovation ecosystem:

1. Policymakers and managers: make increased productivity an explicit objective by including it in sectorwide agreements, subsidies and strategy documents of institutions.

2. Public and private parties: collaborate closely in taskforces on innovations that increase efficiency in the primary process. In multi-year projects, work together to develop and scale up new labour-saving innovations throughout the patient journey.

3. Regulators: facilitate innovation, for example by making productivity or efficiency related to quality of outcomes an explicit assessment criterion for the admission of new innovations, or by providing an early access pathway for innovations in the healthcare market including budgets to develop innovations in practice

4. Associations of medical specialists: advocate for the national implementation of promising (existing) innovations, fuelled by discussions with patients.

5. Finally, financiers: devise the right incentives by setting up a national redistribution fund that guarantees the extra costs that are recouped in other places in healthcare.

To ensure continued access to high quality care, we need to invest smarter

Is it realistic to expect that innovations will make healthcare more productive? We see examples in healthcare across the board. Efficiency-enhancing innovations such as minimally invasive surgery, telemonitoring of chronically ill patients and innovative wound care materials show that many processes can become as much as 30 to 90 percent more efficient. Thanks to a new minimally invasive heart valve replacement procedure, hospitals can save over 60 labour hours (and 70 hours of admission time at the ICU for patients) in comparison with the traditional open hart surgical procedure. The use of such innovations not only improves quality of care for patients, but also enable health care workers to deliver more care better.

Daan Livestro: “Our study shows that we don’t necessarily have to invest more in our health care system: rather, we need to invest smarter. To adopt new innovations too slowly, and in some instances perhaps not at all, is truly a missed opportunity. Only by innovating smartly and rapidly we can ensure that our health system is able to maintain the high standards that we have come to expect.”

On May 27, the study was offered to the Ministry of Health, Welfare and Sport and accepted by the Secretary General, mr. Erik Gerritsen, and Director of Innovation and Healthcare improvement, mr. Gelle Klein Ikkink.

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