Exponential innovation, or getting ahead

Josep Maria Monguet

The sustainability of health services is associated with rational development. The key element is the generation of knowledge-intensive employment, which can only be the result of innovation.

In general terms, innovation in health must have an exponential dimension and be based on:

• The generation of intelligent demand by health professionals
• The participation of citizens and all social and economic agents
• The promotion of business models based on value for users

1. The health sector could soon be the most important source of employment

The United Nations Commission for Health Employment and Economic Growth states that the health sector will lead to the creation of jobs from 2020. It’s already the most active sector in job creation in the United States in 2018 (one in seven new jobs). According to the London Health Commission, in the city of London (8 million inhabitants) about 50,000 jobs linked to the deployment of e-health can be created. Similar studies and reports referring to OECD countries begin. I recommend taking a look at the list of jobs in health services performed by the Bureau of Labour Statistics of the United States, in which more than 40 types of health professionals appear (with the average of the corresponding salaries), this without counting the different possible jobs in the social and economic activity associated with health: engineers, mathematicians, chemists, designers, economists, managers, etc. The deficit in primary and preventive care and that of non-health workers stand out. For every two jobs of health professionals, there may be one job in the health sector for a non-health worker.

2. Generating sustainable employment opportunities will depend largely on the exponential innovation capacity

The majority of the demand for health services is dominated by chronic diseases of an ageing population and needs continued treatment and attention. This can be a nightmare or a whole reef of opportunities if it’s understood that it’s necessary to innovate and, even more, that one must innovate exponentially to offer more and better services with less relative costs. It’s the only way out. Why exponentially? The answer is very simple, knowledge - and everything in our environment - grows rapidly and in a globalized context.

3. To innovate in health, system professionals must be able to create intelligent demand

The process of reform begins when professionals in the sector dedicate their talent and experience to correctly define what is likely to improve. Let's call it smart demand. If problems and improvements can be well identified, solutions fall by their weight.

The health system looks like a sea of islands of scientific excellence with prepared and diligent islanders, but they hardly speak from one island to another. Rather than reorganize the system, it seems that we should start from scratch. Why are there few-year start-ups that outperform older companies? Because the new companies don’t drag any ballast, they are born lean and digital. Perhaps innovation could be the Trojan's strategy to transform the health system from within. Every time an innovation project is initiated in a health centre, after a very short time there is already an immovable principle that falters.

4. Patients have to be part of the equation

Maintaining and improving levels of well-being, both of people and groups, inexorably goes through understanding that health is a responsibility of every user and not only of the professional health sector. The commitment to health must be shared by all social agents and citizens, who have to be deeply concerned with their health.

We must be aware that the starting point is what it is. Up to 45% of health spending could be compromised by the cost derived from errors. If patients had to intervene in making the decisions that affect them, both professionals and patients would be forced to understand each other, just as professionals. This alone would already be a great advance, considering that most of the errors in diagnoses and treatments could be associated with communication deficits (1).

5. We must test and promote business models based on the creation of value for the patient

Talking about the economic dimension of health is taboo. The word business, for many, is synonymous with an attack on equity. They confuse who pays and who provides the service, and there is virtually no awareness of how the income or expenditure is structured. This vision, limiting in my opinion, is a consequence of several factors. On the one hand, the civil service culture and, on the other, also, considering health as a cost instead of understanding that it’s an investment. One of the most important returns of the investment in health - after the well-being of the users - is the creation of jobs that are intensive in knowledge and, therefore, sustainable.

We all have a part of the responsibility to explain it clearly and we can’t avoid it.

Bibliography

(1) Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., ... & Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice.