Explore with Herwig Ostermann, the need to ensure necessary changes for the sustainability of health systems regarding health workforce challenges.
Delving into the world of health workforce challenges, Ostermann, the Executive Director of the Austrian Public Health Institute and member of EHFG’s Advisory Committee, discusses the need to ensure necessary changes for health systems sustainability with regard to the health working force, here he gives special attention to the role of new technologies.
Turning to smart solutions
Mobile phone apps are nowadays indispensable tools for running one’s personal life – as well as the economy and society as a whole. In healthcare they are assuming a greater, sometimes even critical importance, as advances in treating illnesses are increasingly put under strain, even threatened, by growing health professional shortages.
The traditional face-to-face relationship between patient and doctor or nurse will always exist but is becoming increasingly reliant on digital solutions. In Africa, where some rural communities’ live miles from the nearest health centre or clinic, smartphones are vital. They enable patients to talk to real carers, pay health bills or download prescriptions and even detect fake drugs that are flooding the continent.
Here in Europe, healthcare systems are obviously far better endowed, but still face a variety of often bewildering and conflicting challenges: increasing demand, limited resources/budgets and demographic change. Policy makers are therefore being forced to turn to smart solutions in order to cope, new technology, including digital devices, being one of these solutions.
Time to avoid health workforce challenges
Here, the EU can and should play a key role in supporting the efforts being made by its member states to improve healthcare systems, scale up technically and modernise health infrastructure. Over the next five years, under the new leadership at Commission, Council and Parliament, health policy will almost certainly acquire a greater strategic importance. Ensuring the efficient uptake of technological solutions could be a key part in solving these critical challenges.
Put simply, healthcare demand is increasing as life expectancy grows. People are healthier and living longer but, equally, their age makes them susceptible to cancer and chronic conditions like diabetes and hypertension. This conundrum, added to impending healthcare staff shortages in the EU, challenges the ability of health systems to provide the right care in the right place.
We know from bodies such as the World Health Organization (WHO) that the global economy will create some 40 million new health jobs by 2030, mostly in middle and high-income countries. The world in total, nevertheless, will still be critically short of as many as 18 million health workers, mainly in low income countries. Even Europe, however, is not immune from such pressures.
The huge imbalance
The WHO estimates that while the number of physicians and nurses has increased by 10% in the past decade, there are still huge imbalances, even amongst EU member states (OECD, 2017): Some countries enjoy up to three times as many doctors as others. When it comes to nurses, shortages can be even more acute, with some member states having four times as many as their European counterparts. Meanwhile, physicians are ageing, with one in three over 55, and becoming more and more specialised.
Systematic efforts are therefore required to make medical professions more attractive. Going beyond that, solutions should also be sought – and found – in raising the efficiency of health service provision by taking advantage of the increasing array of technological tools available.
As in other sectors, such as transport or commerce, healthcare should leverage the opportunities that technological innovation provides. For example, solutions like telemedicine are capable of relieving the load from healthcare centres. Clinicians can chat with patients, virtually monitor their symptoms and even provide a diagnosis in the case of some diseases. All of this without requiring the physical presence of the patient.
Health insurance funds, health service authorities and also pharmaceutical companies have taken this approach on board and have integrated technology with specially designed smartphone applications for patients suffering from chronic diseases such as diabetes. This digital e-health roll-out could revolutionise healthcare and give patients a more holistic experience while promoting patient empowerment and better self-management of the disease.
In this context, the European Commission is building an eHealth Digital Service Infrastructure which will allow e-prescriptions and patient summaries to be exchanged between healthcare providers. Privacy and data protection are essential to ensure sustainability of these developments.
Moreover, automation of routine tasks by using robots, such as prescription dosing and medicines delivery, leaves more time for workers to focus on higher-level management tasks.
Implementing digital innovation does not mean losing the human element
Some might fear that these disruptive technologies may simply replace humans and the person-to-person touch so vital in healthcare to ensure patient trust and personalised care. I would argue the contrary: implementing digital innovation does not mean losing the human element. In fact, technologies can improve humans’ work by reducing paperwork, thereby giving professionals more time with patients.
Pursuing these goals requires practical solutions. This is why I am pleased that the European Health Forum Gastein (EHFG) highlighted this issue at its event in Vienna entitled ‘Wake-up call for education: future health professions’. Participants discussed the opportunities that technology provides in meeting the evolving challenges, needs, and opportunities of Europe’s workforce and addressed the issue of how to increase the attractiveness of medical professions. Moreover, this year’s Forum ‘EHFG 2019: A healthy dose of disruption? Transformative change for health and societal well-being’ will include a plenary session on the disruptive nature of digital transformation – and how to prevent us from losing the human element along the way.
2019 is the year when policymakers should propel this issue to the top of the European agenda. Gathering over 500 European health policy experts from the realms of policymaking, research, civil society and business, the EHFG 2019 (2-4 October 2019 – Bad Hofgastein, Austria) is the go-to place to debate this increasingly critical issue. Let’s hope the new heads of the EU institutions are awake and listening.
For more information about the EHFG event in Vienna, click here.
About the author
Herwig Ostermann is Executive Director of the Austrian Public Health Institute (Gesundheit Österreich GmbH, GÖG), Associate Professor (part-time) at the Department for Public Health and Health Technology Assessment at the University for Health Sciences, Medical Informatics and Technology in Hall/Tyrol, Austria (UMIT) and a Member of the Advisory Committee of the European Health Forum Gastein.
Austrian Public Health Institute