The Gastein Health Outcomes
The 16th edition of the European Health Forum Gastein (EHFG) held under the main title of “Resilient and Innovative Health Systems for Europe” in the Gastein Valley from 2nd to 4th October 2013, explored the relationship between austerity policies and necessary innovations in health care systems in order to keep them resilient, and looked for answers to the following questions:
1. What are the key strategies to make health systems resilient?
2. What are the most important innovations to promote health system performance and resilience?
3. How can decision-makers best introduce and implement these innovations?
Key strategies to make health systems resilient are policies, prevention and governance. There seemed to be a general consensus that consistent and sustainable policies were needed to make health systems more resilient. Furthermore, a need for a renewed commitment to health in all policies was called for. Another prominent outcome was a call for a good balance between regulations and patient involvement with the aim of putting patients at the centre of care and using patient centred outcomes as the basis for evaluating health care performance.
Regarding prevention, the objective is a sustainable model of prevention not only inside the health sector but cross-sectorally to promote sustainable change.
Governance as a key dimension in creating resilient health systems was a recurring theme. Economic governance calls for health system reforms that ensure cost effectiveness and sustainability and assess performance for the best use of public resources, while keeping them transparent and ensuring accessibility and solidarity. A need for “tailormade” governance structures was expressed in a session where conceptual dimensions of governance, such as transparency and participation, were stressed as the foundation for the decision-making of health policy makers.
As the Greek Minister of Health, Adonis Georgiades said during the EHFG “This is not a crisis, this is the new reality”.
Concerning the most important innovations needed for resilient health systems, three pillars of innovation were identified: governance, technological and social innovations.
Regarding the first pillar of governance, a need to remove barriers between sectors was expressed whereby the crisis could also be seen as a window of opportunity to translate Health in All Policies into practice. This could include measures implemented jointly with other sectors that have a decisive impact on health like education, environment or employment. In addition, we should enhance the use of evidence for decision-making in policy and not forget about the potential benefits of task shifts and skill mixes. This seems to be important especially when strengthening primary care services.
Innovations in information technology ideally supply real time and more accessible data in order to be able to implement strategies earlier. A need to discuss and assess the impact of these new technologies was called for and iinnovative approaches were discussed in several sessions during the EHFG 2013, for example during a parallel forum session on mHealth and a workshop on big data. Furthermore, Health Technology Assessment should not only be performed once for new technologies but be repeated over time – especially in times of financial constraint.
Social innovations should work towards breaking down the barriers mentioned above, such as barriers between health professionals in order to rethink working routines in the health sector. We should also look into innovations that give us more empowerment and support patients during times of crisis. Innovations related to behaviour changes are the most challenging though crucial ones to implement, as we also need resilient people in order to introduce resilient innovation.
Patients, care, technology, assessment and involvement were the terms mentioned most frequently by the EHFG 2013 participants in response to the question of the most important innovations.
What advice should we give to policy makers regarding the implementation of these innovations? It appears vital that the three pillars do not work independently from each other. For technological innovation to support sustainable and resilient healthcare systems for Europe, governance reforms and social innovations are needed.
What was noted as being essential was the basic willingness to embrace change and a continuous demonstration of improvements. Keywords which were mentioned prominently in this context: education, support, evidence, reform, leadership and change. We need leadership to implement the ‘old and new’ measures to redefine the way we look at health including the patient, the health professional, and the population as a whole. And we need an agenda to communicate the value of the reform sustained by information and good evidence, so that we can have a different approach to change.
Watch the EHFG 2013 Movie.
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