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1、Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and HealthcareI N S I G H T R E P O R TJ A N U A R Y 2 0 2 3In collaboration with L.E.K.ConsultingContentsImages:Getty Images,Unsplash 2022 World Economic Forum.All rights reserved.No part of this publication may be reproduc
2、ed or transmitted in any form or by any means,including photocopying and recording,or by any information storage and retrieval system.Disclaimer This document is published by the World Economic Forum as a contribution to a project,insight area or interaction.The findings,interpretations and conclusi
3、ons expressed herein are a result of a collaborative process facilitated and endorsed by the World Economic Forum but whose results do not necessarily represent the views of the World Economic Forum,nor the entirety of its Members,Partners or other stakeholders.ForewordExecutive summaryIntroduction:
4、What is the status quo in health and healthcare?1 What is the vision for health and healthcare by 2035?2 What are the key issues and barriers to face?3 What are the solutions to address these issues?ConclusionAppendix Contributors Endnotes34592Global Health and Healthcare Strategic Outloo
5、k:Shaping the Future of Health and Healthcare2ForewordThe COVID-19 pandemic brought about health,economic,political and environmental challenges and exposed global disparities caused by income,age,race,sex and geography,but it also allowed for innovation in science and medicines development,distribu
6、tion and delivery.We have now reached a time for reflection and have the opportunity to embed any positive changes from the pandemic response as part of our global health and healthcare systems moving forward.Global health and healthcare will face important challenges in the future.In the near-term,
7、worsening mental health,healthcare workforce shortages,supply chain issues,climate change related challenges and macroeconomic instability.In the longer-term,growing demand for services and an increasing funding gap,lack of incentives for innovation,widening disparities in overall health and wellnes
8、s and variable access to advanced therapies.This joint strategic outlook by the World Economic Forum and L.E.K.Consulting aims to unite stakeholders across different sectors,industries and geographies to a shared vision for health and healthcare by 2035.The vision is based on four strategic pillars
9、of equitable access and outcomes,healthcare systems transformation,technology and innovation,and environmental sustainability,with equity as the foundational goal.For each of these strategic pillars,the outlook pre-empts potential barriers public and private stakeholders may face and demonstrates wa
10、ys to mitigate these through case studies from across the world.The case studies highlight the importance of collaboration in fostering long-term change that is replicable and scalable.This strategic outlook is important as it aligns stakeholders towards a shared vision,but also identifies near-term
11、 goals and actions to motivate systemic,long-term system change from now.Investment through this lens,can ensure equality,resilience,innovation and sustainability are embedded as key pillars of health and healthcare in the future.Shyam Bishen Head,Shaping the Future of Health and Healthcare,World Ec
12、onomic ForumPierre Jacquet Vice-Chairman,Global Healthcare Practice,L.E.K.ConsultingGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and HealthcareJanuary 2023Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare3Executive summaryIn the
13、 face of a challenging past few years,the world went off track on health related Sustainable Development Goals.Unprecedented disruptions caused by the COVID-19 pandemic,followed by social,economic,geopolitical and environmental challenges,continue to place complex and interconnected threats on popul
14、ation health,especially impacting vulnerable populations,and increased strains on healthcare systems,particularly healthcare workers and supply of essential health products.It is important to ensure stakeholders,industries,countries,and sectors strive to achieve common health and healthcare goals an
15、d work collaboratively to do so.This strategic outlook lays out a vision for health and healthcare in 2035,formed of four main strategic pillars with equity as the foundational goal.Equitable access and outcomes:Equilibrating access to determinants of health,ensuring health data is representative of
16、 the population and people with equal needs achieve equal health outcomes.Healthcare system transformation:Structuring resilient healthcare systems to provide high-quality care under both expected and unexpected circumstances.Technology and innovation:Cultivating an environment that supports funding
17、,use and implementation of innovation in science and medicine.Environmental sustainability:Reducing the healthcare industrys environmental impact,preparing for and addressing climate change for better health and wellness.For each of the strategic pillars,time horizons to demonstrate near-,medium-and
18、 long-term impact are identified.While striving to achieve each of these strategic pillars,public and private stakeholders will encounter several barriers.To understand the impact of each of these barriers and the solutions deployed to solve them,eight case studies were examined globally.While each
19、case study is nuanced in the barriers it faced,important themes emerged.Concerns around widening global health disparities are prominent.The rate of innovation deployed in the health and healthcare industry is limited by the slow pace of regulatory change.Although shifting,greater collaboration is n
20、eeded to change the status quo from isolated to collaborative working based on common aims that deliver outcomes that are greater than the sum of its parts.None of this collaboration will yield long-term impact unless change is driven at the system level,for which there is currently limited support,
21、incentive or monitoring.The strategic outlook identified a range of levers available to public and private stakeholders to diminish the barriers at play across healthcare systems.Cross-industry collaboration Digitalization,artificial intelligence and big data Global collaboration Policy and advocacy
22、 Public-private partnerships Innovative funding models Patient empowerment Targeted/selective decentralization The vision for health and healthcare in 2035 is ambitious yet achievable.To get there,stakeholders across sectors,industries and geographies need to build on the existing traction and colle
23、ctively lead across their organizations to catalyse long-term change at the system level.Near-term barriers,such as worsening mental health,healthcare workforce shortages,supply chain issues,climate and macroeconomic instability,should be addressed in the context of the longer-term vision.Public and
24、 private stakeholders,alone and in partnership,each have their role to play in shaping health and healthcare systems in 2035 that are equitable,resilient,innovative and sustainable.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare4Introduction:What is the sta
25、tus quo in health and healthcare?The pandemic,geopolitical conflicts,the climate and energy crisis have all detrimentally impacted health and healthcare globally.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare5In late 2019,the Wuhan Municipal Health Commiss
26、ion reported an increase in incidences of pneumonia-like cases with unknown cause.By the end of January 2020,the virus had spread to multiple countries around the world,totalling just under 10,000 cases.A year later,following the fastest vaccine development in history,the first vaccine against Coron
27、avirus disease(COVID-19)received emergency authorization.While COVID-19 triggered growth and innovation in health and healthcare,it also brought about significant health,economic,political and environmental challenges.Within this timeframe,the global healthcare sector experienced unprecedented growt
28、h;overall healthcare spend is expected to reach$12 trillion in 2022,up from$8.5 trillion in 2018.1 Healthcare investments reached record highs in total funding in 2021 with a surge in venture investment and fundraising.A record$23.1 billion was raised by 128 therapeutic-focused biopharma companies t
29、hat went public globally in the areas of innovative therapies namely gene,cell/immunotherapy and tissue engineering.2,3 Following the launch of mRNA-based vaccines,applications in Zika,malaria and seasonal diseases such as influenza are growing,as well as beyond infectious diseases,with a number of
30、cancer vaccines in clinical stages of development.4 Precision medicine continues to grow with biomarker strategies for screening,diagnosis and treatment selection and response monitoring becoming increasingly critical components of drug launches.This is supported by advancements in liquid biopsies,w
31、ith the first tests approved by the United States Food and Drug Administration(US FDA)in 2020 for early pan-cancer detection(Guardant360 CDx and FoundationOne Liquid CDx).Biomarkers are poised to expand into applications beyond oncology,particularly neurologic,immunologic and cardiovascular diseases
32、.Digital investments nearly doubled to$57 billion in 2021,particularly in telehealth and mental health.5 The number of digital health start-ups is increasing,with expansion from tech companies into healthcare(e.g.Amazon),putting pressure on the market.6 With a significant pace of change and digital
33、leaders outperforming laggards in revenue,continued digital innovation is expected.Data aggregation technologies in clinical and commercial settings are maturing with a growing collection of companies providing solutions and enabling pharma to gain better insights.People want on-demand healthcare.We
34、 want greater accessibility to real-time answers.COVID has been the tipping point for the demand for telehealth.We are receiving feedback from physicians that they are building better relationships with patients through telehealth and we are seeing greater uptick in usage by older adults.Jisella Vea
35、th Dolan,Chief Global Advocacy Officer,Honor+Home InsteadThere is increasing recognition that treating patients in lower-acuity settings,such as the home,is less costly.Total home health expenditure growth is expected to outpace total healthcare expenditure growth in nearly all other healthcare segm
36、ents,with increasing focus on home diagnostics,home-administered drug delivery systems and patient monitoring devices.7 Increasing decentralization of healthcare is also aligned with increasing patient centricity,as patients demand greater convenience and medical privacy,as well as value-based care.
37、Artificial intelligence(AI)applications are now targeting many aspects of healthcare,including diagnosis,clinical decision support,disease prevention,monitoring and treatment,patient adherence and self-management and workflow solutions.There is increasing focus on developing regulatory frameworks an
38、d guidelines for the clinical application of AI and its usability.8 The first FDA approval for AI-assisted medical imaging was in 2017,but several other approaches in different areas have been approved since.In AI-assisted drug development and design,all of the largest ten pharmaceutical companies(b
39、y revenue)have either partnered with or acquired AI companies to make use of this capability or are listing a significant number of AI jobs to build this capability internally.9,10Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare6In addition,advances in AI,au
40、gmented reality,virtual reality and improved connectivity allow the emergence of the metaverse.The metaverse can be a platform for several potential applications in healthcare,such as the delivery of telemedicine in a more immersive and interactive environment that can track the patients response to
41、 treatment or the formation of digital twins that can create a simulation using real-world data that can virtually model how the patient responds to a given procedure.11 There are already metaverses that exist,such as the virtual real estate platform Decentraland and digital gaming platforms like Th
42、e Sandbox.Companies are investing more in this space;Microsoft is developing Mesh.A survey of 391 healthcare executives showed that around half believe the metaverse will have a breakthrough or transformational impact in the future,while the rest believe it will be minimal or incremental.12While the
43、re were developments in technology and innovation,the resilience of healthcare systems was tested during the pandemic affecting access to healthcare.The COVID-19 pandemic exposed disparities in global essential healthcare coverage,impacting women,children and adolescents the hardest with a 25%drop i
44、n coverage of essential health interventions.13 A pulse survey by the World Health Organization(WHO)in August 2020 showed that nearly 90%of countries surveyed reported some form of disruption to health services and the greatest disruptions were being reported in low-and middle-income countries(LMICs
45、).14 Supply chain delays and high customer demand during the pandemic resulted in significant disruptions.The impact of this went beyond the healthcare industry and was exacerbated by the global semiconductor chip shortage and blockage of the Suez Canal by a cargo ship in March 2021 for six days res
46、ulting in shipment delays of around$60 billion worth of products.Misinformation,mistrust and political divide continued to be present,with the US Capitol riots in early 2021,the release of the Facebook Files and“partygate”in the United Kingdom.Misinformation and mistrust impaired vaccine efforts and
47、 resulted in multiple protests against vaccines,restrictions and lockdowns.Mental health issues were prevalent throughout the pandemic due to isolation,redundancies,job losses and uncertainty across the population.Pressures on healthcare systems affected the mental health of healthcare workers acros
48、s the globe,leading to significant burnout.Nearly 90%of countries surveyed reported some form of disruption to health services and the greatest disruptions were being reported in low-and middle-income countries.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcar
49、e7Recent trends in global health and healthcare while COVID-19 triggered growth,it also brought about health,economic,political and environmental challengesFIGURE 1Surge in healthcare spend and investmentScientific advancementsDigital innovation,AI and connectivity Alternative care modelsWidening gl
50、obal health disparities Global health and healthcareHealthcare workershortages and burnoutWorsening mental health and well-beingMacro-economic issues(e.g.rising inflation,climate,energy crisis,politics)Source:L.E.K.Consulting;World Economic Forum Beyond the pandemic,major conflicts,such as the Talib
51、an takeover of Afghanistan and Russias invasion of Ukraine,resulted in significant loss of life,impact on health and well-being,human rights violations and broader economic and supply disruptions across the world.The risk of geopolitical divide(e.g.between the US/West and China)may restrict access t
52、o medicines,disrupt supply chains and limit the ability of national health systems to respond to global health problems requiring cooperation and collaboration,for example,anti-microbial resistance(AMR)and the threat of future pandemics.Macroeconomic issues,such as the energy crisis and rising infla
53、tion,continue to affect individuals standard of living,thereby impacting their physical and mental health.In addition,government regulations to reduce inflation are expected to affect the pharmaceutical industry.For example,the Inflation Reduction Act,which empowers the federal government to negotia
54、te prices for some drugs purchased by the Center of Medicare and Medicaid Services,can impact how pharmaceuticals are researched,developed and commercialized.15The climate crisis has continued to have an increasing global impact.In July 2021,the Dixie fire became Californias largest single wildfire
55、in recorded history and was only extinguished in October of the same year.The effects of the climate crisis continued in 2022 with heatwaves across the globe including the US,Europe,China and India,wildfires,and floods in South Africa and Asia,particularly in Pakistan where over a third of the count
56、ry was submerged.These events highlight the global inequities that exist in health and healthcare and the fragility of healthcare systems under the pressure of pandemics,conflicts,economic uncertainty and the climate crisis.In order to benefit equitably from technology and innovation in the healthca
57、re industry,these issues need to be proactively addressed.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare8What is the vision for health and healthcare in 2035?1To achieve equity,transform healthcare systems,encourage innovation and secure global environment
58、al sustainability,with equity as the foundation.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare9The strategic outlook sets out a vision for health and healthcare in 2035.A 2035 outlook allows for sufficient time to respond in the context of other key global
59、 targets,such as the 2030 Agenda for Sustainable Development16 and 2030 nationally determined contributions(NDCs)as part of the Paris Agreement and provides opportunity to implement change to health and healthcare at the system level.The vision for health and healthcare in 2035 is formed of four mai
60、n strategic pillars,with equity as the foundational goalFIGURE 2Equitable access and outcomes Ensuring equal representation,access and outcomes for all Healthcare systems transformationStructuring resilient healthcare systems to provide high-quality careTechnology and innovationCultivating an enviro
61、nment to support innovation in science and medicineEnvironmental sustainabilityReducing impact on the environment,preparing for,addressing climate changeEquity as the foundational goal for all changeHealth is a product of social determinants,including where one lives and works,and health and healthc
62、are inequity continues to be a pressing issue.17 While decentralization is relieving pressure off hospitals and allowing increased access to care,there are still geographic and demographic disparities in access to not only healthcare but high-quality healthcare.The WHO has reported that over half of
63、 the worlds population lacks access to the basic health services they need.18 Customer empowerment and ownership of health through digitalization and healthcare at home are not yet universally accessible and may exacerbate existing disparities.The pandemic had disproportionate impact on certain popu
64、lations,highlighting inequities.For example,the reduction of essential maternal and child health interventions may have caused more than a million additional child deaths.19 One in seven people in LMICs is fully vaccinated for COVID-19.By comparison nearly three in four people in high-income countri
65、es(HICs)have been vaccinated for around a year.20 Beyond the pandemic,only 4%of research and development(R&D)budgets are focused on womens health and there are limitations in the availability of clinical data on women,as those of reproductive age were historically excluded from clinical trials.In ad
66、dition,multiple studies found that in many areas of healthcare,women experience poorer outcomes than men,such as in dementia care and management of acute pain.21 The goal is to have equitable access to determinants of health,ensuring health data is representative of the population and ensuring peopl
67、e with equal needs achieve equal health outcomes.Among European Union(EU)countries,deaths and losses due to ill health account for 20%of the total costs of healthcare and 15%of total costs of social security benefits.Losses due to reduced labour productivity costs are around 1.4%of annual gross dome
68、stic product(GDP).22 Eliminating health inequity is estimated to equal a projected$350 billion return to society.23 Equitable access and outcomes in health and healthcareSource:L.E.K.Consulting;World Economic Forum Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healt
69、hcare10Addressing health inequity is not just a societal goal but there is business incentive for employers to play a more proactive role in investing in their employees health.Employers share the burden of chronic diseases and health inequities that drive many chronic conditions,such as obesity and
70、 diabetes.This generates costs for employers such as greater healthcare expenses,absences,medical appointments and reduction in productivity.Companies that provide wellness programmes and benefits packages have been shown to help narrow the health disparities gap,particularly those focused on vulner
71、able populations.Contributing to creating a more equitable society is beneficial for company exposure and culture.Businesses have a powerful voice and can advocate for policies that can meaningfully improve the health of communities,employees and families.The long-term goal is to provide access to u
72、niversal health coverage(UHC)globally.WHO defines UHC as all people receiving the health services they need,including health initiatives designed to promote better health,prevent illness and provide treatment,rehabilitation and palliative care of sufficient quality to be effective while at the same
73、time ensuring that the use of these services does not expose the user to financial hardship.24 Research indicates that while private financing can play a role in UHC,the onus is on public funding and allocation of general government revenues to ensure coverage of the population not in salaried emplo
74、yment and drive improvements in health system performance.25,26 Value-based agreements can be incorporated into this model to share accountability across more stakeholders and incentivize providers,insurers,pharmaceutical companies and physicians to focus on outcomes.Time horizons to demonstrate imp
75、act in the 2035 outlook:BOX 1Near-term:Continue investment in decentralization and alternative care models(e.g.home care)to help improve access to essential health and healthcare systems globally.Medium-term:Incorporate more equal representation in clinical trials to improve the evidence base for de
76、cision-making and unlock understanding of different diseases and appropriate treatment across different regions.Longer-term:Make disproportionate investment in health and healthcare services in LMICs to narrow the global health disparity gap.Businesses have a powerful voice and can advocate for poli
77、cies that can meaningfully improve the health of communities,employees and families.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare11While COVID-19 put significant pressure on healthcare systems and demonstrated the importance of resilience,this was not an
78、isolated incident and will not be the only health crisis likely to be faced.During the 2014 Ebola outbreak in West Africa,disruptions to malaria,human immunodeficiencyvirus/acquired immune deficiency syndrome(HIV/AIDS)and tuberculosis treatment had a detrimental indirect impact on mortality rates.In
79、 Guinea,more additional deaths occurred from disrupted malaria treatments than from Ebola itself.33 An estimated 20 to 40 countries experience significant new disease outbreaks each year,34 and the WHO names AMR as one of the top ten public health threats globally.35 Unexpected pressures on healthca
80、re systems are not restricted to pandemics but also economic crises or effects of climate change.Beyond pandemic situations,ageing populations and the high prevalence of chronic conditions and non-communicable diseases(NCDs)require forward planning.Deaths from NCDs,such as cardiovascular,cancer and
81、respiratory diseases,and diabetes,now exceed all communicable disease deaths combined.They account for 41 million global deaths every year,which is 71%of global deaths overall.Of the 41 million deaths,29 million occur in LMICs.36 However,health system services for prevention,education,screening and
82、treatment of NCDs remain inaccessible to billions of people living in rural regions in LMICs.On average,in the EU,public and private expenditure on preventive care accounted for 2.8%of total health expenditure in 2018,with the highest shares recorded in Italy(4.4%)and Finland(4.0%)and lowest in Slov
83、akia(0.8%).37 In addition to increasing investment in prevention,there is a need to focus on the preservation of health once individuals are diagnosed with a condition to reduce the impact on health systems.The goal,therefore,is healthcare systems transformation to provide high-quality care under bo
84、th expected and unexpected circumstances,such as pandemics,geopolitical crises,supply chain bottlenecks and inflation,and to minimize the negative consequences of these disruptions.Investment in healthcare system transformation can protect economies from destabilising shocks,such as economic disrupt
85、ion,unemployment and redundancies,and protect people from premature death.Healthcare systems transformationThe COVID-19 pandemic demonstrated the importance of resilient healthcare systems.Disruption of global supply chains affected the provision of medicines,diagnostics and protective equipment.An
86、analysis of 81 studies across 20 countries showed a median reduction of 37%overall in health services,with the greatest reduction in visits of 42%.27 Disruption to services was greatest in LMICs;in the WHO pulse survey to assess the continuity of essential health services during the COVID-19 pandemi
87、c,HICs reported disruption to 34%of services,whereas LMICs reported 50%.28 LMICs also reported greater bottlenecks in accessing COVID-19 tools(e.g.diagnostics,therapeutics,personal protective equipment,vaccines).29 A study of out-of-hospital cardiac arrests in France showed the incidence doubled,cou
88、pled with a reduction in survival at hospital admission between March and April 2020.30 In Australia,a one-year disruption to healthcare services is expected to lead to 1,719 additional deaths between 2020-44 among colorectal cancer patients.31 Conversely,the pandemic may have provided the opportuni
89、ty to alleviate some pressure on healthcare systems by catalysing the uptake of decentralized trials and remote care models32 and highlighted the role of diagnostics as a foundational component to ensure equitable access to therapeutics and standard of care.In terms of the research system,although t
90、here were dips in enrolment and availability,I actually think the pandemic helped improve healthcare and access to clinical trials.It advanced our ability to provide remote care,which improves convenience,adherence and availability of information.Jeff Allen,Chief Executive Officer,Friends of Cancer
91、ResearchTime horizons to demonstrate impact in the 2035 outlook:BOX 2Near-term:Ensure all healthcare systems globally return to pre-pandemic stability.Medium-term:Invest in and diversify supply chains to ensure healthcare systems are resilient and reliable for all countries globally.Longer-term:Refo
92、cus healthcare systems on the value of the services delivered,as opposed to the volume,incorporating better prevention and preservation of care and consistent reporting of outcome metrics.of global deaths annuallyNCDs account for 71%Global Health and Healthcare Strategic Outlook:Shaping the Future o
93、f Health and Healthcare12Health technology and innovation have significant future growth potential in new treatments and modalities improving patient outcomes,better and earlier diagnostics for prevention as well as earlier treatment,and technology that improves the quality and efficiency of healthc
94、are provision.Healthcare spending continues to outpace GDP growth on a global scale a development that is not sustainable.Consequently,drug prices and reimbursements are put under pressure to contain costs.The goal is to cultivate an environment that supports funding,use and implementation of innova
95、tive approaches in science and medicine,including wellness,therapeutics and healthcare delivery.Innovation has the potential to reduce overall healthcare spending by improving efficiency and outcomes.For example,National Health Service(NHS)England says one in four general practitioner appointments a
96、re potentially avoidable,and telemedicine is important for relieving the burden on the health system.38 A study in Houston showed that 5,570 patients treated with telehealth-enabled care over 12 months showed a 6.7%absolute reduction in potentially medically unnecessary emergency department visits,$
97、928,000 annual cost savings($2,468 saved per visit averted).39 In the US,chronic diseases affect 50%of the population and contribute to more than 85%of healthcare costs.40,41 Therefore,better prevention,monitoring and personalized recommendations leveraging digital and AI-powered techniques can have
98、 significant impact on overall spend.While there are some examples,more robust evidence linking investment in health technologies to contained costs and improved outcomes will facilitate recognition and uptake of innovation by public bodies.Beyond healthcare savings,healthcare innovation supports ov
99、erall economic output.A model built to project ageing populations demonstrates future reductions in output of 17%by 2056 and 39%by 2096 relative to an economy with constant population distribution.The model demonstrates that curing diseases like Alzheimers and dementia can lead to a compounded outpu
100、t increase of 5.4%.42However,incorporation and use of technology takes time due to the receptiveness of the end-user,availability of the required infrastructure particularly in LMICs and cost to the healthcare system.Therefore,innovators need to focus not only on their projected revenues but the ext
101、ent to which their products and services will ultimately lead to cost-savings,improved efficiencies and true value-add to existing treatment paradigms.Technology and innovationTime horizons to demonstrate impact in the 2035 outlook:BOX 3Near-term:Incentivize investment to drive innovation in medicin
102、e development and commercialization,supply chain optimization and healthcare delivery.Medium-term:Harmonize data use and its applications across the healthcare industry and across geographies.Longer-term:Work with policy-makers to create a regulatory environment that cultivates and drives innovation
103、 across all geographies and all parts of the healthcare system.In the US,chronic diseases affect 50%of the population and contribute more than 85%of healthcare costs.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare13The healthcare industry has a large climat
104、e footprint,accounting for an estimated 4.4%of global net carbon dioxide emissions.43 In England,the NHS accounts for around 4%of greenhouse gas emissions.44 Of this,62%of emissions are from medicines,equipment and other supply chain sources(e.g.freight).45 Pharmaceuticals contribute around 20%of th
105、e emissions,compounded by over 300 million in medicines going unused each year in England resulting in sub-optimal usage of therapeutics and over-prescribing and waste,causing soil and water contamination.46 Along with the impact of the healthcare industry on the environment,there is the impact of t
106、he climate crisis on health and healthcare.This can be through extreme weather events,heat stress,poor air quality,water quality and quantity,food security and vector distribution.47 As a result,mortality,heat-related illness,respiratory illness,water and vector-borne diseases,malnutrition and menta
107、l health of individuals are likely to suffer through the climate crisis.The goal is to reduce the impact of the healthcare industry on the environment and prepare for and address climate change for better health and wellness of the global population.Net-zero commitments include more than 70 countrie
108、s,including China,the US and the EU,who are collectively responsible for 76%of global emissions,and 1,200 companies.48 The pharmaceutical and medical technology sector as a whole achieved a major breakthrough in Race to Zero,whereby 20%of the major companies(by revenue)have committed to halving emis
109、sions by 2030 at the latest.49 Healthcare policy-makers are adopting environmental objectives for instance,the NHS is aiming to reduce its carbon footprint by 80%by 2040,50 there is growing interest in incorporating environmental sustainability into health technology assessments51,52,53,54 and incre
110、asing focus on how prevention and better management of chronic conditions can improve carbon emissions.55 While the increasing list of countries and companies with net-zero targets is encouraging,the commitments made to date fall short of what is required to meet the Paris Agreement of limiting glob
111、al warming to 1.5 degrees Celsius compared to pre-industrial levels.56 Across countries,particularly the largest emitters,stronger 2030 targets in NDC and bold,immediate steps to reducing emissions are now needed.Extreme weather events(e.g.floods,heatwaves,wildfires and storms)are increasing in freq
112、uency and severity.This exacerbates inequities as it affects social determinants of health such as housing and food.It tests the resilience of healthcare systems affecting access to healthcare,disproportionately impacting more vulnerable and disadvantaged communities.57,58 The WHO estimates that hea
113、lth shocks and stresses push around 100 million people into poverty every year and that climate impact can worsen this trend.The richest 1%of the worlds population is estimated to produce double the emissions of the poorest 50%of the worlds population,while 94%of pollution-related deaths occurred in
114、 LMICs in 2016.59,60 In addition,between 2030 and 2050 around 250,000 additional deaths associated with climate change are expected due to malnutrition,malaria,diarrhoea and heat stress.The cost of direct damage to health is estimated to be around$2-4 billion per year by 2030.61Environmental sustain
115、abilityTime horizons to demonstrate impact in the 2035 outlook:BOX 4Near-term:Work to embed environmental,social and governance pillars into the health and healthcare industry by defining and tracking a set of metrics centrally.Medium-term:Make disproportionate investment in LMICs to reduce the impa
116、ct of climate change on health for example,reduce the number of people pushed into poverty each year due to climate shocks and stresses.Longer-term:Reduce the climate footprint of health and healthcare as an industry,focusing mainly on addressing key segments responsible for the majority of emission
117、s(e.g.supply chains,pharmaceuticals development and wastage)while maintaining patient centricity and equity.in medicines go unused each year in Englandmillion$300Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare14What are the key issues and barriers to face?2
118、To achieve the vision,several issues and barriers need to be addressed,many of which require public-private collaboration.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare15There are several issues and barriers to face in achieving this vision,some of which w
119、ill become increasingly challenging to address over time.Therefore,proactive action by public and private stakeholders is needed to address these barriers and issues with equity as the foundational goal.Challenges in funding due to continued increases in healthcare spending above GDP growth(which is
120、 unsustainable and puts return on investment for innovative medicines at risk)are placing significant pressure on healthcare systems.It will be increasingly important to ensure that funding is allocated on the basis of patient outcomes according to defined criteria over a set time period and that eq
121、uity is defined as equal outcomes rather than equal access.For example,the NHS Outcomes Framework is a set of indicators developed by the Department of Health and Social Care to monitor the health outcomes of adults and children in England;example indicators include one-year survival from all cancer
122、s and emergency re-admissions within 30 days of discharge.62 In 2021,the US FDA issued a draft guidance document,Core Patient-Reported Outcomes in Cancer Clinical Trials,which provides recommendations to sponsors on which patient-reported outcomes(PRO)concepts to measure in cancer clinical trials an
123、d at what frequency.63Issues and barriers to address for achieving goals in each pillarEquitable access and outcomeHealthcare systems transformationTechnology and innovationEnvironmental sustainabilityChallenges with funding and reimbursementBaseline health and wellness and global discrepanciesHealt
124、hcare literacy and trust in industrySkilled labour shortage and hospital capacity constraintsDeteriorating mental health and well-beingData interoperability and confidentialityConnectivity to internet and lack of digital infrastructureMaintenance and scalability of required pandemic capacityEnsuring
125、 patient centricity and high quality care in decarbonizationSupply chain issuesRestrictions/lack of incentives for innovationLimited diversity in health data and gaps in data/evidence generationPace of regulatory changeLimited standardization in measuring outcomes over timeDisproportionate impact of
126、 climate issues on health of LMICsThere are several issues and barriers where public and private stakeholders play a role,and each given barrier impacts the ability to achieve goals in multiple pillars FIGURE 3Source:L.E.K.Consulting;World Economic Forum Significant public and private roleSignifican
127、t private roleSignificant public roleGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare16Baseline health and wellness have been deteriorating as a result of ageing populations and unhealthy habits,increasing NCDs.Disparities in baseline health between differen
128、t demographic and geographic populations affect the ability to achieve resilient healthcare systems and equitable access to health.Therefore,prevention,earlier diagnosis and preservation of health and earlier engagement of younger populations in health and wellness before sickness are increasingly i
129、mportant.Isolated use of speciality services limits the ability of healthcare systems to improve the prevention,treatment and preservation of patients overall wellness.For example,vision care and dental services are connected to a wider range of systemic disorders(e.g.high blood pressure,diabetes,he
130、art disease,rheumatoid arthritis,etc.)and can act as predictors of such disorders in a less invasive and cost-effective way.64,65 Challenges around baseline health and wellness were highlighted as one of the most important focus areas in health and healthcare,along with proactive investment in preve
131、ntion.Even things that are not related to healthcare access directly(e.g.good nutrition,good preventative care,the internet)will continue to be important.For example,there is lots of focus on broadband access in rural areas,which is a significant barrier,but this is also a problem in urban areas whe
132、re some patients have WiFi access but do not have the space or privacy to conduct their telehealth consultation.The integration of wellness and healthcare is not done well yet.Jeff Allen,Chief Executive Officer,Friends of Cancer ResearchSomething as simple and non-invasive as an annual vision care e
133、xam is about so much more than seeing clearly.Through it,eye doctors can also detect signs of over 270 serious conditions,including diabetes and heart disease sometimes even before symptoms appear.And when we can help catch these conditions early,we can empower patients and healthcare systems to red
134、uce costs and improve overall health outcomes.Michael Guyette,President and Chief Executive Officer,VSP VisionIn addition to prevention,there needs to be greater focus on preserving health.We need to provide an intensive support package to preserve the health of individuals once they have been diagn
135、osed.Sally Lewis,Director,Welsh Value in Health CentreGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare17The COVID-19 pandemic has exacerbated public scepticism towards technology and innovation in healthcare.Following the large volumes of misinformation abou
136、t the pandemic and vaccinations,there is a need to improve healthcare literacy and rebuild and reinforce trust in the healthcare industry.Levels of healthcare literacy vary across the population and geographies,and access to and acceptance of reliable,evidence-based information sources is important
137、to allow people agency and decision-making ability in health.There is a need for a large and well-trained workforce to undertake the expected and unexpected challenges that will be faced.However,skilled-labour shortage and hospital capacity constraints are growing issues in healthcare provision ther
138、e will be an estimated shortage of 10 million healthcare workers worldwide by 2030,66 primarily in LMICs.The unequitable distribution is exacerbated as physicians are increasingly migrating to HICs in search of better working conditions and career opportunities,which has economic and health conseque
139、nces in LMICs of origin67 and the broader global community(e.g.incorrect use of antibiotics due to limited speciality or experience in LMICs further exacerbates global AMR problems).Private equity investment in healthcare has grown dramatically over the last decade;estimated annual deal values have
140、gone from$41.5 billion in 2010 to$119.9 billion in 2019,68 and in 2018,the number of doctors who were employed by a company surpassed the number who owed their own practices for the first time.69 Outpatient services(e.g.ophthalmology)accounted for three-quarters of all private equity buyouts in heal
141、thcare in 2020.70 This consolidation has potential ramifications on doctor supply,as many do not adjust to the culture of reporting structure and policies,and provider dynamics,as they are able to negotiate higher payments from insurance companies that in turn leads to higher premiums for patients.T
142、he pandemic exacerbated the challenges faced by healthcare workers including burnout,illness and mental health and well-being issues(e.g.workplace violence and harassment).Even before the pandemic,the healthcare sector was one of the most hazardous sectors to work in;healthcare workers are four time
143、s more likely to be assaulted than other professionals in the general workplace,with those most at risk including junior doctors and nurses,those working in government hospitals,emergency departments,intensive care units or isolated areas.71 While some efforts are being made to improve healthcare se
144、ctor working conditions(e.g.the recent WHO and International Labour Organization(ILO)guide on developing and implementing stronger occupational health and safety programmes for health workers72),healthcare workers are still at risk,with high potential for burnout and jeopardy towards their health an
145、d well-being leading to many professionals leaving the sector and reduced recruitment into the sector.There is a serious need to take pressure off acute care and medical staff;efforts must be reprioritized to build a resilient healthcare system.Mental health and well-being issues are not limited to
146、healthcare workers;there are significant efforts to address these issues across the broader population through novel therapies(including psychedelics),telehealth and community-based mental healthcare,and digital tools and online education programmes to train providers.This need is even greater in LM
147、ICs;while 70%of people with psychosis are reported to be treated in HICs,only 12%of people with psychosis receive mental healthcare in LMICs.73 Private organizations could play an important role in taking responsibility for the mental well-being of their employees and While there are several laws pr
148、otecting our safety and well-being as physicians in India,the threats of violence and burnout are real,and one of the contributors as to why doctors are considering other professions or are looking to pursue medical specialities in other countries.Kashish Malhotra,Physician,Department of Internal Me
149、dicine,Dayanand Medical College and Hospitalhealthcare workers worldwide by 2030Shortage of10millionGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare18Given the expected heavy reliance on digital and cloud-based solutions in the future due to workforce availa
150、bility,data interoperability and confidentiality issues are important barriers to fully using digital solutions and gaining sufficient trust for widespread use for both back-end and customer-facing technology.While data aggregation can allow data sharing and identification of trends and insights,loc
151、al data can reveal valuable information but is challenging to share and can result in significant trust issues if not communicated transparently.To be aggregated,however,data needs to be harmonized across organizations and countries to be of value.Data ownership policies need to be clearly defined a
152、nd data security reinforced to cultivate an environment that allows for the safe collection and sharing of valuable insights that improve healthcare delivery.Customers also need to understand the context for data sharing.Localized relationships with trusted community leaders as advocates can help,bu
153、t this introduces challenges around the scalability of solutions.Consistency and quality of data collection are important for recording outcomes,which is necessary to facilitate the financing of digital solutions.With new technology,customers expect a seamless experience they can trust that meets th
154、e specific needs of the users in the digital interface and the hardware.It is important to ensure that the quality of care is maintained when decentralizing part of the healthcare system through digitalization.It is also vital that decentralization is appropriately selective of patient populations w
155、here in-hospital care is not required to avoid poorer outcomes.Additionally,three billion people are currently not connected to the internet;74 of those who are,there are still issues with cloud storage and bandwidth,mainly in LMICs.This makes the implementation of digital solutions more challenging
156、 and exacerbates inequities further by preventing access to these innovations.There is a need to ensure that solutions are compatible with communities without internet access and countries with limited digital infrastructure.In Alzheimers we have the approach of nothing for us,without us.It is impor
157、tant to include the needs of the target population for tech developments.For example,if you are working with an over 80s population it is not just about making the interface easy to use but ensuring that the hardware has the right speaker quality,font size,touch screen for the needs of these people.
158、Jisella Veath Dolan,Chief Global Advocacy Officer,Honor+Home InsteadGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare19Decarbonizing cannot be at the expense of quality,reach or continuity of patient care.Patient care experience must remain our north star so
159、we achieve better outcomes for people,society and the planet.Elly Darkin,Senior Manager,Global Corporate Affairs,AstraZenecaDuring the pandemic,there was significant increase in scale and repurposing of capacity in drug manufacturing and diagnostics.As part of pandemic preparedness and globalization
160、,there is an additional increase in capacity committed in countries around the world to future vaccine efforts.However,issues remain around maintaining this capacity in non-pandemic situations and showing agility in repurposing and scaling this capacity on short notice should other pandemic situatio
161、ns arise.While the aim is to ensure that the right capacity and sufficient supply chain infrastructure is in place,the impact of this and the broader healthcare system on the environment needs to be taken into account.One of the main issues with decarbonizing healthcare systems is ensuring that chan
162、ges are made in a patient-centric way,and that quality of care is maintained in this transition.Decisions made should not result in higher cost of care to patients,nor restrict access to necessary medications with a large carbon footprint,therefore limiting impact on patient outcomes.Supply chain is
163、sues were prevalent during the pandemic and impacted a range of industries,however,in the healthcare industry,the lack of availability of medicines or equipment means that the lives of healthcare workers and patients are at risk.During the pandemic,those countries without local manufacturing capabil
164、ities were some of the last to receive essential medicines and equipment despite their need being the greatest.The localized and concentrated nature of manufacturing and supply chain resources and knowledge limits the ability of LMICs to secure long-term and reliable access to medicines and equipmen
165、t.Therefore,it is important that supply chain infrastructure is resilient,distributed,diversified and tracked closely to predict and mitigate against disruptions for all stakeholders equally.Supply chain security requires vetting and verification of suppliers to avoid introducing counterfeit product
166、s into the supply chain to protect patients and healthcare workers.The application of digital solutions can have a significant beneficial impact on monitoring and tracking product supply.The healthcare supply chain has a large carbon footprint,mainly from production,packaging,transport and disposal
167、of pharmaceuticals,medical devices and hospital equipment and instruments.75 Therefore,decisions regarding the fortification and geographic diversification of supply chains should take into account environmental impact.Supply chain issues have brought forward the importance of global connectivity wh
168、ile highlighting equity issues across geographies.Global access and reliable supply chains have been hampered by strict national export bans and a lack of patient regionally diversified sourcing and production due to restrictions and a lack of incentives for tech transfers.Beyond tech transfers,comp
169、anies are not incentivized to adopt broader innovation around product development,process design,service or business models,which further limits opportunities to improve overall population health.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare20Standardized
170、 outcomes measurements by disease are important for a sustainable healthcare system that helps patients so we do not waste money on things that do not help people.Stefan Larsson,Distinguished Fellow,World Economic ForumUnfortunately,the pace of innovation is currently faster than the pace of regulat
171、ory change.Regulatory change needs to be linked to outcomes,as what is efficient is not always the most effective.This,and a lack of harmonization of regulation across jurisdictions,impact digital innovation and the funding and reimbursement of innovative therapy modalities.The lack of standardized
172、outcomes measurements by disease is a barrier to being able to offer outcomes-based care and making informed reimbursement and investment decisions.The challenge is made even harder by the misplaced need for short-term results in a system where the true value of investment is more easily revealed ov
173、er the years.Furthermore,with increasing decentralization,it is more challenging to ensure that the quality of care is standardized and consistent.The impact of climate issues disproportionately affects LMICs,which contribute less to emissions but are particularly vulnerable to climate change and ha
174、ve less resilient healthcare infrastructures.76 Policy changes to encourage lowering emissions are at odds with encouraging urbanization and economic growth in LMICs,which in effect can exacerbate climate impact on healthcare.Discrepancies in health equity are entrenched in healthcare data,given the
175、 limited diversity in clinical trial demographics.As big data and AI are increasingly deployed,these issues can be further exacerbated due to existing biases in the data.There needs to be proactive focus on diversity and clear guidelines for increasing inclusion.There are significant gaps in data an
176、d evidence generation despite the increase in data,which restricts the ability to identify priority areas for funding,deliver outcomes-based care and raise awareness of issues,such as inequities in the impact of climate change on health,that need to be addressed.We should acknowledge existing data g
177、aps and use AI to close these rather than integrating biases and worsening them.Ivor Horn,Director,Health Equity and Product Inclusion,GoogleGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare21What are the solutions to address these issues?3Public and private
178、stakeholders can use a range of levers to resolve issues in health and healthcare globally.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare22While these barriers prohibit the achievement of equity,resilience,innovation and environmental sustainability in hea
179、lth and healthcare,addressing these barriers provide opportunities to create value for businesses,governments and society.There are several levers to resolve these issues driven by public,private or both stakeholders,and solutions can make use of multiple levers as subsequently demonstrated by the s
180、election of case studies.Levers that private and public stakeholders are employing to address issues and barriers in health and healthcareFIGURE 4Digitalization,AI and big dataPatient empowermentTargeted/selective decentralizationGlobal collaborationPublic-private partnershipsInnovative funding mode
181、lsPolicy and advocacyCross-industry collaborationPrivate-drivenPublic-drivenPublic-and private-drivenCross-industry collaborations can occur between healthcare providers and a range of other industries such as consumer/retail or digital solutions companies to address a number of barriers.In one such
182、 example,a technology platform,Honor Technology,and an at-home health service company,Home Instead,have combined their capabilities to offer Home Insteads high-touch care model supported by Honors technological and digital solutions.This collaboration allows Honor to scale its technology geographica
183、lly and better empower Home Insteads workforce.In such cross-industry collaborations,the key to success is mission alignment across the two organizations joining forces.In the case of digital solutions,it is particularly important to ensure that the technology is designed in collaboration with the c
184、ustomer to account for their specific needs and tech readiness,while engagement is guided by on-the-ground support through a trusted member of the community or carer.In addition,alignment on data collection and ensuring data integration from the beginning across the organizations is key to continuin
185、g to improve services and demonstrate value proposition,along with transparency in data collection to the consumer.As a result,agencies using the Honor care platform have a workforce turnover rate that is half the industry average,and 94%of them feel they have the tools and resources they need to be
186、 empowered in their jobs.In addition,94%of the older adults they care for have a positive experience with their professional caregivers.The Honor care platform helps caregivers feel respected and provides them the schedules they desire,which is key to enable Home Instead agencies to recruit and reta
187、in the workforce needed to meet growing demand for home care services.Home Instead and Honor TechnologySource:L.E.K.Consulting;World Economic Forum Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare23Patient empowerment is a key lever to encourage patients to
188、have ownership of their health and wellness.To support this,South Africa-based health insurance company,Discovery Vitality,developed a behavioural change platform that incentivizes customers to adopt a range of health behaviours including increased physical activity,healthy eating and regular screen
189、ing.The key to success in supporting behaviour change is incentives.Simply providing guidance on good health choices is insufficient in changing behaviour,but personalized interventions and incentives lead to better engagement,trust and outcomes.The private sector is particularly well-positioned to
190、offer these types of incentive structures.Data gathered over decades show that increasing engagement with the platform reduces mortality risk and life expectancy.For those with the highest engagement,life expectancy reaches 83-89 years compared to South Africas average life expectancy of 64 years.Vi
191、tality makes living a healthy lifestyle fun for me.By gamifying the act of healthy living,it motivates me to reach my weekly goals by offering valuable and practical rewards.As a person living with a disability,it is even more important to try to live an active life.Brandon Beack,Participant,Discove
192、ry Vitality programmePolicy and advocacy are important levers to drive systematic change across a broader population.For example,the Ayushman Bharat Digital Mission(ABDM)is an initiative launched by the Ministry of Family and Health Welfare,Government of India,under the aegis of the National Health
193、Authority,to build,launch and scale foundational infrastructure,and enable the worlds largest digital health landscape.It aims to develop the backbone necessary to support Indias integrated digital health infrastructure and bridge the gap among healthcare stakeholders through digital highways.This i
194、ncludes generating a unique patient identifier,health professionals and facility registry,a mobile app for personal health records,a health information exchange consent manager for patient control over data collection,claims processing and a unified digital health interface for appointment booking,t
195、eleconsultation,service discovery and other services.The key to success in these types of solutions is the security and privacy of data,as well as data interoperability at the centre of the design and build of the model.In addition,adoption is a major element of the journey and sustained engagement
196、with all partners,particularly small-scale healthcare service providers,is essential to drive adoption and shift from traditional healthcare delivery methods to digital.As of the end of September 2022,nearly 250 million ABHA unique identifiers have been created,and 160,000 health facilities and 91,0
197、00 healthcare professionals have been registered with the platform.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare24Digitalization,AI and big data to better connect healthcare stakeholders and provide access to a wider set of healthcare information to impro
198、ve decision-making is an important underlying theme in several case studies(e.g.ABDM,Home Instead and Honor).In Bayer Consumer Healths work in Guatemala,digitalization via QR codes on individual product sachets aims to improve affordable access to over-the-counter(OTC)medicine by reducing packaging
199、costs,improving healthcare literacy and empowering patients while reducing carbon footprint.The role of OTC products in middle-income countries of Latin America(like Guatemala)helps individuals save on average four productive days,worth$123 revenue per person per year a significant income for low-in
200、come consumers who can earn between$2 and$15 per day.While digitalizations role in addressing health and healthcare issues will likely increase in the future,challenges around accessibility(e.g.ensuring access to mobile telephones with camera functionality)and regulatory approval must be considered.
201、As demonstrated by the case study in Guatemala,when discussing data interoperability in the context of health and healthcare,the digital solutions being deployed do not need to be advanced or overly ambitious.The emphasis should be on building the right data infrastructure for the future while under
202、standing how best to apply the minimum data set now to inform decision-making and improve outcomes for patients.On data,we know where we are trying to get to with this and need to accept its a multi-year endeavour the focus should be on building the infrastructure and getting that right and doing wh
203、at we can with the minimum data set we have at that point in time.Its important we dont try to boil the ocean.Sally Lewis,Director,Welsh Value in Health CentreDecentralization is a lever to alleviate pressure on hospital capacity.However,it needs to be done in a selective and targeted way to decentr
204、alize healthcare segments with large populations that can benefit from the privacy and convenience of decentralized care with no negative impact on outcomes.Many examples of decentralization use digital solutions,however,internet access is not universal.Singapore-based health social enterprise,reach
205、52,aims to tackle remote access issues in areas with limited data coverage through an offline first health technology platform that enables a full range of health services.This solution supports implementing community-based and tech-powered healthcare delivery models for NCDs,including a 3-in-1 offe
206、ring of coaching,testing and medications at a subsidized cost.The platform works on basic mobile phones with significant offline functionality.Data is synced at specific locations or when a mobile signal becomes available.The key to success with this type of platform is not relying entirely on the d
207、igital solution but having a human component to encourage use and empower members to manage their health conditions.reach52 collaborated with municipal health providers in Pototan,Philippines and MedTech social enterprise,Medtronic LABS,to upskill existing community health workers to promote sustain
208、ability and scalability.They also incorporated local residents as peers in programme facilitation to build participants trust and sense of belonging.As a result,76%of members had their systolic and diastolic blood pressure under control by the end of month six,compared with 64%(systolic)and 73%(dias
209、tolic)in month one.Ive had diabetes for 30 years now.It has been a challenging journey,especially with the burden of medicine costs and there are a lot of foods that I must avoid.My family always worry about my condition and I always have to disturb them whenever I need to do my check-ups.Im really
210、happy that Padayon arrived in our barangay and gave us easier access to blood pressure and sugar checks,affordable medicines and diabetes education.Participant,64 years oldGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare25Global problems require global solut
211、ions.The negative health,economic and environmental effects of one country or organization are far-reaching and extend beyond borders.Global collaboration,particularly between stakeholders generating disproportionate impact(e.g.HICs,blue chip or multinational corporations),is important to be effecti
212、ve and sustainable in the solutions delivered.The healthcare sector contributes over 4%of global greenhouse gas emissions.77 Launched at COP26,the Sustainable Markets Initiative(SMI)Health Systems Task Force is a global private-public partnership effort to accelerate the delivery of net zero,patient
213、-centric health systems through scalable action,recognizing the deep interconnection of public and planetary health.Members include chief executive officers or equivalents from global life sciences firms(e.g.AstraZeneca),healthcare systems(e.g.NHS England),institutions(e.g.WHO)and academia(e.g.the K
214、arolinska Institute).The Task Force is committing to global action as a collective focusing on decarbonization across three core areas:supply chains,patient care pathways and digital health solutions.The Task Force initiatives include aligning a set of common supplier standards to incentivize decarb
215、onization efforts,jointly pursuing renewable power purchase agreements and identifying green transport corridors in supply chains,tracking and publishing emissions across patient care pathways,and deploying digital health solutions to decarbonize clinical trials.Beyond climate,many other global heal
216、th and healthcare problems require global collaboration.For example,AMR presents a significant global mortality burden with unequal distribution in LMICs due to the greater prevalence of critical infections,lack of laboratory testing capabilities and limited access to second-and third-line agents.Se
217、veral global initiatives were launched to combat this,including international guidelines,strategies and action plans,antimicrobial stewardship programmes,global awareness campaigns and surveillance programmes(e.g.the Global Antimicrobial Resistance and Use Surveillance System).More co-ordinated inve
218、stment in global health and neglected disease areas,such as malaria and schistosomiasis,is also needed on an international scale to reduce the negative health,social and economic impact on the most vulnerable populations.Innovative funding models,where the innovation is derived either from the sourc
219、e of funding or the degree of innovation(pletely new or building on existing models),will be needed to meet the growing demand for services and increasing funding gap.Funding solutions need to be context-dependent to maximize impact and sustainability,as well as be implemented into systems that are
220、reorientated to focus on the outcomes achieved versus the volume of services delivered.For example,NHS Wales is deploying mixed funding models to bring about behavioural change in their healthcare landscape and is reviewing the allocation of resources at a macro,meso and micro level as part of their
221、 initiative to promote value-based healthcare for the population.NHS Wales has established a commitment to a financial strategy that will embed the financing of value through linking resource allocation,resource use and outcomes achieved across communities.Multiple approaches to financing for value
222、are being harnessed,including national formulae,value-based procurement,value-based contracting,data use and remote care.Key success factors for NHS Wales approach include that the policy and infrastructure were in place to support such change,a system-level approach was adopted to ensure consistenc
223、y and continuity across services,and different funding models were flexed to meet the needs of the local areas,conditions or populations they were serving.The work in NHS Wales led to the allocation of 20 million towards wider implementation of value-based healthcare and triggered the development of
224、 standardized PRO measures,which aligned data standards,processes and information exchanges to allow for the aggregation of national data to report system-level progress.Alongside innovative funding models,transparent reporting of the cost of medicines and greater investment into real-world evidence
225、 are needed.For example,in the context of cell and gene therapies where the cost of a one-time infusion could reach$2.8 million in the US,instalment-based funding models could be applicable given the small patient numbers and ability to collect real-world data over a long-term horizon.In LMICs,where
226、 the barriers to such therapies are even higher(e.g.lack of infrastructure,limited trained workforce,insufficient policy in place),financing solutions need to be more innovative to ensure equal access and outcomes.Potential models could include multistakeholder approaches to voluntary licensing,dona
227、tion programmes,value-based tiered pricing or subscription-based payments.78 For example,in Thailand,patients undergoing haematopoietic stem cell transplants receive$21,000 from the government before treatment and up to one year after transplantation for ongoing treatment and monitoring of beta thal
228、assaemia or acute lymphoid leukaemia.79 In Argentina,the government formed a price agreement with Biogen to ensure access to treatment of the rare disease spinal muscular atrophy for 260 patients.80 In Taiwan,the National Health Insurance(NHI)has a separate fund that uses 24.2%of tobacco tax to pay
229、medical expenses for rare diseases.81Funding is extremely context-dependent and if we try to impose a uniform financial model it will fail;having access to a range of funding models and being able to apply those flexibly depending on the scenario,country or healthcare system is key to success.Sally
230、Lewis,Director,Welsh Value in Health CentreThe cost of a one-time infusion could reach$2.8 millionGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare26As the health and healthcare challenges rise in complexity,the need for innovative solutions that span across
231、geographies,industries and sectors is increasing.Public-private partnerships(PPP),where partners share risks,resources,accountability and decision-making authority,are a key lever that makes use of the collaboration of different stakeholder groups.82 The Global Antibiotic Research and Development Pa
232、rtnership(GARDP)is a not-for-profit organization,founded in 2016 by WHO and the Drugs for Neglected Diseases initiative(DNDi),focused on providing countermeasures to manage the emergence of AMR.AMR is a public health priority with 1.3 million deaths directly attributed to antibiotic resistance in 20
233、19 alone.83 In order to reduce this growing AMR-attributed mortality,barriers need to be addressed,such as a dry antibiotic pipeline due to the lack of market incentives for R&D,inequalities in new antibiotic access,especially in LMICs despite disproportionate burden and recurrent shortages of off-p
234、atent antibiotics due to a fragile supply chain.To address these barriers,GARDP is developing a public health portfolio to manage the emergence of AMR,taking into account local public health and clinical needs on a not-for-profit basis.GARDP is collaborating with over 70 partners in more than 16 cou
235、ntries to support late-stage clinical development and access to antibiotics.For example,GARDP signed a first-of-its-kind licence and technology transfer and collaboration agreement with a pharmaceutical company and the Clinton Health Access Initiative to expand access to a novel antibiotic in 135 LM
236、ICs.The success of GARDP is driven by their ability to work closely with partners to understand their specific needs and flexibly across projects to address the gaps identified(e.g.innovative financing models,market shaping and procurement activities,awareness raising).Public-private partnerships ar
237、e fruitful in that they bring about collaborations that might not otherwise occur,involving stakeholders that are tackling the same problem but from different lenses.They are particularly useful in addressing product-agnostic questions,where the value is in improving efficiencies or scientific under
238、standing.Too often we see many companies trying to find the path through the forest themselves,and each of them getting lost and not learning from one another.Public-private partnerships help bridge this divide to find solutions to common problems in a shorter time.Jeff Allen,Chief Executive Officer
239、,Friends of Cancer ResearchGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare27These case studies demonstrate how a range of solutions can be applied to address important barriers in health and healthcare today.Although the challenges faced vary by country or
240、region,the most common barriers included healthcare literacy and trust in industry,baseline health and wellness,global discrepancies,skilled labour shortage,and hospital capacity constraints.The most used levers include digitalization,AI and big data,patient empowerment and cross-industry collaborat
241、ion.Solutions were most effective when levers were used in combination with one another.For example,Discovery used cross-industry collaboration,patient empowerment and digitalization in combination to increase average life expectancy by 25 years for its members in South Africa,leading to significant
242、 individual and system-level impact.The impact can be greatest when multiple stakeholders work to solve a common problem using different levers in parallel.Over-investment in short-term solutions will not facilitate change at the system level nor be replicable or scalable across markets.Efforts shou
243、ld focus on compounding the strengths of public and private stakeholders,incentivizing innovation through policy and collaborating globally across industries to achieve far-reaching and long-term impact on the health and healthcare of the population.Case studies illustrate opportunities to use lever
244、s to a range of barriers across geographiesFIGURE 5Source:L.E.K.Consulting;World Economic Forum Case studiesCross-industry collaborationPublic-private partnershipPatient empowermentTargeted/selective decentralizationDigitalization,AI and big dataGlobal collaborationInnovative funding modelsPolicy an
245、d advocacyHome Instead and Honor Technology:Decentralization and technologyDiscovery:Vitality programme for patient empowermentNational Health Authority:Building a digital health landscapeBayer:Digitalization to provide equity and sustainabilityreach52 and Medtronic:Digitalization and equity AstraZe
246、neca:Implementing net zero NHS Wales:Innovative funding models and value-based careGlobal Antibiotic Research and Development Partnership(GARDP):Partnerships to manage AMRMain focusOther relevant leversGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare28Conclu
247、sionIn the last three years,the world experienced a major pandemic,multiple geopolitical conflicts,and climate and energy crisis effects,which all have a detrimental impact on health and healthcare globally,with the most vulnerable populations being the most impacted.While triggering growth and inno
248、vation in the form of a surge in healthcare spend and investments,scientific advancements,improved digital innovation and connectivity and alternative care models,the pandemic also exposed global health disparities,had a detrimental impact on mental health and well-being,and exacerbated macro-econom
249、ic issues and the climate crisis.In a time where barriers are complex,involving multiple stakeholders with competing priorities,it is increasingly important to work together and define clearly what the vision for health and healthcare looks like in 2035.Equitable access and outcomes for all is a key
250、 pillar and will require significant and disproportionate investment in the countries or regions lagging behind.Healthcare systems need to be reorientated to think about success in the context of broader outcomes across health and wellness for individuals,communities,populations and systems over mul
251、tiple years in the face of expected and unexpected circumstances.An environment that supports funding,use and implementation of innovative approaches in science and medicine needs to be cultivated,in particular in countries or regions where infrastructure and opportunities may not be as advanced.For
252、 environmental sustainability,reducing the healthcare industrys impact on the environment is key(e.g.supply chain and decentralized care)while also preparing for and addressing climate change for better health and wellness across all countries,including those that suffer a disproportionate impact.Ea
253、ch strategic pillar is important,but collectively striving for them all will help ensure that sustainability,equality,resilience and innovation are embedded into future health and healthcare systems.The vision for health and healthcare in 2035 is ambitious yet achievable.To get there,stakeholders ac
254、ross sectors,industries and geographies need to build on the existing traction and collectively lead across their organizations to catalyse long-term change at the system level.The biggest barriers in health and healthcare in 2023 are predicted to include worsening mental health,healthcare workforce
255、 shortages,supply chain issues and climate and macroeconomic instability(e.g.energy supply and inflation).While it is important to keep these barriers in mind,they should be addressed in the context of the outlook for 2035 to ensure activities are complementary to striving towards systemic,long-term
256、 change.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare29Action is needed now;nearer-term initiatives and targets that balance the needs of different stakeholders should be enacted to build upon successes to date.In 2023,private stakeholders should:1.Implem
257、ent the WHO guidelines on mental health at work84 and other evidence-based research to preserve,monitor and remediate employee welfare,as well as define and track metrics over time to demonstrate impact and advance understanding of key determinants of well-being in health and healthcare workplaces.2
258、.Incentivize private industry investment to drive innovation in medicine development and commercialization,supply chain optimization and healthcare delivery.Outline how innovative products and services can lead to contained costs,improved efficiencies and better outcomes at the individual and system
259、 level,which could be scaled globally considering the different tech capabilities across markets.Also,work with policy-makers to outline ways to cultivate regulatory environments that support rather than restrict the adoption of technology and innovation.3.Mandate that environmental,social and gover
260、nance pillars are embedded equally into the health and healthcare industry by defining and tracking a clear set of metrics centrally to encourage widespread adoption and standardize expectations across the industry in collaboration with public bodies.Public stakeholders should:1.Internationally coop
261、erate(e.g.via the World Trade Organization and other trade and investment fora)to create an environment that facilitates and promotes distributed supply chains via a global network with a focus on building capacities and investing in underrepresented geographies with vulnerable populations.2.Redesig
262、n systems to focus on the value of outcomes achieved over the volume of services delivered and embed the financing of value through linking resource allocation,resource use and outcomes achieved across communities.Implement policies that ensure the changes are at the system level but allow for local
263、 autonomy and flexibility in funding models.Define a clear set of short-,medium-and long-term impact measures to allow for national data aggregation and evidencing of system-level impact.Educate all stakeholders,including patients,physicians,payers and policy-makers to ensure alignment and embed val
264、ue as the norm.3.Mitigate national divergences in data regulations by converging an international body that sets out rules and guidelines to harmonize data use and its applications within health and healthcare.Alongside this,track,monitor and publish data-related trends to update policy-makers on ke
265、y changes required to support the widespread use and adoption of data applications in the industry while balancing the needs of privacy,personal data protection and security.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare30AppendixCross-industry partnership
266、 case study:Home Instead and Honor TechnologyA1Overview:Between 2015 and 2050,the proportion of the worlds population over 60 years will nearly double from 12%to 22%.85 All countries face major challenges in maintaining the baseline health and wellness of their ageing populations,especially in the c
267、ontext of increasing pressure on healthcare services capacity and funding.Catalysed by the pandemic,options to deliver high-quality care while maintaining value are increasingly attractive.Home Instead is the worlds largest private home care provider for older adults operating through more than 1,20
268、0 locations in Europe,North America,Asia,Australia and New Zealand.Home Instead is built on the concept of“high-touch”care,engaging the patient and their families through a franchise model that allows building localized relationships and delivering care that meets the personalized needs of older adu
269、lts and their families.Barriers faced:Declining baseline health and wellness with an ageing population,creating an increased demand for services and a need to scale more quickly Skilled labour shortage across healthcare and home care Deteriorating mental health and well-being of the healthcare workf
270、orce as well as the broader population,including family caregivers Need for technology to allow scalability of local agency presence and the ability to serve more people Levers used:Cross-industry collaboration Patient empowerment Targeted/selective decentralization Digitalization,artificial intelli
271、gence(AI)and big data Solution:Home Instead was acquired by Honor Technology,a leading technology and operations platform,with the aim to combine high-touch care with best-in-class technology and digital solutions.The tech and digital elements empower patients,families and the workforce,while the pl
272、atform is integrated within local Home Instead agencies to unlock scale.This increases the capacity of the in-person geographic presence and local footprint to serve more people better and to better empower workforce.Key learnings:In a cross-industry collaboration,the perspective and experience of t
273、he two companies can differ;in this case the tech perspective and the personal care service perspective.Therefore,mission alignment across the two companies is important.Mission alignment guides the decision-making process for achieving partnership goals.Mission alignment is important to engage the
274、workforce in a decentralized model,and making use of tech allows for building a sense of community for the workforce.Technology is used to connect the entire care landscape and empower patients,their carers and the workforce,but humans and local presence are still necessary to deliver the experience
275、.Any customer-facing tech should be designed in collaboration with the customer to make it fit for purpose.Additionally,to ensure the tech use by older adults,a human coach trusted by the customer(home care professional,community leader or family member)should support the customer with tech readines
276、s.Data collection is very important to ensure proper outcomes are measured and that there is a clear understanding of the efficacy of interventions.There needs to be alignment at the beginning of cross-sector partnerships regarding how the data will be collected and integrated to ensure care is cons
277、istent and continuously improving to address patients and carers needs.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare31 For sharing non-aggregate data,patients should have visibility on which data is shared and the rationale based on discussions with a tru
278、sted member of their local community,a family member or a carer.Funding routes need to be established,and as a result,it is important to understand what information and data will be required to express the value proposition of the service appropriately.Impact:In this first year following the acquisi
279、tion,the initial integration of the Honor care platform and the Home Instead franchise network has empowered Honor Technology to expand its footprint in the US with the long-term goal of supporting Home Instead agencies in every state and other countries.The Honor care platform helps the caregiving
280、workforce feel respected,provides them with schedules and hours they desire,and treats them as professionals.Consequently,care professionals who use the Honor care platform express that they have the tools and resources they need to be empowered in their jobs(94%)and will be working for the same age
281、ncy a year from now(93%).Agencies using the Honor care platform have a workforce turnover rate that is half the industry average.By supporting the workforce in this way,Home Instead agencies can continue to be employers of choice and recruit and retain the workforce needed to meet the growing demand
282、 for home care services.Older adults and their families have a positive experience through care delivered by the Honor care platform and local agency.Older adults express positive feedback about their professional caregivers who use the Honor care platform(94%).A Home Instead client shared the follo
283、wing about his experience with his Care Pro:“The love and care has just been fabulous.Its kept me from feeling lonely.Its kept me happy and wanting to continue to live”.Remaining challenges and role of key stakeholders:Public stakeholders:Public decision-making needs to be faster to keep up with the
284、 speed of innovation and involve input from private stakeholders to gain expert insights.Social care and healthcare are intertwined and should be merged into the landscape.Some countries are further ahead than others in doing this.Private stakeholders:Engaging with people earlier in age to manage we
285、llness rather than sickness can improve baseline health issues.There are disparities in access to the internet within and across geographies;tech solutions should take this into account to avoid increasing global disparities.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health
286、 and Healthcare32Patient empowerment case study:Discoverys Vitality programmeA2Overview:Despite the well-evidenced relationship between lifestyle factors(e.g.diet,smoking,sleep)and health,many adults fail to meet recommended guidelines related to these behaviours.For example,in Australia in 2020-202
287、1,only 45%of adults aged 18 years and over were sufficiently active,while only 4%of men and 13%of women were consuming the recommended number of daily servings of vegetables,and 41%of men and 48%of women were meeting recommendations for fruit intake.86 A higher proportion of males than females were
288、more likely to drink at levels exceeding lifetime risk guidelines and 1 in 10 people(10.7%)aged 18 years or over were current daily smokers.87 In South Africa,57.4%of individuals 15 years or over were physically inactive.88 Discovery is a shared value insurance company with a pioneering business mod
289、el that incentivizes healthy behaviour leading to better health outcomes,lower claims and lower lapses.Barriers faced:Baseline health and wellness and global discrepancies Healthcare literacy Deteriorating mental health and well-beingSolution:Discovery Vitality is a scientifically-proven behavioural
290、 change platform that incentives customers to adopt a range of healthy behaviours including increased physical activity,healthy eating,mental wellness and regular health screening.Customers earn points through physical activity,healthy eating,regular screening and more.Points earned are then convert
291、ed into a range of rewards including discounted gym membership,discounts across a range of retail partners and discounted fitness devices.The Vitality behavioural change platform has been scaled globally through partnerships with leading insurers and is available in 40 markets and covers more than 2
292、0 million members.Levers used:Patient empowerment Cross-industry collaboration Digitalization,AI and big dataKey learnings:It is not enough to provide people with guidance on good health choices incentives are a uniquely powerful tool in driving better behaviour,and insurers are well-placed to provi
293、de these incentives,given they are one of the few actors that can monetize better health.The repeatability of the model has been a vital factor in its ability to scale because the shared-value insurance model is underpinned by principles that work across industries and markets,it has been able to gr
294、ow rapidly to over 40 countries covering more than 20 million lives.Personalization is key using data strategically to offer people timely and relevant interventions and rewards drives engagement and trust,as well as better outcomes.People will trust organizations with their data if they know it wil
295、l only ever be used to their benefit.Compounding good behaviours across lifestyle categories can have a significant impact on both the business and the client Discovery is creating an interconnected environment where clients with multiple products,who are engaging in better health,driving and financ
296、ial behaviour,get incredibly rich rewards,keeping them healthier for longer,while Discovery benefits from clients who are lower risk overall and remain engaged in the various programmes.The depth of the offering can seem over-complicated to consumers,so work needs to be done with advisers,brokers an
297、d brand communicators to simplify the offering and its various components.Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare33Mortality risk by age and Vitality statusThe impact of Vitality member status on claims and lapse rateFIGURE 6FIGURE 72022242628303234
298、3638404244464850525456586062646668707274767880828486889092949698100Probability of deaths per 100,000No VitalityBlueSilver and bronzeGold and diamond15%Lower claims40-60%Lower lapsesSouth AfricaSouth AfricaUKUKNo VitalityBlueSilverGold Discoverys Vitality programme was launched in 1997,leading to dec
299、ades of data collection on the impact of behaviour change on health and ageing.Data show that at each age,gold and diamond Vitality members have significantly lower mortality risk and higher longevity compared to other Vitality status members and those without Vitality.Members achieve a specific sta
300、tus based on their level of engagement,with diamond being the highest and blue the lowest.While the average life expectancy in South Africa is 64 years,Vitality gold and diamond members have a life expectancy of 83 and 89 years,respectively;the former is in line with Italy and Australia while the la
301、tter is higher than the average life expectancy in Japan.Customer impact:Source:Discovery HealthSource:Discovery HealthGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare34Business impact:The shared value health insurance model results in a virtuous cycle where
302、by customers,incentivized to adopt healthy behaviours,increase their levels of physical and mental fitness,which then leads to lower reserves for health insurance.These savings are then reinvested into lower premiums and/or additional rewards and incentives for further customer behaviour change.Disc
303、overys Vitality programme has led to a 15%reduction in health insurance claims and 40-60%lower lapses,with a positive correlation between the level of engagement,and claims and lapses.I have asthma but have managed to get it under control with exercise.I know I have to exercise to keep healthy.But w
304、ithout a carrot,I find it hard to make my goals I found the rewards tangible from the get-go.Ros Karamba,Participant,Discovery Vitality programmeI was overweight and unhealthy,my face was puffy,I was eating badly and not exercising all of which I had allowed to happen in my 50s.I realised that I had
305、 to change my lifestyle and look after myself before turning 60.There was a massive change in my medical results.Everything dropped into a good range:from cholesterol to blood pressure and blood glucose levels,and I was in line with my Vitality age-weight range for the first time in years.Everything
306、 was just working properly.Jackie-Anne Collette,Participant,Discovery Vitality programmePersonal impact:Policy and advocacy case study:National Health Authority India Ayushman Bharat Digital MissionA3Overview:Indias 1.4 billion people seek healthcare through a maze of public and private providers th
307、e majority of these interactions are captured on hand-written paper records or not at all.Ayushman Bharat Digital Mission(ABDM)is an initiative launched by the Ministry of Family and Health Welfare,Government of India,under the aegis of National Health Authority,to build,launch and scale foundationa
308、l infrastructure,and enable the worlds largest digital health landscape.It aims to develop the backbone necessary to support the integrated digital health infrastructure of India and bridge the existing gap among different stakeholders of healthcare landscape through digital highways.ABDM will creat
309、e a seamless online platform through the provision of a wide range of data,information and infrastructure services,duly using open,interoperable,standards-based digital systems while ensuring the security,confidentiality and privacy of health-related personal information.ABDM takes a“citizen-centric
310、”approach in healthcare to strengthen the accessibility and equity of health services,including a continuum of care with citizens as the owners of data.Barriers faced:Healthcare literacy and trust in the industry Skilled labour shortage and hospital capacity constraints Data interoperability and con
311、fidentiality Connectivity to the internet and lack of digital infrastructureLevers used:Policy and advocacy Patient empowerment Digitalization,AI and big data Cross-industry collaborationGlobal Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare35Solution:ABDM has bui
312、lt and rolled out various building blocks(through modules,gateways and protocols)to address the existing challenges the healthcare sector currently faces,which are built on the principle of open application programming interfaces(APIs)that the healthcare landscape can consume:Ayushman Bharat Health
313、Account(ABHA)number:A 14-digit random unique number designed as a patient identifier,created with minimum demographic details.Healthcare Professionals Registry(HPR):A comprehensive repository of all healthcare professionals involved in the delivery of healthcare services across both modern and tradi
314、tional systems of medicine.Health Facility Registry(HFR):A comprehensive repository of health facilities of the nation across different systems of medicine.It includes both public and private health facilities including hospitals,clinics,diagnostic laboratories and imaging centres,pharmacies,etc.ABH
315、A mobile app:Enables an individual to manage information about their personal health records(PHR)on a platform through nationally recognized interoperability standards that can be drawn from multiple sources.This includes viewing of a longitudinal record consisting of all health data,lab reports,tre
316、atment details and discharge summaries across one or multiple health facilities on one platform.Health Information Exchange Consent Manager(HIE CM):A gateway that interacts with an individual and obtains consent for any intended access to personal or health data to ensure that an individual is in co
317、mplete control of what data is collected,how/with whom it is shared and for what purpose,and how it is processed.ABDM enables interoperability while maintaining privacyFIGURE 8Digital public goods(DPGs)Health information providers(HIP)ABHAPublic health programesDoctors and hospitalsDiagnostic centre
318、sHealth lockerHealth information use(HIU)Public health programmesDoctors and hospitalsCitizensHealth lockerHealth facility RegistryHealthcare professionals RegistryHealth Information Exchange(gateway)and Consent ManagerProviding health recordsViewing/sharing of health records after consentHealth inf
319、ormation with user consent is exchanged seamlessly between ABDM building blocks and entities involvedUsing health recordsUnified health interface(UHI):Envisioned as an open protocol for various digital health services.The UHI network will be an open network of end-user applications(EUAs)and particip
320、ating health service provider(HSP)applications.The UHI will enable a wide variety of digital health services between patients and HSPs,including appointment booking,teleconsultation,service discovery and others.Source:National Health Authority India Global Health and Healthcare Strategic Outlook:Sha
321、ping the Future of Health and Healthcare36UHI From platform-centric model to network-based modelFIGURE 9Platform-based systems are siloedABDM is providing a unified health interfaceAn open network for digital health servicesNo provision to communicate across platformsPlatform-centric modelOpen netwo
322、rk-centric modelPlatform 1(Teleconsultation)Platform 2(Online pharmacy)Platform 3(Lab services)PatientPatientPatientApplication 1(All services)PatientApplication 2(Telecommunication)PatientApplication 3(Lab services)PatientHSP applicationDoctorsHSP applicationLaboratoriesHSP applicationDoctors and h
323、ospitalsPharmaciesLaboratoriesHospitalsProprietary protocolProprietary protocolProprietary protocolProprietary protocolProprietary protocolProprietary protocolOpen protocolsOpen protocolsHealth claims exchange(HCX):A digital“provider-payer”partnership for seamless e-claim processing.It seeks to help
324、 claims processing information move across providers and payers.The implementation of HCX is expected to reduce the cost per claim and provide better data on service-level agreements(SLAs)for various processes,like time to pre-authorization/discharge.HCX:A digital“provider-payer”partnership for seam
325、less e-claim processingFIGURE 10Health claims exchange(HCX)Insurance company NVerify submitted formsAuto adjudicate claimsManually adjudicate claimsInsurance company oneOpen data for monitoring/-service-level agreementsAutomated tech to verfiy claims formsAuto adjudicate claimsManually adjudicate cl
326、aimsRoute to insurer/third-party administratorOpen APIsHMIS*HospitalCommon e-claim standard across government/private health claimsDigital health records in structured format six documents finalized by ABDMDigital KYC*with ABHA*Know-your-customer*Health management information systemSource:National H
327、ealth Authority India Source:National Health Authority India Global Health and Healthcare Strategic Outlook:Shaping the Future of Health and Healthcare37Key learnings:Offering solutions with open APIs and standards as digital public goods drives scalability and long-term interoperability.Partnership
328、 with all partners drives accelerated adoption of solutions.Adoption is a key element of the journey,especially for small-scale healthcare service providers.Offering required support to integrators is important for special cases of limited connectivity,digital illiteracy and limited human resources.
329、Keep citizens at the heart of the mission building a citizen-centric healthcare model.Keep security and privacy of data at the heart of the design of the architecture built.Information,education and communication(IEC)activities are important to drive awareness among stakeholders.Interoperability of
330、healthcare data to drive improved health and wellness outcomes.Keeping stakeholders involved and engaged throughout is important.Integrating a fragmented sector/players requires sustained engagement with industry partners Capacity building of stakeholders drives the switch from traditional methods o
331、f healthcare delivery to digital healthcare delivery.Impact:ABDM is enabling the delivery of quality healthcare that is integrated,affordable,accessible,inclusive and sustainable(the numbers below are as of 27th September 2022).244,065,706 ABHA numbers created 159,616 health facilities registered on
332、 HFR 90,541 healthcare professionals registered on HPR 13,831,843 health records linked with ABHA/ABHA address 980 active integrators on ABDM sandbox to become ABDM compliant,with 60+private and public players already live Launch of HCX and UHI soonRemaining challenges and role of key stakeholders:G
333、iven ABDM is envisioned to digitize the entire healthcare environment in the country,its success relies on its adoption by all players.Thus far,the adoption of ABDM has been a key challenge,which has been limited and staggered mainly due to data interoperability,confidentiality and connectivity to the internet and lack of digital infrastructure:Heavy partner dependency:Dependency on partners for c