Opinionated – Simply does it

By - World Healthcare Journal

Opinionated - Simply does it

In his regular column, Opinionated, WHJ Publishing Director Steve Gardner reflects on some of the major issues facing the international healthcare sector. In this issue, are big ambitious projects possible? Or even deliverable?


When you think about it, the challenge of providing universal healthcare is a self-perpetuating one. As technology and medicine continues to advance we all live longer, and as population growth continues the challenge is exacerbated still further.


Average life expectancy across the globe has increased by 26 years since 1950, meaning there are another 874m lifetimes of healthcare to provide for. Add that to a ten year growth rate of 10.7% in birthrates and there is a huge problem if we are to come close to hitting the UN sustainable development goal of Universal Health Coverage by 2030. Indeed, the WHO estimates that there are currently some 3.5bn people across the globe without access to even the most basic of healthcare.


The need for big solutions?


Last month I chaired a fascinating panel discussion at Clyde & Co’s offices in London on the rise and importance of digital health. It’s a massively important area as, with a workforce crisis looming and the increase in life expectancy across the globe, the answers to our future capacity problems in global healthcare simply have to be digitally based.


But what really fascinated me about this discussion, and many others I have been involved with, is our natural tendency to try and match these big problems with equally big solutions.


As we’ve shown many times here in the UK, system-wide change is a big, unwieldy, expensive and difficult thing to effect. The more complex and far-reaching the solution, the harder it is to implement. Whether it’s a digital ecosystem and infrastructure that universalises patient records, or a systemic change to create an integrated care system, It will require multiple suppliers, providers and stakeholders to work in harmony to deliver a solution.


Look at any major healthcare multi-stakeholder project and it will be clear how hard it is to achieve workable solutions. There will be mistakes and missteps, the law of unintended consequence will come to bear and there will inevitably be disputes, overruns; and shifts in political and public perception and increased cost.


Equally, from a simple commercial perspective (and I am a simple, commercial individual), proposing and winning a large, complex contract is only for very brave, large organisations with deep pockets. Whether we’re talking about the business development time or the time required for procurement and delivery, the cash flow risk to any business increases proportionally to the size, value and complexity of the project.


Starting small


Now I am not arguing that big, visionary, system-wide solutions are impossible, or that they are unnecessary. However, having spent a significant proportion of the last few years helping to export healthcare solutions around the globe in everything from digital to infrastructure to regulation, one thing I have learned is the need to start small, or at the very least, small-ish.


The propositions that work and the ideas that have legs address specific and targeted problems. Despite The overall ambition that a vendor is looking to supply maybe a game-changing, massive project which will influence the healthcare of millions, it’s vital to begin with a smaller, more manageable project which not only allows the customer to purchase success, but also creates trust and confidence for both parties. From These beginnings projects and partnerships can grow to successfully deliver the ambition.


Large projects and broader change takes a whole series of smaller interlocking steps and real change can only be effected incrementally.


Going back to the various debates I’ve been privileged to be part of, it’s great to hear the big idea and the big dreams, but if we’re to put any of them into practice we need to think of what that first, discreet step will be.


Digital health covers a wide spectrum of technologies, applications and intervention from personal apps providing access and supporting self-management of chronic conditions to clinical decision support, from electronic records to anonymised clinical datasets. All have tremendous potential to contribute to sustainable universal healthcare. But it is most unlikely to be in one single step and far more likely to be multiple small steps.


Simply put, don’t sell me a dinner I can’t consume in a single sitting, but do pass the mustard!


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