With the 27th European Association of Hospital Managers (EAHM) Congress being held in Cascais, Lisbon at the end of September, HealthManagement interviews Alexandre Lourenço, President of hosting organisation, the Portuguese Association of Hospital Managers, on the changing face of hospital management and the new era of ‘care.’
Why have you focused on the theme "Redefining the Role of Hospitals - Innovating in Population Health" for the 27th EAHM congress in Cascais, Portugal?
Healthcare and hospitals are probably the most complex structures ever developed by the human being. Hospital management is one of the most complex management areas that anyone can work in. Nevertheless, our industry is facing several new and old challenges. On one hand, people increasingly look at our sector as unreliable, unsafe and prone to error. On the other hand, we are also increasing our costs without the economy to support it. The changing demographics, the pace of technological innovations, and the changing user associated with consumer expectations drive our increasing health expenditures.
The expectation of the population continues to rise. Actually, this is the greatest challenge we face. We believe that we need to change the way that we provide care, and that’s why we will be discussing the role of hospitals, because hospitals need to rethink the way that they are organised and the way that they provide services.
We need to develop a model of care for the people - an integrated model of care that includes other stakeholders, not only the primary care or long-term care providers, but also social care providers. We need to innovate the way that we provide care, and we need to adopt new technologies and incorporate new providers - new providers that could help us improve the quality of care and the experience of the patient.
At the same time, we need to ensure sustainability, not only financial sustainability but also human resources and environmental sustainability, as an example.
At the end, managers need to understand and accept that this change will happen with them or without them. This is why we need to rethink practices to assure that hospitals find their role regarding the population that they serve; we need to ensure that people really are at the centre and that we provide continuity of care across the life cycle of each individual.
What health innovations do you believe will really be implemented in hospitals in the next 3 to 5 years?
We have partnered with different organisations that are also working on this topic including public health and business schools and the European Institute of Innovation and Technology for Health (EIT Health), and we will discuss during the congress innovative provision models. We will talk about big data, remote monitoring for complex and chronic patients, integrated services using AI technologies and of course precision medicine, and new drugs that will change the way that we provide care. The most challenging thing for innovation is to address the demographic shift (ageing), and to provide care outside of the hospital walls.
The goal is to engage with other partners, but also to implement patient-centred services that will allow personalised and individual care. Most of the patients that are seeking hospital services, secondary and tertiary care services, are 65 years and older. They are senior citizens, and we need to provide tailor-made services to them.
I really believe that as far as this segment of the population is concerned – a population that tends to suffer from multiple chronic diseases we should focus on avoiding hospitalisation by developing outpatient services. We need to focus on patients that are seriously in need of care outside the hospital setting. This aged population with multiple chronic diseases and complex needs is where hospitals need to focus on by providing outpatient services so that we can avoid hospitalisations. What we need to do is to really personalise services for this population segment. We need to develop reimbursement models and innovative solutions to do so and we need to do this within the next 3 to 5 years.
What are the biggest challenges facing the C-suite in healthcare and how can the sector address these?
One of the biggest challenges is to acquire competencies; specific competencies to lead the needed change. This is one of the issues that worry me. Our skills and competencies are not sufficient to lead a healthcare system change. The other issue is, of course, sustainability. More than 40% of the European hospitals are at risk of defaulting on their financial responsibilities. Unsustainability is thus a problem that we need to address, mostly regarding waste reduction. We need to develop tools inside the hospital to reduce waste, increase efficiency and avoid unnecessary care.
The Organisation for Economic Co-operation and Development report on wasteful spending will be discussed during the Congress and we will share several best practices cases on this topic. This is quite relevant for managers to take notice and to develop waste reduction strategies in their own organisations.
We need to develop transformational hospital leaders; we need to develop new patient-centric organisations that will lead through innovation within an integrative health ecosystem thinking. With reference to competencies, a big factor is enhancing digital literacy in all healthcare professionals and improving digital literacy for the new health professionals who are just coming out of medical and nursing schools.
The way we provide healthcare is changing, and it will continue to change. The issue of data and technology is a great example. We will soon see new professionals playing a central role in the hospital – health coaches, genetic counselors, disease specific case managers, information management experts and “med-engineers”. Most of the hospitals don’t have them right now, but we need to address the issue of digitisation of systems, digitisation of healthcare. Therefore, managers need to be aware and prepared to lead the change.
During the Congress, we will have several technical visits. Specifically, on digitisation we have prepared a visit to a local hospital that has achieved significant levels of digitisation. This is one of the four hospitals in Europe that have achieved such a high level of digitisation - HIMMS EMRAM Stage 7. Also, on this topic, we have prepared visits to the National Contact Centre where participants will acknowledge several programs on remote care and eHealth solutions.
How can digital health innovations support new ways of solving old healthcare problems to maximise patient safety and change how care is delivered?
First of all, we need to work on avoiding unnecessary hospitalisation. We can do so through remote monitoring technology. There are several examples, in COPD, cardiac insufficiency, where we can remotely monitor patients with chronic conditions and minimise risks that are related to hospital admissions.
We have several interesting examples that we are going to showcase and discuss at the Congress. We can now certify patients according to the risk of nosocomial infections and actually select those with a higher risk, and work with them to reduce that risk. We will also discuss the Estonian genome project, where citizen’s genomes are sequenced. We will probably have really good outcomes in the future by studying diseases and avoiding them in the first place. By harnessing digitalisation, we can really personalise care, adapt technologies to the specific patient, creating a safer healthcare system that avoids unnecessary risk for patients.
What is the importance of shifting focus to identifying emerging social changes and lifestyle trends to benefit patients and healthcare professionals?
The issue is that hospitals are not sustainable, and they are not providing good service if they do not respond to the population’s changing needs, and this is why these kinds of topics, like lifestyle, are quite relevant. Hospitals have an important role in promoting health, disease prevention, and action in the community.
What are you most excited about with 27th EAHM Congress? What do you want to see happen there amongst healthcare professionals?
We are thrilled about this Congress. We have developed a comprehensive scientific programme because we wanted to include the participation of major international organisations relevant to healthcare management; not only healthcare managers organisations but also medical associations and international organisations as well as the European Commission, WHO or OECD for example, and others that can help us develop a new way of thinking about healthcare.
During this Congress, we will be holding our hospital innovation event where we welcome startups to present their products and connect with hospital executives and CEOs. We are also going to offer a roadshow for SMEs that will have the opportunity to pitch their products and receive valuable advice from hospital CEOs. In addition, during the congress, we will be organising technical visits to hospitals, contact centres, research facilities, and industrial factories. We will run various workshops, like one we are organising with the European Investment Bank, where we will discuss how to use loans and European structural funds to promote and finance hospital investment strategies.
We will also host several pre-congress courses with faculty from medical schools (like Harvard Medical School), business schools (like IESE Business School), and other universities (Karolinska Institutet, Nova School of Business & Economics, University of Twente). We aim to bring together several stakeholders to promote new ways of seeing healthcare and hospital management. Most of all, from this congress we want to create a new agenda from all of these organisations that will be present, giving them an opportunity to take part in creating a European healthcare management agenda that will allow us to deliver a new way of providing better care in a changing Europe.