By Dr. Philippe Salphati, Managing Director and Partner at Tefen
I've recently met Dr. Michel Bodkier in his office at the 8th arrondissement of Paris, not far from Sanofi, another French giant of the life science industry.
During our conversation, Michel kindly shared his vision of the future of health as well as key drivers that would help recover a performing healthcare system, a system that would focus entirely on patient's outcomes improvement and increased efficiency. We have discussed these issues and their occurrence around the globe, and their occurrence in France alone.
Michel Bodkier co-founded, together with Jérôme Nouzarède, the company Elsan 20 years ago, a leading company in the management of private hospitals and clinics sector. Over the last 20 years Elsan has been growing until the recent acquisition of MédiPôle Partenaires, positioning Elsan as the undisputed leader in France. Today, Elsan has over 24,000 employees, 6,500 practitioners serving 2 million patients every year. Its annual consolidated sales are 2 Billion€ (post acquisition).
“Learning to collaborate and share information to better serve the patient”
It becomes very difficult for independent hospitals to grow and invest in the latest technologies, that could benefit both practitioners and patients. To continue offering excellence for patients, these independent organisations need to join their forces to achieve a critical size and build up investment capabilities. Consolidation of those activities become also essential to increase capacity to innovate and develop key medical capabilities.
For example, investing in sophisticated oncology treatments, diagnostic, personalised and predictive medicine will contribute to improve the patient’s outcomes and health care system efficiency. No matter what is the company's or organization's type, the ability to turn it into a center of excellence, to exchange information in real-time, is crucial for improving the quality of medical interventions and overall performance of healthcare systems, and as a result – improve the patient's outcome.
"Measuring performance and finding innovative ways of improvement"
Key performance indicators are defined at national level. In the US, for example, there are seven defined indicators:² Mortality, readmissions, safety of care, patients experience, effectiveness of care, timeliness of care, and efficient use of medical imaging. National indicators have been also defined in France.
The digital revolution and the technological development leads to the generation of a high volume and variety of data, contributing to improve the performance and quality of medical interventions nearly in real-time and benchmark them with “best practices”.
"Recovering an efficient and effective patient-centric health system focusing its resources on prevention, personalisation of care and effectiveness of interventions"
The French healthcare system has been ranked at the top of the WHO (World Health Organization) ranking (which includes 191 countries), for the last twenty years,³ building its reputation on its highly skilled medical teams. In fact, the public health system in France is offering patients a universal health coverage and access to all to the best available care.
However, according to the British observatory, Legatum Institute (Prosperity Index)⁴ and Bloomberg Health Care Efficiency Index,⁵ France has been respectively ranked 8th, 9th and 14th in 2012, 2014 and 2016.
Healthcare is an industry that is assessed against efficiency and customer satisfaction, like any other industry. Staying competitive in the healthcare industry means continuously improve patient service in terms of quality, innovation and experience, while lowering the cost of services.
Even if the French healthcare system is still considered among the best in the world, it must become more efficient. France has seen its pole position challenged by many other European countries, both in term of patient outcomes improvement and efficiency.
“Developing infrastructure, process and governance to enable sharing of medical data nationally and even internationally, always in the interest of the patient, may have a powerful impact”
All health systems should achieve two complementary objectives:
(1) Improve patient's outcomes
(2) Increase efficiency on each intervention all along the patient care pathway
Today, the challenge is not to generate data, but to share and process this data so that it'll be beneficial for patients and for the healthcare system. The digital revolution and technological advancement (e.g. Big Data, Artificial Intelligence) allow us to deal with massive volumes of data, to better understand each patient condition and personalize the treatment as much as possible.
Another use of data to improve patients' outcomes is by the patients themselves (mostly in the US), who engage actively in the management of their own health. The patients request to be better informed, and seek the best medical service to address their conditions (i.e. seeking for a second medical opinion). They also become more favourable to share their medical data.
A study recently published in the British Medical journal reported that “nearly 71% of the 5,000 users surveyed, allow their doctors to access their social media accounts such as Facebook, if it would help them manage their health”. The start-up company "Patients Know Best“, empowering patients to access their medical data and share them with family or healthcare professionals, confirms this trend. Patients, being more informed and health-conscious, want to take part in their doctors’ medical decisions. Isn’t it what the authorities have been trying to promote for more than two decades?
While this trend is gaining more popularity in the US, in France we observe this trend at a slower pace and with a more conservative approach and readiness level. Four reasons can explain the progressive adoption of data mining in the French health care system:
1. The Interoperability, or the ability to share data between institutions or across different services of the same organization
2. The types and quality of shared data (structured or unstructured, images and texts, etc.)
3. The use of this data in terms of system, skills, procedures and governance
4. The legislative arsenal which gradually adapts and aims on the one hand to guarantee the anonymization of patients' data, and on the other hand to understand and leverage the benefits of digital technology and artificial intelligence for patients and the health care system
The competitiveness of the French healthcare industry is a strategic objective for both patients and public health system. Ethical, technological and scientific stakes must be addressed, while continuing to stimulate, support and facilitate innovation, so it benefits the greatest number of patients, especially those suffering from severe diseases and for which the vital diagnosis is committed.
Data sharing, nationally but also internationally, throughout the course of health, is a key element of innovation that has the power to customize medical interventions. It goes without saying that the eventual sharing of the genome, decided by the patient, would be an additional element in the personalization of care.
Our ability to generate, interpret and share data, will pave the way for patient outcomes improvement or even for medical breakthrough, while increasing the health system efficiency and performance. The examples of these benefits are already numerous, and teach us that we must embrace the future!
² CMS, Center for Medicaid and Medicare services
³ WHO, measuring overall system performance in 191 countries, 2000
⁴-⁵ 2016-legatum-prosperity-index-pdf and Bloomberg Health-Care Efficiency Index, 2014
Digital Transformation, Business Design and Transformation, and Commercial Excellence expert in the Life Sciences sector