CEO Opinion: Healthcare Services and Technology – in and for – the Baltic Sea Region
New services and new products – in particular within cross-cutting technologies such as Logistics and ICT -need to be applied to improve healthcare systems and reduce costs
Article for ScanBalt News by Ernst Kreppenhofer, Managing Partner, Sentiero Logistiq, Hamburg
Health is a key factor of regional stabilisation and economic development.
However, the health sector needs improvement by better and easier services for doctors and nurses through innovative technology at the hospitals and at home.
These can for example be transcare-services (logistics and other services areas), supported treatment, monitoring and rehabilitation in the patient’s own home before, during and after hospitalisation.
Innovative technologies are also a key component in reducing the costs of healthcare.
Health economy and health care in the Baltic Sea Region: A positive trend and serious challenges
Health economy and healthcare marekts throughout the Baltic Sea Region is in an upheaval.
Due to the financial conditions and the ongoing demographic trends a high economic pressure have been developed which is growing year by year for most of the healthcare institutions. This situation leads to (sometimes compulsive) rationalization measures to divestitures, staff reduction, investment backlog and even to business and private company insolvencies especially in the field of general practitioners (family doctors).
It is to be feared that the financial constraints will continue. The present and the expected future financial contributions to healthcare are not unlimited, they simply can not continue to increase (example: the health insurance contribution in Germany has risen in the last 30 years from an average of 7 to an average of 15.5%). The increasing financial burden on the citizens is a political issue which may lead to social problems if left unsolved. Therefore more cost-efficient and better healthcare systems must be developed.
Overall this and other trends leads to a very positive picture of the Health care technology and service market in the Baltic Sea Region as documented by ScanBalt® fmba in 2013 (from the report The Health Economy in the Baltic Sea Region
Challenges and Opportunities – Market Analysis).
”The Baltic Sea region market for health technologies is strong and growing. The drive is mainly based on the need to upgrade and modernize the health care systems while at the same time reducing health care costs caused by ageing populations and meeting the challenges of rising consumer power and patient mobility.
The states and regions around the Baltic Sea together with individual universities, hospitals, innovation agencies and other important public and private stakeholders should do everything possible to exploit the opportunities and assist to remove barriers for a more efficient use of existing resources in our region.
Otherwise the Baltic Sea region can miss the opportunity to meet the demand of the market and others may take the lead. There is no lack of competition.”
The great challenges for the Baltic Sea Region healthcare today (as for Europe as such) are:
– the aging populations
– the depopulation of the country-side
– Improve services for elderly and handicapped persons in rural areas
– costly new methods of treatment, as well as
– budget limits
The financial constraints have already led to dramatic situations, especially in country sides/rural areas at publicly owned hospitals and in healthcare services.
The next few decades the situation willl predictable worsen if nothing is done.
Workable and sustainable approaches for the future healthcare
So as mentioned the connection and interdependance between available financing, technology and services is in focus.
It is thus of the outmost importance that new services and new products – in particular within cross-cutting technologies such as logistics and ICT – have to be applied meaning they have to be developed, tested, implemented and integrated.
An important point is that health care staff must be relieved to be able to concentrate on their core tasks – the human medical care activities – and thus should be equipped with technologies and services that allow them to perform their duties faster, more effective and more cost efficiently.
This also means health care delivered with less non-medical tasks for the doctors and the special qualified nurses.
Below: Figures for hospitals in Germany, Denmark and Estonia.
The importance of eHealth and Telemedicine
For many years, buzzwords like e-health and telemedicine are being perceived mostly in the language of health care. The common understanding is reasonably clear and the services established to a various degres all over the Baltic Sea Region. The base-laying services for patients and healthcare providers are (in summary):
Patients: directory of names and addresses, recipes and recipe-related consultation, appointment calendar, price comparisons, information on prevention and treatment, waiting list and information from hospitals.
Healthcare providers (doctors, hospitals, nursing, therapists etc.):GPS, Patient Appointment Book, web access to laboratory data, access to radiological images, looking for diagnoses from the electronic health file, medical records communication/data exchange with hospitals, secure e-mail-transfer, regional-communication (authorities, agencies, medical personnel) etc. Also diagnosis and treatment while bridging spatial or temporal distance between doctors, hospitals, pharmacist and patient, or (as an example) between two or more consulting physicians by means of telecommunication and/or data exchange.
The future technology based health care dictates a need for new healthcare regional service networks, which are more efficient, more secure, more time effective and last but not least more patient related.
Ambient Assisted Living/Assisted Personal Health
These and other “sounding” terms and designations characterize a new relationship between patients, medicine, information and service/support that can be called “personal health systems” or “TeleCare”.
The focus is on simple, user-friendly and comprehensive technologies – especially for the treatment of high-risk patients – e. g. via permanent, direct and local unbound communication and data transfer.
The service partner (e.g. the nurse) and the patient will at all times be available for reciprocal contact via the mobile support. This means the transfer of the physical condition data and the therapeutic responds to them. The aim is that the communication takes place automatically, i.e. the “Personal Health System” reports on a hourly, daily or weekly basis (periodically) a status of the patient to the doctor/nurse or a service centre. The transmitted data will be checked automatically, deviations will be documented and at a given predefined treshholds leads to alarms.
Another variant of this connectivity can be used e.g. for risk patients: The system immediatly automatically reports that a certain state of assisted data have changed.
Healthcare Logistics: The “at-home” support of the patient – TeleCare
Especially for elderly people, those with disabilities or those with permanent diseases it is a necessity to guerantee services for them based on e-Health/Telemedicine and TeleCare.
This applies in particular to the regions outside the big cities, meaning rural regions, regions with significant problems in the area of demographic change and regions with a less efficient infrastructure and low offering of mobility.
In these regions, elderly persons or patients with a handicap will be actively supported through TeleCare (smart logistics).
Integrated regional concepts
Europe is a Europe of regions. And with programs like ERDF for the financial and economic development of the regions much can be done.
In the future only those regions will be successful, who are fulfilling certain conditions and offers good integrated living together with optimal environmental and working conditions. These conditions includes healthcare in all its diversity.
So far there is a need for a transnational model for the country side/rural areas of the Baltic Sea Region to realize a more effective healthcare support and a better patient service in dual mode by using modern and cyber-physical orientated technologies, IT and Internet and direct orientated logistics (TeleCare) services.
It is worth to notice that a significant benefit for the regions and states is that new and on modern technology orientated solutions leads to new and higher added value working places thereby increasing the income of the regions/states.
Unfortunately efficient regional healthcare networks are still lacking – especially in country-side/in rural areas – connecting the demand and the offer of a better individual care for elederly and handicapped persons with an intelligent concept and integrating the relevant stakeholders.
It is thus desirable and would be a thoroughgoing success if decision and opinion makers in politics, healthcare, higher education and regional economic development could agree on a common plan. This would be of benefit for all the relevant stakeholders not least the patients, would lead to a reduced financial burden and show the way forward for states and regions.
Health SUPPORT net: Changing HealthCare
The logistics and supply chain as well as IT and communications suffer in many regions from the same or related problems: Only a few centralized health care suppliers with the necessary know-how and the necessary (financial) standing and knowledge face a number of small businesses providing technology solutions.
And notoriously the small service providers have difficulties to offer or to realize a project in the health sector due to various barrieres for public-private collaborations which are well described e.g, public procurement routines.
But in the community of a joint project (called Health SUPPORT net), the situation would be different. Next to a very good starting position the combination of relevant stakeholders working for that project, will for an SME provide good opportunities to reach enter into closer collaboration with the public heath care providers.
A project like Health SUPPORT Net should provide a review on the actual situation in Baltic Sea region healthcare and include results from previous and related projects.
In particular it should focus on the regional situations in rural areas, communication and direct monitoring of patients, supply and support situation, technical situation (incl. ICT) – and communication possibilities for patients in their home areas.
A study on the different situations in the BSR countries is an opportunity to become familiar with statistics, databases, governmental and regional information and data structures, laws and health insurance and different types of patient support.
This would then again provide an excellent back ground for a number of pilot activities directed towards introduction of new technologies in the health care systems.
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