samedi, mars 16, 2013

Healthcare productivity is better than you think

Published in French in Les Echos, 03/04/2013

A Mozart string quartet takes just as long to play in 2012 as it did in the 18th century. That is why the price of live performances has not gone down, unlike the price of most products that have experienced an increase in productivity. This is what economist William Baumol calls the “cost disease.” This disease concerns services based essentially on professionals’ time and skills – in the case of healthcare, doctors, caregivers and healthcare workers in general.

                And yet, significant progress has been made in the field of cancer treatments. Development of surgical techniques leads to less invasive operations and fewer complications. Digital imagery, combined with specific markers, makes for greater certainty in diagnoses and more targeted procedures. The digital revolution in medicine enhances both the quality and productivity of healthcare. It transforms medical techniques (digital or robotic imagery), patient care (data analysis to better target procedures and reduce costs) and access to treatment (sharing medical images through networks, thus reducing test duplications and the exodus of doctors from certain regions). Unfortunately, this progress is not always visible: when a factory worker increases his output by 50% in return for a 20% raise, statistics show increased productivity. If the healthcare system reduces the mortality rate of cancer by 50% thanks to a 5% increase in costs, statistics only show the cost increase. Healthcare is not in the grip of a “cost disease;” it is suffering from an imperfect assessment of its value! To solve this problem, we need better to improve the way we measure both the value of healthcare procedures and the quality and rapidity of treatments at the national level, and the way we benchmark this value at the European level. Of course, healthcare cannot be reduced to mere statistics, but it deserves more than the sole costs numbers.

Furthermore, our country has undeniable industrial strengths: world-renowned practitioners, cutting-edge research facilities such as the Gustave Roussy Institute, Inria and the Atomic Energy and Alternative Energies Commission, innovative start-ups such as Medtech (a robotic surgery specialist) and world-class production sites and centers of expertise, such as General Electric’s mammogram equipment production site in Buc. However, we are not the only ones who want to develop this sector. There is little chance of France winning this worldwide competition without a truly industrial healthcare strategy.

                This is particularly true in the field of digital healthcare, where we need a strategy to develop not only infrastructure, but contents and uses as well. Regarding infrastructure, the problem has less to do with “technical” layers (networks or hosting solutions) than these layers’ interaction with equipment of diverse origins, not to mention change management to bring hospital professionals on board. When it comes to content and use, France rolls out four times fewer digital imagery systems than Denmark. We are closing the gap thanks to regional “cloud” projects, but it is essential to continue guiding and encouraging these projects at the national level.

                Rather than “cost disease,” our healthcare industry is suffering from a two-fold vision problem: it is both far-sighted, as it has trouble seeing its own advantages close-up, and short-sighted, as it is unable to make out a long-term industrial strategy that would help develop its strengths.