Tuesday, December 17, 2024
It seems that it is primarily the financial value that determines the success of a healthcare innovation, or in other words: what are the direct returns or savings in euros? Is this a healthy form of selection, or should we look more broadly at the value of healthcare innovation? This was the central question at the Medical Delta Café "What Determines the Value of Innovation?" on December 11.
In four short presentations, speakers from different perspectives shared their views on the valuation of healthcare innovations, after which they engaged in discussions with each other and with the audience.
Medical Delta PhD candidate Sanne Allers (Erasmus School of Health Policy & Management) researched for her dissertation the financial barriers to valuable healthcare innovations and how these obstacles can be lowered. She focused, among other things, on the innovator's perspective and analyzed the entire process, from development to implementation.
Her research shows, among other things, that healthcare innovations are often selected based on commercial potential, such as profit or cost savings, while societal or health value is often overlooked. “Funding mechanisms typically encourage innovation with high commercial value. The primary focus on financial value should be shifted towards value for health and society,” she explained. One way to achieve this is through mission-driven innovation. “As a society, decide what you consider important and steer public funding for healthcare innovation projects in that direction. Private money often follows the opportunities created with public funding.”
Desirable, Feasible, and Viable
At healthcare institution Pieter van Foreest, the focus is on promoting the self-reliance and independence of clients. Innovation advisor Mascha Slager, as the second speaker, emphasized the importance of also considering support from the clients' personal network. “This is how we discuss with each other who can provide care and support, and in what way.”
The value of healthcare innovations is assessed by three stakeholders: clients and residents, healthcare professionals, and the organization. They evaluate the value of innovations based on desirability, feasibility, and viability. 'Desirability' focuses on actually solving the problem and improving the quality of life, care, and/or work. 'Feasibility' focuses on the integration of the innovation into existing processes, and 'viability' on the level of impact and financial feasibility.
Even with a positive case, innovations face challenges, such as contract management (is the client the consumer or the healthcare organization?), logistical obstacles, and the many different stakeholders. "Success depends on a lot of stakeholders. Even if the added value of an innovation is significant, that doesn’t always mean it will become a successful innovation."
Appropriate care
“Which healthcare innovation has the most value for society? It’s a difficult question to answer,” said Robin Toorneman, senior advisor on healthcare innovations at the Netherlands Institute for Health Services Research. “We believe it’s important that they contribute to appropriate care and are implemented and scaled in the right way.”
The perspective of the patient plays a central role in this; together with patients and healthcare professionals, it is assessed which innovations are relevant and have proven added value for the health of patients. In addition, costs and societal value are carefully weighed: how does the health gain compare to the price?
In this regard, the Netherlands Institute for Health Services Research focuses on innovations that not only target disease treatment but also promote health. "Appropriate care relieves the healthcare system, reduces rising costs, and ensures better and more accessible care, allowing patients to benefit from new and suitable treatments." The societal perspective and sustainability also play a role in determining the value of healthcare innovations. Toorneman referred to mission-driven innovation. "I would encourage innovators to align their solutions with one of the healthcare agreements."
Collaboration and openness to change
Dennis Japink, coordinator of value assessment at DigiZo, emphasized the importance of collaboration between various parties in determining the value of innovations. Conversations about "working differently" and embracing innovation are central to this process. By assessing value according to a fixed framework, clarity and objectivity are achieved. "When you collectively objectify what has value, you can then establish it and act accordingly. This prevents objections from arising repeatedly, precisely because you have made decisions together at an earlier stage."
For DigiZo, the value of innovation is not only about factors such as technology, quality, and safety, but also about people's willingness to work with it and be open to change, explained Japink. "‘Soft factors’, such as ease of use and organizational readiness, are crucial. Only in this way can clients effectively use the innovation, and the organization can successfully integrate it."
Medical value or prevention?
In the subsequent discussion, a balance was sought between the interests of different stakeholders, such as patients and healthcare institutions. They sometimes have different priorities, which raises the question, for example, of who is responsible for the funding of a healthcare innovation for people at home: the patient or the healthcare organization? Toorneman suggested that a distinction might need to be made between medical care and general prevention. "Hospitals provide appropriate care when there is a medical necessity. Some forms of prevention are reimbursed, but for general prevention for healthy people, more costs might shift to the citizen themselves."
The current financing system in healthcare primarily focuses on medical innovations. This raises the question of whether the focus should also be on preventive care. However, innovations in the field of prevention are less frequently reimbursed because collective resources are mostly directed towards medical applications. To change this, it is important for society to collectively determine where the value lies, one of the conclusions of the discussion stated. “This requires collaboration, out-of-the-box thinking, and demonstrating the benefits of change,” said Slager.
By thinking outside of traditional frameworks and collaborating, a transition from medical to preventive innovations can occur. “One of the most effective preventive lifestyle interventions we've seen so far is Pokémon Go,” Toorneman illustrated the out-of-the-box thinking. “With healthcare innovations, also show what it replaces, so you can stop doing something instead of adding more,” Japink concluded.
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Photo's: Eelkje Colmjon
