[Obesity Discussion]

To create a sustainable health system, what are the common characteristics? PricewaterhouseCoopers study identifies seven key features of sustainable systems, whether they be governments, networks of affiliated health-related organizations, or individual organizations:
1. Quest for Common Ground: A vision and strategy is needed to balance public versus private interests in building an infrastructure and in providing basic health benefits within the context of societal priorities.
2. A Digital Backbone: Better use of technology and interoperable electronic networks accelerate integration, standardization, and knowledge transfer of administrative and clinical information.
3. Incentive Realignment: Incentive systems ensure and manage access to care while supporting accountability and responsibility for healthcare decisions.
4. Quality and Safety Standardization: Defined and enforced clinical standards
establish mechanisms for accountability and enhanced transparency, thereby building consumer trust.
5. Strategic Resource Deployment: Resource allocation appropriately satisfies competing demands on systems to control costs while providing sufficient access to care for the most people.
6. Climate of Innovation: Innovation, technology and process changes are a means to continuously improve treatment, efficiency and outcomes.
7. Adaptable Delivery Roles and Structures: Flexible care settings and expanded clinical roles provide avenues for care that are centered on the needs of the patient.
How, specifically, are various health systems addressing the need for sustainability? Some solutions will require far-reaching changes in national policy. Policy solutions can be influenced but are not made by the managers of healthcare organizations. Other areas over which management has some ability to effect change are plentiful and are driving solutions. By looking at these solution drivers, health leaders can begin to formulate responses to the major challenges facing their health systems.
Transferable lessons are emerging. The range of potential solutions that are emerging from health systems across the globe is depicted throughout the body of this report. They involve changes to systems, policies and structures. New financing incentives and models. Modifications to peoples roles, skills and attitudes. Altered processes and workflows. Discoveries of new technologies and new uses of old devices.
Across boundaries, languages and cultures, these are the strategies being employed by health systems across the world. The solutions are out there. In the global market of health.
Conclusion
Threatened sustainability and convergence. At the broadest level, these are the issues facing health systems across the globe.
Transferable lessons are emerging. The variety is astounding yet so are the commonalities. Around the world and across all sectors of the industry, healthcare leaders are exploring many of the same solutions:
Collaboration. Payers, hospitals, physicians, and community service organizations are working together to foster standardization and adoption of technology and process changes. They are teaming to enhance access and portability of healthcare services. They are coming together to realign incentives to accomplish mutual goals.
Consumerism. Providers are reorganizing themselves in a patient-centric continuum through care management approaches. Payers are developing consumer-oriented benefits plans. Pharmaceutical and life sciences companies are using new pharmacogenomic discoveries to pursue personalized medicine.
Technology assessment and dissemination. Payers, providers and community organizations are coming together on a regional and/or national basis to establish infrastructure and communications standards. They are developing incentives that will distribute the risks and rewards more evenly. Payers and research organizations are evaluating technology relative to productivity and lifespan.
Transparency. New payment and reporting methods are emphasizing safety, performance and accountability for health organizations across all industry sectors. Payers and providers are participating in pay-for-performance programs. Industry trade groups are establishing quality and safety standards. Governments are establishing reporting mechanisms and requirements.
Portfolio management. Hospitals, pharmaceutical companies, life science organizations, and payers are increasingly called upon to manage their service portfolios in a balanced, fiscally responsible manner. Governments are calling for rational approaches to regional service planning. Providers are organizing and allocating services to meet consumers needs for access, manage quality of care, and reduce duplication and inefficiency.
Manpower management. New models of developing, recruiting and retaining manpower are developing to address the root causes of gaps in service and impending future needs.
The following table summarizes the solution drivers for change.
Solution Drivers for Change
Solution DriverDescriptionTransferable Lessons
SystemIndustry standards and government regulations are the solutions over which individual organizations have the least direct influence. However, healthcare organizations must devote some resources and participate in national policy debates in order to create a more sustainable health system.
1. Collaborate across traditional sectors and territory boundaries
2. Determine what care or benefits are basic to public health and structure an insurance system for the rest
3. Use regulation to encourage and strengthen competition
4. Organise care from the patients point of view: establish a patient-centric continuum of care
5. Think small
6. Anticipate ways to deliver care to patients who increasingly move and travel
FinanceOrganizations must concentrate on improving their financial position in order to meet global challenges. These solutions will be based in both revenue and expense areas, as well as knowing when and how to make investments.
1. Make consumers more personally responsible for the cost of seeking care
2. Put prices on the menu; disclose charges
3. Learn from existing systems when designing performance-based reimbursement
4. Incentivize clinicians for outcomes, not activity, through pay-for-performance models
5. Design financial incentives to anticipate cream-skimming
6. Access new sources of capital through public-private partnerships
PeopleUltimately, healthcare is delivered by people for people. The capacity for staff to accept and embrace change will make or break solutions because people are the implementers. Organizations that can help their people manage change will be at an advantage in the global health system.
1. Establish shared incentives to accomplish mutual goals
2. Make wellness the preferred, if not mandated, lifestyle
3. Train workers in new technologies
4. Leverage nursing more widely
5. Challenge conventional training models to create new resources and roles that meet future needs
ProcessProcess redesign to increase efficiency and efficacy will be a required competency in the fast changing healthcare environment. Exploiting new technologies, clinical developments and globalization will require process change for organizations to be efficient and nimble.
1. Reinforce clinicians roles as facilitators of appropriate care
2. Reach agreement on quality standards
3. Make error reporting voluntary and anonymous
4. Publish or perish: report performance to enhance transparency and knowledge sharing
5. Leverage quality to move the market
6. Listen to consumers
TechnologyNew medical technologies and new ways to capture and use medical data are just a few examples of how technology can make health systems better. Health organizations will need to choose wisely within limited budgets when it comes to how and what technology they buy.
1. Invest in a shared IT infrastructure
2. Leverage technology to eliminate duplication and administrative inefficiencies
3. Make technology a reason to collaborate
4. Move information, not people
5. Customize care to patients genetic needs
6. Value technologys impact on productivity and lifespan
About PricewaterhouseCoopers
PricewaterhouseCoopers Healthcare practice is one of the leading healthcare professional services organizations, providing assurance, tax, advisory and consulting services to this highly integrated sector. The firm works with organizations that represent the healthcare delivery spectrum: integrated delivery systems, hospitals, physician organizations, payer and managed care organizations, pharmaceutical and health science companies, ministries of health, government and other policymakers, professional associations, and investors. Visit PwC on the Web at PricewaterhouseCoopers HealthCare.
PricewaterhouseCoopers (PricewaterhouseCoopers) provides industry-focused assurance, tax and advisory services for public and private clients. More th clients and their stakeholders.
Health Research Institute
PricewaterhouseCoopers Health Research Institute provides new intelligence, perspective and analysis on trends affecting all health-related industries, including healthcare providers, pharmaceuticals, health and life sciences, and payers. The Institute helps executive decision makers and stakeholders navigate change through a process of fact-based research and collaborative exchange that draws on a network of more than 4,000 professionals with day-to-day experience in the health industries. The Institute is part of PricewaterhouseCoopers larger initiative for the health-related industries that brings together expertise and allows collaboration across all sectors in the health continuum.

©2005. PricewaterhouseCoopers LLP. All rights reserved. PricewaterhouseCoopers refers to PricewaterhouseCoopers LLP (a Delaware limited liability partnership) or, as the context requires, other member firms of PricewaterhouseCoopers International Limited, each of which is a separate and independent legal entity. *connectedthinking is a trademark of PricewaterhouseCoopers LLP, HealthCast is a service mark of PricewaterhouseCoopers LLP.