tag:blogger.com,1999:blog-16622965651574314512024-03-05T08:57:36.630+01:00Service Design - The Good, the Bad and the UglyWhat is good service design? What are examples of things gone wrong and why? I am collecting thoughts and experiences here about services in general and health services in particular and am looking forward to your comments.Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.comBlogger57125tag:blogger.com,1999:blog-1662296565157431451.post-67172829253464953482016-07-14T23:12:00.003+02:002021-04-22T16:16:57.998+02:00Oliver Wyman breakfast at Davos<div dir="ltr" style="text-align: left;" trbidi="on">
Back in Davos, I was invited to a very interesting breakfast event by Oliver Wyman on "Sugar, obesity and diabetes - The other global food crisis". I now discovered that they published a report about it in which I was quoted quite extensively. For example here:<br />
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There is an <a href="http://www.oliverwyman.com/insights/publications/2015/dec/sugar--obesity-and-diabetes---the-global-food-crisis.html#.V4ekdPl96M8" target="_blank">article</a> on the Oliver Wyman website about the breakfast event and you can also download a <a href="http://www.oliverwyman.com/content/dam/oliver-wyman/global/en/files/insights/health-life-sciences/2016/Oliver%20Wyman%20HLS%20WEF%202016%20Sugar%20Obesity%20and%20Diabetes.pdf" target="_blank">report</a> summarizing our discussion.</div>
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-70076863794864723582016-02-25T20:26:00.000+01:002016-03-12T18:07:14.800+01:00World Economic Forum blog: Who should own our health data?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "times new roman";">In October I wrote a piece for the World Economic Forum blog on health data and questions around who (should) own it.</span></div>
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Who should own our health data?</span></div>
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<span style="color: #141414; font-family: "neue helvetica w01" , "helvetica neue" , "helvetica" , sans-serif; line-height: 29.7px;">The amount of available health-related data is exploding. The increase is driven by both healthcare data, such as electronic medical records, but also user-generated data, such as activity and sleep profiles collected by wearables. The available data is set to more than double every two years until 2020, according to</span><a href="http://www.emc.com/analyst-report/digital-universe-healthcare-vertical-report-ar.pdf" style="border-bottom-color: rgb(213, 224, 232); border-bottom-style: solid; border-bottom-width: 1px; box-sizing: border-box; color: #005c9c; font-family: 'neue helvetica w01', 'helvetica neue', helvetica, sans-serif; line-height: 1.125; text-decoration: none; transition: all 0.15s ease-out;" target="_blank">a study by EMC and the research firm IDC</a><span style="color: #141414; font-family: "neue helvetica w01" , "helvetica neue" , "helvetica" , sans-serif; line-height: 29.7px;">. This translates into a 15-fold increase between 2013 and 2020. If one imagines this amount of data stored on tablet computers, the resulting stack, which in 2013 is around 8,800 km high, would be more than one third of the way to the moon by 2020.</span></div>
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Continue reading here: <a href="http://www.weforum.org/agenda/2015/10/who-should-own-our-health-data">http://www.weforum.org/agenda/2015/10/who-should-own-our-health-data</a></div>
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-55818524421820054842016-02-23T15:25:00.000+01:002016-02-23T15:25:09.298+01:00Immunotherapy breakthrough: Did we just get a small step closer to curing cancer?<div dir="ltr" style="text-align: left;" trbidi="on">
Nice to see our message on the severity of the NCD crisis is getting picked up. After <a href="http://www.welt.de/wirtschaft/article152000946/Der-wachsende-Wohlstand-macht-die-Welt-krank.html" target="_blank">an article in the German newspaper "Die Welt"</a> covered <a href="http://www.weforum.org/reports/how-to-realize-returns-on-health" target="_blank">our report</a>, I just got quoted in a World Economic Forum blog post on a breakthrough in immunotherapy for cancer:<br />
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<span style="-webkit-text-size-adjust: 100%; color: #141414; font-family: 'Neue Helvetica W01', 'Helvetica Neue', Helvetica, sans-serif;">"Non-communicable diseases such as cancer are more than a personal tragedy – they're a threat to global prosperity. Their cumulative direct and indirect cost over the next 15 years will be around five times the cost triggered by the financial crisis in the 15 years following 2008"</span><br />
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Read the full blog here: <a href="http://www.weforum.org/agenda/2016/02/did-we-just-get-a-step-closer-to-curing-cancer">http://www.weforum.org/agenda/2016/02/did-we-just-get-a-step-closer-to-curing-cancer</a></div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-71338624351147239252016-02-22T14:58:00.000+01:002016-03-12T18:06:08.139+01:00Can the private sector help achieve universal health coverage?<div dir="ltr" style="text-align: left;" trbidi="on">
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The next blog post in the series by the World Economic Forum where constituents of the Forum engage with the ideas of my report <a href="http://www.weforum.org/reports/how-to-realize-returns-on-health" target="_blank">"How to Realize Returns on Health"</a> is by Sania Nishtar of Heartfile.<br />
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Can the private sector help achieve universal health coverage?</h1>
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<span style="color: #1b1b1b; font-size: 18px;">When the world committed to ending poverty, protecting the planet and ensuring prosperity for all with the</span><span style="color: #1b1b1b; font-size: 18px;"> </span><a href="http://www.un.org/sustainabledevelopment/sustainable-development-goals/" style="color: #416ed2; font-family: -apple-system-font; font-size: 18px; max-width: 100%; text-decoration: none;">17 Sustainable Development goals</a><span style="color: #1b1b1b; font-size: 18px;">, we knew no single entity would be able to achieve such lofty goals – it would take collaboration. “A successful sustainable development agenda requires partnerships between governments, the private sector and civil society,” Goal 17 stated.</span><br />
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Continue here: <a href="http://www.weforum.org/agenda/2016/02/how-can-we-achieve-universal-health-coverage">http://www.weforum.org/agenda/2016/02/how-can-we-achieve-universal-health-coverage</a></div>
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-78696990823624576892016-02-19T14:49:00.000+01:002016-03-12T18:04:49.790+01:00What can technology do for global health?<div dir="ltr" style="text-align: left;" trbidi="on">
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The World Economic Forum is currently publishing a series of posts engaging with the ideas of my World Economic Forum Report <a href="http://www.weforum.org/reports/how-to-realize-returns-on-health" target="_blank">"How to Realize Returns on Health"</a>. The first post is by Jonathan Jackson of Dimagi.<br />
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What can technology do for global health?</h1>
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This year, the focus of the World Economic Forum's Annual Meeting in Davos was on the Fourth Industrial Revolution, and how the technology revolution is changing all aspects of our world. The effects are particularly profound in the healthcare field.</div>
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Continue here: <a href="http://www.weforum.org/agenda/2016/02/how-can-we-leverage-technology-to-bridge-the-global-healthcare-divide">http://www.weforum.org/agenda/2016/02/how-can-we-leverage-technology-to-bridge-the-global-healthcare-divide</a></div>
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-89789184767163507052016-02-18T20:22:00.003+01:002016-07-14T22:59:34.328+02:00World Economic Forum Blog: The silent pandemic that threatens the global economy<div dir="ltr" style="text-align: left;" trbidi="on">
On Monday, the second blog by me and the partner I worked for in the last 10 months went live on the World Economic Forum blog.<br />
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The silent pandemic that threatens the global economy</span></h1>
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<span style="color: #141414; font-family: "neue helvetica w01" , "helvetica neue" , "helvetica" , sans-serif; line-height: 29.7px;">Non-communicable diseases (NCDs) such as cancer and diabetes are a silent pandemic of our own making and a real threat not only to human health but to global prosperity. To put this threat into perspective: the cumulative direct and indirect costs of NCDs over the next 15 years will be about five times the costs triggered by the global financial crisis in the 15 years following 2008, according to Bain analysis based on data from the </span><a href="http://www.weforum.org/reports/global-economic-burden-non-communicable-diseases" style="border-bottom-color: rgb(213, 224, 232); border-bottom-style: solid; border-bottom-width: 1px; box-sizing: border-box; color: #005c9c; font-family: "neue helvetica w01", "helvetica neue", helvetica, sans-serif; line-height: 1.125; text-decoration: none; transition: all 0.15s ease-out;">World Economic Forum and Harvard University</a><span style="color: #141414; font-family: "neue helvetica w01" , "helvetica neue" , "helvetica" , sans-serif; line-height: 29.7px;"> and the </span><a href="https://dallasfed.org/assets/documents/research/staff/staff1301.pdf" style="border-bottom-color: rgb(213, 224, 232); border-bottom-style: solid; border-bottom-width: 1px; box-sizing: border-box; color: #005c9c; font-family: "neue helvetica w01", "helvetica neue", helvetica, sans-serif; line-height: 1.125; text-decoration: none; transition: all 0.15s ease-out;">Federal Reserve Bank of Dallas.</a></div>
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Continue reading here: <a href="http://www.weforum.org/agenda/2016/02/the-silent-pandemic-that-threatens-the-global-economy">http://www.weforum.org/agenda/2016/02/the-silent-pandemic-that-threatens-the-global-economy</a></div>
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-32467764461337136902016-02-02T16:25:00.004+01:002016-02-02T16:25:59.736+01:00WEF/ Bain report online<div dir="ltr" style="text-align: left;" trbidi="on">
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My report is online on the WEF website. Let me know what you think!</div>
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After demonstrating in <a href="http://www.weforum.org/reports/maximizing-healthy-life-years-investments-pay" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; box-sizing: border-box; color: #315b9b; line-height: 1.125; text-decoration: none;">Maximizing Healthy Life Years</a> that health can have a positive return on investment, the 2016 report <a href="http://www3.weforum.org/docs/WEF_Future_of_Healthy_How_to_Realize_Returns_on_Health_2016.pdf" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; box-sizing: border-box; color: #315b9b; line-height: 1.125; text-decoration: none;">How to Realize Returns on Health</a> shows how to tackle the silent NCD pandemic: why we should focus on Maximizing Healthy Life Years (MHLY) instead of just treating disease, why we need to act boldly now and how investments into health can have healthy returns in a multi-stakeholder environment by creating Ecosystems of Health.</div>
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Developed by the World Economic Forum in collaboration with Bain & Company, this report covers</div>
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<li><span style="font-size: 1.125em; line-height: 31.5px;">How investments into health can have healthy returns</span></li>
<li><span style="font-size: 1.125em; line-height: 31.5px;">How Ecosystems of Health align private and public stakeholders across sectors and industries</span></li>
<li><span style="font-size: 1.125em; line-height: 31.5px;">How the individual must be put at the center to make these ecosystems happen</span></li>
<li><span style="font-size: 1.125em; line-height: 31.5px;">How Ecosystems of Health create the foundation for market-driven solutions to tackle NCDs and to Maximize Healthy Life Years</span></li>
<li><span style="font-size: 1.125em; line-height: 31.5px;">Important success factors for healthier lives</span></li>
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<a href="http://www3.weforum.org/docs/WEF_Future_of_Healthy_How_to_Realize_Returns_on_Health_2016.pdf" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; box-sizing: border-box; color: #315b9b; font-size: 18px; line-height: 1.125; text-decoration: none;">Download the pdf here</a></div>
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-29408776476253314022016-01-28T14:00:00.000+01:002016-01-28T14:00:04.704+01:00Are sugar taxes the answer?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt;">Two tools for putting
direct financial value on what are otherwise societal costs are regulation and
taxes. One example are taxes on sugar which seek to reflect some of the societal
cost incurred by obesity: In France beverages with added sugar or sweetener
have been subject to an excise duty since 2012 and added sugar in soft drinks
has been taxed as part of the Public Health Product Tax in Hungary since 2011 </span><span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt;">[1, p. 18f]</span><span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt;">.</span></div>
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<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt;">The effects of these
taxes were firstly the desired decrease in consumption. The Mexican soda tax led to a decrease of purchase of sugary drinks by 12% in the first year and most importantly, the biggest reductions have occurred among the poor [1]. </span></div>
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<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt;">On the other hand, profitability stayed mostly
stable. However, in some case cases profitability also de- or increased </span><!--[if supportFields]><span
lang=EN-GB style='font-size:10.0pt;mso-bidi-font-size:11.0pt;font-family:"Arial",sans-serif;
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EN-US'><span style='mso-element:field-begin;mso-field-lock:yes'></span>ADDIN
CSL_CITATION { "citationItems" : [ { "id" :
"ITEM-1", "itemData" : { "abstract" :
"Preface Europe\u2019s increasing obesity prevalence is of growing concern
to EU policy makers given its detrimental health effects and associated burden
on public health systems. In recent years there has been interest, both within
the EU and globally, in the use of taxes on high in fat, sugar or salt foods
(this definition of food includes non-alcoholic beverages) to reduce their
consumption, and address obesity. Over the last few years, several governments
of EU Member States have introduced taxes on specific food categories and food
ingredients such as confectionery, ice cream, soft drinks, sugar, fat,
artificial sweeteners and sa lt. The effectiveness of such taxes in
discouraging consumption of the targeted foods or ingredients, however, is
uncertain. In addition, these taxes can have complex social, economic and
environmental consequences for individuals, companies and sectors. The desire
to undertake the present study originates in the discussions held among
stakeholders participating in the High Level Forum for a Better Functioning
Food Supply Chain. This study Food taxes and their impact on com petitiveness
in the agri-food sector was granted to the ECSIP consortium with Ecorys
Netherlands as lead partner. Responsible for the management of the project and
overall analysis are Robert Haffner, Patrick de Bas and Eszter Kantor with
Jan-Maarten de Vet providing quality control. Key support staff includes
Katelyn Price (literature review and coordination support) and Maarten van der
Wagt (quantitative anal ysis). Other Ecorys contributors are Lilian Tilburgs
and Anastasia Yagafarova. For the case studies, the project team drew on the
services of Janne Sylvest & Benita Kidmose Rytz (DTI; case study Denmark),
Karen Thorsted Hamann (IFAU; case study Finland), Pierre Padilla (IDEA; case
study France), P\u00e1sztor Zsolt (Eufund Consultants; case study Hungary),
Katelyn Price (Ecorys Netherlands; case study Ireland) and Valentina Patrini
(Ecorys Brussels; case study Italy). The project team was advised by a team of
experts. The advisory panel consisted of: Professor Dr Xavier Gellynck and Dr
Bianka K\u00fchne (University of Ghent), Dr Fabian Zuleeg (European Policy
Centre) and Professor Dr Sijbren Cnossen (CPB Netherlands Bureau for Economic
Policy Analysis). We would like to thank the steering group of the European
Commission for its constructive comments and excellent guidance and advice
throughout the entire period of this study. We also thank the numerous
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brands. Thus, taxes appear to not be suitable universal tool. It can be useful
to shift buying patterns for commodities, e.g. from cooking oils high in
saturated fats to those lower in these fats, but consumers will continue to
purchase what they consider indulgences, such as chocolates or high end ice
cream, with a certain indifference to the price. Also the introduction of food
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women come from added sugars in the taxed product groups (chocolate, sweets,
soft drinks) </span><!--[if supportFields]><span lang=EN-GB style='font-size:
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lang=EN-GB style='font-size:10.0pt;mso-bidi-font-size:11.0pt;font-family:"Arial",sans-serif;
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EN-US'><span style='mso-element:field-end'></span></span><![endif]--><span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt;">. Added sugars in other common product groups such as cakes, biscuits,
ice cream, preserves, condiments or fruit yoghurts are currently not subject to
the tax. The difficulties in deciding where to draw the line highlight one of
the key weaknesses of using taxes as a key policy option.<o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt;">However, another
important effect of these food taxes are that they accelerate reformulations
already partially under way to respond to consumer demands for “lighter” or
healthier products. An impact assessment of the Hungarian Public Health Product
Tax found that 40% of manufactures reformulated their products. Of the
reformulations, 30% completely removed the targeted ingredient and 70% reduced
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reformulated to meet their criteria, for example by reducing added sugar in
sauces. Furthermore, new products specifically formulated to meet the choices
criteria were developed following the launch of the logo </span><!--[if supportFields]><span
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lang=EN-GB style='font-size:10.0pt;mso-bidi-font-size:11.0pt;font-family:"Arial",sans-serif;
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<br /></div>
<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt; line-height: 115%;">Passing regulation mandating healthier products is unlikely to succeed
but indirect measures that shape markets in a way that align RoH with RoI are
possible. For example current occupation health and safety reporting
requirements could be expanded into employee health and the health impact of
products and services. The latter creates more transparency for customers, who
can use this information in their purchasing decisions. In this regard valuable
lessons can be learned from the effect an increased emphasis on sustainability
has had on consumer purchasing decisions and consequently the products
portfolios of manufactures. Employee health reporting would allow reflecting better
health in risk assessments, thereby increasing shareholder value. Other forms
of regulations could be standards regarding upper levels of acceptable health
impact and the possibility to buy health certificates from low impact
companies, analogous to emission certificates.</span><br />
<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt; line-height: 115%;"><br /></span>
<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt; line-height: 115%;">(The views expressed in this piece are my own and do not reflect the WEF or Bain)</span><br />
<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt; line-height: 115%;"><br /></span>
<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt; line-height: 115%;"></span><br />
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 32pt; text-indent: -32pt;">
<span lang="EN-GB" style="font-size: 9pt;">[1] </span><a href="http://www.bloombergview.com/articles/2016-01-08/mexico-s-soda-tax-success"><span style="font-size: x-small;">http://www.bloombergview.com/articles/2016-01-08/mexico-s-soda-tax-success</span></a></div>
<div class="MsoNormal" style="margin-left: 36.0pt;">
<o:p></o:p></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 32pt; text-indent: -32pt;">
<span lang="EN-GB" style="font-size: 9.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-bidi-font-size: 12.0pt; mso-hansi-font-family: Calibri; mso-no-proof: yes;">[2] ECSIP consortium, “Food
taxes and their impact on competitiveness in the agri-food sector,” 2014.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 120%; margin-bottom: 7.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-size: 9pt; text-indent: -32pt;">[3]</span><span style="font-size: 9pt; text-indent: -32pt;"> </span><span style="font-size: 9pt; text-indent: -32pt;">World Cancer Research
Fund International, “Curbing global sugar consumption,” 2015.</span></div>
<span lang="EN-GB" style="font-family: "arial" , sans-serif; font-size: 10pt; line-height: 115%;"><br /></span>
<br />
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-85194473181841083152016-01-27T10:09:00.001+01:002016-01-27T10:11:32.306+01:00Health at the Annual Meeting <div dir="ltr" style="text-align: left;" trbidi="on">
<iframe frameborder="0" height="306px" scrolling="no" src="https://webcasts.weforum.org/widget/1/davos2016?p=1&hl=english&w=550&h=306&id=76067" width="550px"></iframe>
<br />
Health featured prominently on the program of this year's WEF Annual Meeting. There were over 35 sessions on health in the official and the private program. The meeting started with US Vice-President Joe Biden's moonshot to combat cancer (video above) and later during the meeting the Forum launched <a href="http://www.weforum.org/global-challenges/future-of-health-253dcdf3-464e-4fe2-9944-eb5a9a040d96">health as its 10th Global Challenge</a>. As the health team we had worked hard for the latter, so it was really great to see this become reality.<br />
<br />
The new Global Challenge will on the one hand continue my work on how to keep people healthier for longer but also combine it with work on health security and how to handle and combat epidemics of infectious diseases. The idea behind the Global Challenge mirrors the insight from my work that these are issues that transcend healthcare and have to be addressed collaboratively across industry and sector boundaries.<br />
<br /></div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-55105413431860996102016-01-22T13:19:00.000+01:002016-01-22T13:19:19.675+01:00Summary of my World Economic Forum/ Bain report<div dir="ltr" style="text-align: left;" trbidi="on">
I am at Davos right now, where we will launch the report which I authored for the World Economic Forum. Below the summary - will let you know once the report goes live on the WEF website :)<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIch_zWnvNXuEZA8XjVWIdqUY1MaJJvUU67DJ1xc5iOxhu-zfTNo6Gjnf5YZtSMm8C6uFi03CjAtHguVotjw2MyLoly2v9LQWQBh3Rf8UKr32lxrEMK3I-exKlU5uucgrSmhRP0mvkYH97/s1600/Davos.jpg" imageanchor="1"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIch_zWnvNXuEZA8XjVWIdqUY1MaJJvUU67DJ1xc5iOxhu-zfTNo6Gjnf5YZtSMm8C6uFi03CjAtHguVotjw2MyLoly2v9LQWQBh3Rf8UKr32lxrEMK3I-exKlU5uucgrSmhRP0mvkYH97/s640/Davos.jpg" width="640" /></a><br />
<u><br /></u>
<br />
<div style="background-color: white; border: 0px; color: #5a5a5a; font-family: 'Helvetica Neue', arial, sans-serif; font-size: 14px; font-stretch: inherit; line-height: 1.45em; margin-bottom: 1em; padding: 0px; text-align: left; vertical-align: baseline;">
<u>"How to Realize Returns on Health" - Executive summary</u></div>
<div style="background-color: white; border: 0px; color: #5a5a5a; font-family: 'Helvetica Neue', arial, sans-serif; font-size: 14px; font-stretch: inherit; line-height: 1.45em; margin-bottom: 1em; padding: 0px; text-align: left; vertical-align: baseline;">
This report focuses on the role of different stakeholders in shaping an ecosystem of health and how to use market forces to make such a system, and the associated returns on health (RoH), happen.</div>
<div style="background-color: white; border: 0px; color: #5a5a5a; font-family: 'Helvetica Neue', arial, sans-serif; font-size: 14px; font-stretch: inherit; line-height: 1.45em; margin-bottom: 1em; margin-top: 1em; padding: 0px; text-align: left; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Maximizing Healthy Life Years (MHLY) are investments in preventing non-communicable diseases (NCDs) and mental ill-health. These investments can pay off and generate opportunities across all industries, not just typical healthcare players.</strong> All industries are becoming concerned about the health of consumers through the direct or indirect impact of products and services they use, the impact of corporate operations on communities, and the health of employees and the work environment.</div>
<div style="background-color: white; border: 0px; color: #5a5a5a; font-family: 'Helvetica Neue', arial, sans-serif; font-size: 14px; font-stretch: inherit; line-height: 1.45em; margin-bottom: 1em; margin-top: 1em; padding: 0px; text-align: left; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">An ecosystem of health is always specific to a particular issue, i.e. the RoH sought.</strong> Such an ecosystem can align stakeholders with different perspectives around a common goal about desirable returns. The fundamental architecture of an ecosystem of health is based on two roles: health shapers and designers/deliverers. Health shapers who are motivated by social benefits, such as government and non-governmental organizations (NGOs) or organizations from the private sector, can utilize a <strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">range of mechanisms to </strong>(re)<strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">shape markets</strong> in a way that ensures delivering on health outcomes is a viable business. By setting standards and norms, aggregating demand or catalysing behaviour change, these health shapers align RoH with return on investment (RoI) and enable positive business cases for a second type of stakeholder that <strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">designs and delivers offerings</strong>. This report illustrates these concepts of ecosystem roles (shaping, designing, delivering) and includes multiple examples from different sectors and industries.</div>
<div style="background-color: white; border: 0px; color: #5a5a5a; font-family: 'Helvetica Neue', arial, sans-serif; font-size: 14px; font-stretch: inherit; line-height: 1.45em; margin-bottom: 1em; margin-top: 1em; padding: 0px; text-align: left; vertical-align: baseline;">
In some cases, RoH and RoI are already aligned in the current environment, delivering a short-term payback for private ventures. If they are not, health shapers can strengthen the alignment either by decreasing barriers or by creating additional incentives, such as cost/benefit sharing.<strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Cost/benefit sharing is a renegotiation of costs and benefits and can take either the form of spreading the cost of improved health among stakeholders, sharing the benefits, or both</strong>. It can unlock the value of healthy living when beneficiaries of good health and investors are not aligned. This is particularly critical if the project requires a large investment but benefits different stakeholders.</div>
<div style="background-color: white; border: 0px; color: #5a5a5a; font-family: 'Helvetica Neue', arial, sans-serif; font-size: 14px; font-stretch: inherit; line-height: 1.45em; margin-bottom: 1em; margin-top: 1em; padding: 0px; text-align: left; vertical-align: baseline;">
<strong style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">An ecosystem of health creates the foundation for market-driven solutions to tackle NCDs and MHLY. Because markets depend on customers, the individual must be at the centre to make these ecosystems happen.</strong> The engine to set MHLY in motion is to increase both demand and supply for healthy products and services. The behaviour of individuals and their underlying habits and social norms play an important role in creating demand and ensuring supply translates into demand. On the other hand, important levers to translate demand into supply include financial viability, either by providing a short-term payoff or through attractive cost/ benefit sharing. Supply can also be driven by an attractive long-term payoff, often a combination of direct financial returns and indirect returns, such as a competitive advantage. Long-term payoffs are more durable with innovative financing models, such as impact bonds, or stronger ties of health impact to shareholder value, e.g. through inclusion of health in stock market indices.</div>
<div style="background-color: white; border: 0px; color: #5a5a5a; font-family: 'Helvetica Neue', arial, sans-serif; font-size: 14px; font-stretch: inherit; line-height: 1.45em; margin-bottom: 4px; margin-top: 1em; padding: 0px; text-align: left; vertical-align: baseline;">
Looking ahead, key areas for action are laying the foundations for ecosystems of health, shaping an individual-centric environment for MHLY and providing the tools and platforms for multistakeholder collaboration and innovation.</div>
</div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-31121511246017208532016-01-19T12:39:00.000+01:002016-01-19T12:39:02.294+01:00WEF Secondees<div dir="ltr" style="text-align: left;" trbidi="on">
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So, the Annual Meeting of the World Economic Forum in Davos is about to start. As this means our WEF assignments are almost over, Bain & Company posted short profiles of my colleague Lyu and myself on their <a href="http://www.bain.com/about/world-economic-forum/WEF-externships.aspx" target="_blank">website</a>.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLtuDu5OxBWYqejPDahgA_yYYXDRecOPHGCbGKSgZ67Lw88lC5Gb5TMDenydUFzw-SulOT3fZ8Q8qW7d43927jgCeWwpqT26Qx2LaaLT-0kaILrV8fUC5uB2ZXXji8vYk9ixdTfVG6NfAq/s1600/IMG_1872+-+Copy.JPG" imageanchor="1"><img border="0" height="336" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLtuDu5OxBWYqejPDahgA_yYYXDRecOPHGCbGKSgZ67Lw88lC5Gb5TMDenydUFzw-SulOT3fZ8Q8qW7d43927jgCeWwpqT26Qx2LaaLT-0kaILrV8fUC5uB2ZXXji8vYk9ixdTfVG6NfAq/s400/IMG_1872+-+Copy.JPG" width="400" /></a><br />
<br />
Lyu is working on Future of Electricity:<br />
<blockquote class="tr_bq">
"<span style="background-color: white; color: #000302; font-family: "arial" , sans-serif; font-size: 13px; line-height: 20px;">The Future of Electricity 2016 focuses on how to improve investment attractiveness of power markets in fast-growing countries. The countries need to attract $13 trillion of capital to power sector between 2015 and 2040 to be able to serve enormous new demand for electricity as their economies grow. During the assignment, the team developed eight recommendations for improving investment attractiveness of power markets in fast-growing economies that will help them to achieve social and economic objectives, including universal access to reliable affordable power and environment sustainability."</span></blockquote>
... and his take on the WEF is:<br />
<blockquote class="tr_bq">
<span style="background-color: white; color: #000302; font-family: "arial" , sans-serif; font-size: 13px; line-height: 20px;">"Managing the Future of Electricity project in the World Economic Forum was invaluable experience. It combines in-depth industry analysis, its implications for the world and interaction with key stakeholders that shape global agenda in power: CEOs, other senior executives and policy makers. It was also very enjoyable to work side by side with people that live by the Forum's motto – 'To improve the state of the world.'"</span></blockquote>
<br />
My project has been looking at the "Future of Healthy":<br />
<blockquote class="tr_bq">
<span style="background-color: white; color: #000302; font-family: "arial" , sans-serif; font-size: 13px; line-height: 20px;">"</span><span style="background-color: white; color: #000302; font-family: "arial" , sans-serif; font-size: 13px; line-height: 20px;">In the first year, the project established "Maximizing Healthy Life Years" as the new currency of economic prosperity and demonstrated that health can yield a positive ROI. The second year of the project focused on how to align multiple stakeholders across sectors and how to set up the right incentives for investments in health. "Ecosystems of Health," which are specific to a particular "Return on Health," align health value with economic value and are set up by shaping markets and supply chains accordingly. These systems harness the forces of demand and supply to improve health of individuals and populations, while also delivering a positive return on investment."</span></blockquote>
... and I also thought it was a great experience:<br />
<blockquote class="tr_bq">
<span style="background-color: white; color: #000302; font-family: "arial" , sans-serif; font-size: 13px; line-height: 20px;">"The work at the World Economic Forum was an exciting opportunity to pursue my interest in healthcare. It also allowed me to link my work at Bain, focused at the business side of health, with the work around systemic change that I did for the English National Health Service prior to joining Bain. Being part of the Forum brought me in contact with some of the most inspiring people and working with global leaders really allowed me to have an impact on the global agenda. I truly believe that a problem on the scale of non-communicable disease can only be solved by collaborative action of stakeholders and by harnessing market forces."</span></blockquote>
<br /></div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-84466406509652445722015-11-19T16:07:00.000+01:002015-11-19T16:07:00.368+01:00Who should own our health data?<div dir="ltr" style="text-align: left;" trbidi="on">
I already mentioned that we had a workshop in San Francisco earlier this year. I summarized some of our insights in a blog post for the World Economic Forum: <a href="https://agenda.weforum.org/2015/10/who-should-own-our-health-data/" target="_blank">Who should own our health data?</a></div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-55314713524321841542015-11-16T16:01:00.000+01:002015-11-16T16:01:00.353+01:00Annual Meeting of New Champions in Dalian<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwk-0i1R5OQzY4eAtYMI-YdmfAiv5p-JcxZt_zBtEpxOXC60NxAwlPHCQ2H2wah3cN95ghFJBw4Gp1X_bZqSGSrFe3A8HjE7eFTQp_Zp0U9tp8WyYZaXvwxVqtP1zVfiDif_6VqOUbFyCd/s1600/IMG_4310.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwk-0i1R5OQzY4eAtYMI-YdmfAiv5p-JcxZt_zBtEpxOXC60NxAwlPHCQ2H2wah3cN95ghFJBw4Gp1X_bZqSGSrFe3A8HjE7eFTQp_Zp0U9tp8WyYZaXvwxVqtP1zVfiDif_6VqOUbFyCd/s400/IMG_4310.JPG" width="300" /></a></div>
One of the exciting parts of my work at the World Economic Forum is that I get to meet interesting people all over the world. I have been running a workshop series on different aspects on how to prevent non-communicable diseases. In June, we were in San Francisco looking what value proposition IT/ tech can have in this space, in September we were in Dalian for the Forum's Annual Meeting of New Champions (also dubbed "Summer Davos"), where we looked into how physical and built environments shape health and in October we ran a final workshop in Tokyo on consumerization of health.<br />
<br />
Dalian was particularly exciting as this was my first WEF summit and gave me an idea what to expect from Davos. And we had a fantastic group of people attending my workshop, including two ministers of health, executives from the for- and not-for-profit sector as well as leading academics. Gates Cambridge, my scholarship during my PhD at Cambridge, actually wrote a blog about it, which you can find <a href="https://www.gatescambridge.org/news/investing-healthy-populations" target="_blank">here</a>. <br />
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-85856091577003422412015-11-12T18:47:00.000+01:002015-11-12T18:47:51.282+01:00OECD Health Indicators 2015<div dir="ltr" style="text-align: left;" trbidi="on">
For all the number crunchers among us, the OECD has published its "Health at a Glance 2015" report with dashboards and data on health indicators & status, pharmaceutical spending, non-medical determinants of health, health workforce, health care activities, access to care, quality of care, health expenditure and financing, the pharma sector, and ageing and long term care.<br />
<br />
My favorite chart is public and private per capita health spending in the OECD countries:<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhOl0ETakfKGRkF03Dj-EVaFodmY_cK7LKqOgqx1IJUJ8uksWaSp-ymN5bmhtHuRF-RqfNX5FYbgpJbD53nX8iPVIoT0wi0qMq1c018FsntP4DqZinYL2Bg_V4q8xoJmjuiPUWl0g6GlNqM/s1600/Health+expenditure.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="194" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhOl0ETakfKGRkF03Dj-EVaFodmY_cK7LKqOgqx1IJUJ8uksWaSp-ymN5bmhtHuRF-RqfNX5FYbgpJbD53nX8iPVIoT0wi0qMq1c018FsntP4DqZinYL2Bg_V4q8xoJmjuiPUWl0g6GlNqM/s320/Health+expenditure.JPG" width="320" /></a></div>
The US are the biggest spender (adjusted by purchasing power) by a large margin but they are also outspending all other countries except the Netherlands and Norway on public health spending. Or to put differently: the amount of public money the US spends on health would be enough to cover all health costs in most other countries.<br />
<br />
The full report can be found here:<br />
<div class="MsoNormal">
<span lang="EN-GB"><a href="http://www.oecd.org/els/health-systems/health-at-a-glance-19991312.htm">http://www.oecd.org/els/health-systems/health-at-a-glance-19991312.htm</a>
<o:p></o:p></span></div>
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-29845811738866543582015-11-12T15:54:00.000+01:002015-11-12T16:24:35.459+01:00My work at the World Economic Forum<div dir="ltr" style="text-align: left;" trbidi="on">
As you might know, since May I have been taking a semi-break from my work at Bain & Company. Until the Annual Meeting in Davos in January, I am seconded to the World Economic Forum as a project manager for the <a href="http://www.weforum.org/projects/future-healthy" target="_blank">Future of Healthy project</a>.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR6IZd8u4HOdBqCFWdvWpTU8wOUuhIOzhRDDhIQRhc-9QXYihmW7aAUQy0uVuuwTIV9fu8Wn18s0ZHcamI8sbcbd1UfWEqIvqtZcdhl0lim3NzLwU6nKOSENMGMzpRfTxQN_cuXfsDFU3C/s1600/IMG_5952.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR6IZd8u4HOdBqCFWdvWpTU8wOUuhIOzhRDDhIQRhc-9QXYihmW7aAUQy0uVuuwTIV9fu8Wn18s0ZHcamI8sbcbd1UfWEqIvqtZcdhl0lim3NzLwU6nKOSENMGMzpRfTxQN_cuXfsDFU3C/s400/IMG_5952.JPG" width="400" /></a></div>
FoH is a two year project on the prevention of noncommunicable diseases (NCDs). Last year it was all about a paradigm shift from curing disease/ preventing deaths to actually Maximizing Healthy Life Years and how interventions that do so are investments that pay off (the report can be found <a href="http://www3.weforum.org/docs/WEF_Maximizing_Healthy_Life_Years.pdf" target="_blank">here</a>). My project is looking at how to bring stakeholder from different sector and industries together and how to align their incentives with positive health outcomes.<br />
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-28213190245741075502015-08-13T15:27:00.002+02:002015-11-12T16:12:24.876+01:00Incentives<div dir="ltr" style="text-align: left;" trbidi="on">
Over three years ago, when I was still living in the UK, I had an IUD (inter-uterine device or "copper coil") fitted. For those of you who are not English: Health care by the National Health Service is free at the point of service and this includes contraception. Hence I paid nothing for my IUD. Now it makes intuitive sense that the IUD won't be good forever and I was actually given a piece of paper stating that it will have to be replaced after 10 years - which I figured was fair game.<br />
<div>
<br /></div>
<div>
When I moved back to Germany, I suddenly hear that an IUD (also copper ones) supposedly have to be replaced after 3 to 5 years. Now, you have to know that contraception is usually not covered by German insurance. I leave it to you to draw your own conclusions.</div>
<div>
<br /></div>
<div>
I still did a bit of research and what I found is even more interesting:</div>
<div>
<ul style="text-align: left;">
<li>Official, WHO-based recommendation is that copper IUDs can be worn for up to 10 years, depending on their copper content, and hormonal IUDs for 3 to 5 years<br />(<a href="http://www.webmd.com/sex/birth-control/intrauterine-device-iud-for-birth-control">http://www.webmd.com/sex/birth-control/intrauterine-device-iud-for-birth-control</a>)</li>
<li>According to the WHO, the type I have is actually WHO effective for up to 12 years<br />(<a href="http://apps.who.int/rhl/fertility/contraception/soacom/en/">http://apps.who.int/rhl/fertility/contraception/soacom/en/</a>)</li>
<li>However, there are actually studies that copper IUDs are effective for up to 20 years<br /><a href="http://www.reuters.com/article/2014/03/13/us-iuds-effective-idUSBREA2C1B320140313">http://www.reuters.com/article/2014/03/13/us-iuds-effective-idUSBREA2C1B320140313</a><br /><a href="https://www.arhp.org/Publications-and-Resources/Quick-Reference-Guide-for-Clinicians/Non-hormonal-Choosing/IUC">https://www.arhp.org/Publications-and-Resources/Quick-Reference-Guide-for-Clinicians/Non-hormonal-Choosing/IUC</a><br />Trussell J. Contraceptive failure in the United States. Contraception. 2011;83(5):397-404</li>
</ul>
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Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-56864346301128716412013-11-30T14:39:00.001+01:002013-11-30T14:41:29.719+01:00My second paper: "Why are healthcare services fuzzy?"<div dir="ltr" style="text-align: left;" trbidi="on">
My second paper just got published in AMJ, an open access journal. Below the abstract and the link to the journal. Very excited to see this finally happen.<br />
<br />
<h3>
Why are healthcare services fuzzy?</h3>
<h3>
Abstract</h3>
<div>
<b>Background</b><br />
Healthcare organisations are an
enigma to many people in- and outside the service. Organisational
fuzziness is a common state, characterised by a lack of clarity, lack of
awareness, lack of organisational knowledge, and the reliance on
practice and custom instead of transparency. <br />
<b>Aims</b><br />
The
objective of this study was to obtain a better understanding of what
causes this fuzziness and provide an actionable description of fuzzy
organisations. Such a description is essential to managing and
preventing organisational fuzziness. <br />
<b>Method </b><br />
We
used a longitudinal case study in an integrated health- and social care
organisation to obtain a thorough understanding of how the organisation
functions. These in-depth insights allowed the identification of three
generators of fuzziness.<br />
<b>Results</b><br />
We found that
the three main generators of organisational fuzziness are change,
informal organisation and complexity. Organisational fuzziness is thus
partly due to the inherent complexities of human systems. However, also
continuous change and the inability of the system to adapt its formal
structures resulted in structures deteriorating or no longer being
appropriate.<br />
<b>Conclusion</b><br />
Existing approaches to
explain unclear or absent structures in healthcare organisations by
describing these organisations as complex adaptive systems (CAS) are too
simplistic. While aspects relating to people and their interactions are
indeed complex, fuzziness of structural aspects are often the result of
continuous change and insufficient organisational capacity to adapt to
it.</div>
<br />
http://www.amj.net.au/index.php?journal=AMJ&page=article&op=view&path[]=1857</div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-57411471809478534272013-10-31T11:45:00.001+01:002013-10-31T11:46:19.947+01:00Paper now open access<div dir="ltr" style="text-align: left;" trbidi="on">
Just to let you know, my paper on the contributions of carers and staff in service design is now available as open access:<br />
<br />
http://onlinelibrary.wiley.com/doi/10.1111/hex.12107/pdf<br />
<br />
Thanks to the CLAHRC for making this happen :)</div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-5115414430847017082013-10-08T12:35:00.000+02:002013-10-08T12:35:00.237+02:00The final reckoning: how much should end of life care cost?<div dir="ltr" style="text-align: left;" trbidi="on">
This is a repost from a blog article I was invited to write for the <a href="http://gatescambridge.wordpress.com/2012/07/09/the-final-reckoning-how-much-should-end-of-life-care-cost/" target="_blank">Gates Scholars Blog</a><br />
<br />
---------------------------------------<br />
<br />
The big innovation in the 19th and 20th century was the acknowledgement that health is a systemic issue. If people do not seek medical advice for small problems due to economic reasons, these small problems can become big problems and cause further poverty. This realisation led, for example, to the establishment of the NHS in 1948.<br />
<br />
Nowadays we are facing the sustainability challenge: will we be able to keep affording the systems set up as a result? One problem is the ageing populations of many developed nations – it is estimated that in the US on average between 25% and 56% of healthcare spending occurs in the final 12 months of life. A second problem is, ironically, continuing progress in the medical sciences which allows us to treat more diseases and prolong lives. But the associated costs are spiralling out of control. Also, scientific progress creates illusions regarding what it possible and feasible. Combined with the lack of a culture that discusses death as a part of life many doctors find themselves under pressure to do whatever is possible, regardless of quality of life – or costs.<br />
<br />
The latter point – placing a monetary value on life – might sit very uncomfortably with some readers. However, when we look at health as a systemic issue the question of money is bound to arise in one form or another. Every dollar or pound can only be spent once. A cancer treatment that prolongs life for a couple of months (at often a pretty terrible quality of life) can cost £40,000, which could also pay the annual salary of a palliative nurse. In the United Kingdom the discussion is open. The National Institute for Clinical Excellence (NICE) makes decisions about which treatments are covered by the National Health Service (NHS) based on the calculation of quality-adjusted life years. But systems which do not have this transparency, such as the fragmented German system of different public and private payers and various associations representing healthcare providers, also have to make decisions regarding which treatments are considered effective and value for money in order to contain costs and kept health insurance affordable.<br />
<br />
Another issue which affects the sustainability of our healthcare systems is the human side. Organisational structures are filled by people, both staff and patients. As the people in them change structures have to adapt and vice versa. A system in which structures and people are out of synch will not work in the long run. A popular contemporary line of argument is that because healthcare is fundamentally an interaction between people, it is complex and non deterministic. Other arguments for this complexity model are based on the enormous variety of issues faced by healthcare providers, although this is strictly speaking not a characteristic of complexity but rather indicates a complicated problem. Semantics aside, the focus on complexity are as one-sided as the earlier models of rational technocratic top-down blueprints which the complexity model seeks to supersede. It is not a question of one or the other, but rather ‘horses for courses’.<br />
<br />
A climbing rose is a good simile for how organisational success depends on interactions between staff and structures. A climbing rose (staff) requires a scaffold (structures) to reach its full potential. The shape of the scaffold will have a key influence on the shape of the final rose bush, but it is not possible to completely determine the shape of the bush from the shape of the scaffold and sometimes it becomes necessary to change the shape of the scaffold. On the other hand, the best scaffold in the world is worthless without the right, good, healthy plants.<br />
<br />
I think the challenges we face are so big that a more open discussion regarding end of life care will be inevitable. On the other hand, a new direction in the policy debate that seeks to reconcile technocratic approaches to structures with insights about the complexity of human interaction should help to ensure a system that can adapt to changing environments and new challenges.</div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com1tag:blogger.com,1999:blog-1662296565157431451.post-67920077736812270742013-10-01T12:29:00.000+02:002013-10-31T11:46:41.500+01:00Paper: What can carers contribute to service design?<div dir="ltr" style="text-align: left;" trbidi="on">
My paper is finally out - I submitted it last year in June and it was published as early view this July. I carried out a study with three groups of stakeholders and assessed to which degree they agree on priorities for service design.<br />
<br />
Of course I am biased, but I think this is really important and interesting research as it is the first time that we can quantify the contribution of different stakeholder groups which historically had different amount of influence on the service design process. For example, experts and policy makers usually have a lot of influence, carers (and patients, but unfortunatly I was not able to include them) usually have much less. One of the reason why they have so much less influence is because those with the power over the process doubt how useful their contribution can be (I guess you can call this a certain degree of professional arrogance) and this is exactly where my work chimes in. I can actually show that they can contribute new idea which established stakeholders recognize as valuable.<br />
<br />
The article is available as open access:<br />
<a href="http://onlinelibrary.wiley.com/doi/10.1111/hex.12107/abstract">http://onlinelibrary.wiley.com/doi/10.1111/hex.12107/abstract</a><br />
<br />
<h2 class="articleTitle" style="text-align: left;">
<span class="mainTitle">Exploring the boundary of a specialist service for adults with intellectual disabilities using a Delphi study: a quantification of stakeholder participation</span></h2>
<div id="hex12107-cr-0001">
<i>Eva-Maria Hempe, Cecily Morrison, Anthony Holland</i></div>
<h3>
</h3>
<div class="para" style="text-align: left;">
<b>Background</b></div>
<div class="para" style="text-align: left;">
There are arguments that a specialist service for adults with intellectual disabilities is needed to address the health inequalities that this group experiences. The boundary of such a specialist service however is unclear, and definition is difficult, given the varying experiences of the multiple stakeholder groups.</div>
<div class="para" style="text-align: left;">
<b>Objectives</b></div>
<div class="para" style="text-align: left;">
The study reported here quantitatively investigates divergence in stakeholders’ views of what constitutes a good specialist service for people with intellectual disabilities. It is the first step of a larger project that aims to investigate the purpose, function and design of such a specialist service. The results are intended to support policy and service development.</div>
<div style="text-align: left;">
<b>Study design</b></div>
<div style="text-align: left;">
A Delphi study was carried out to elicit the requirements of this new specialist service from stakeholder groups. It consisted of three panels (carers, frontline health professionals, researchers and policymakers) and had three rounds. The quantification of stakeholder participation covers the number of unique ideas per panel, the value of these ideas as determined by the other panels and the level of agreement within and between panels.</div>
<div class="para" style="text-align: left;">
<b>Findings</b></div>
<div class="para" style="text-align: left;">
There is some overlap of ideas about of what should constitute this specialist service, but both carers and frontline health professionals contributed unique ideas. Many of these were valued by the researchers and policymakers. Interestingly, carers generated more ideas regarding how to deliver services than what services to deliver. Regarding whether ideas are considered appropriate, the variation both within and between groups is small. On the other hand, the feasibility of solutions is much more contested, with large variations among carers.</div>
<div class="para" style="text-align: left;">
<b>Conclusions</b></div>
<div class="para" style="text-align: left;">
This study provides a quantified representation of the diversity of ideas among stakeholder groups regarding where the boundary of a specialist service for adults with learning disabilities should sit. The results can be used as a starting point for the design process. The study also offers one way to measure the impact of participation for those interested in participation as a mechanism for service improvement.</div>
</div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-46383678119120044332013-09-24T12:14:00.000+02:002013-09-24T12:14:00.553+02:00US Health Care Spending<div dir="ltr" style="text-align: left;" trbidi="on">
Two interesting links, explaining why US Health Care costs are so high (also in comparison to other developed countries). In a nutshell: lack of transparency about costs + inherent power imbalances = a flawed market.<br />
<br />
Time Magazine - "Bitter Pill: Why Why Medical Bills Are Killing Us"<br />
<a href="http://content.time.com/time/magazine/article/0,9171,2136864,00.html">http://content.time.com/time/magazine/article/0,9171,2136864,00.html</a><br />
<br />
8-minute video. "Why Are American Health Care Costs So High?"<br />
<a href="http://www.youtube.com/watch?v=qSjGouBmo0M">http://www.youtube.com/watch?v=qSjGouBmo0M</a></div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-17721731876235066032013-09-17T12:10:00.000+02:002013-09-17T20:00:53.421+02:00Applicability of Engineering Design Processes in the Design of Integrated Intellectual Disabilities Services in England<div dir="ltr" style="text-align: left;" trbidi="on">
I have been quiet for an aweful long time - and a lot has happened since. Most importantly: my thesis is all done, approved and on the shelves of the Cambridge libary, so I am now a doctor (yeah). I since moved back to Germany and for the last 14 month I have been working as a consultant in Munich, with a focus on health care projects.<br />
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In case you are interested, I pasted the abstract of my thesis below. If you want to read the full thing, drop me a message (ideally with a bit of beackground on what you do and why you are interested in my work) and I can send you the pdf.<br />
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<span lang="EN-GB" style="font-family: "Calibri","sans-serif"; font-size: 18pt; line-height: 150%; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">Applicability of Engineering Design Processes in
the Design of Integrated Intellectual Disabilities Services in England</span><br />
<br />
<div class="MsoNormal" style="margin: 0cm 0cm 6pt;">
<span lang="EN-GB" style="font-size: 10.5pt; line-height: 150%;"><span style="font-family: Calibri;">This
dissertation investigates the applicability of engineering design processes for
the design of integrated intellectual disabilities (ID) services in England. It
aspires to contribute to the development of an engineering-design-style (ED)
design process for a particular integrated health and social care organisation.
Healthcare services in the developed world are faced with challenges arising
from a growing burden of chronic disease and aging populations. In order to
address these challenges, a more holistic understanding of health that also
considers social factors is needed. A local integrated care service for people
with intellectual disabilities constitutes an interesting case study as these intellectual
disabilities services have several decades of experience in integrating health-
and social care.<o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="margin: 0cm 0cm 6pt;">
<span lang="EN-GB" style="font-size: 10.5pt; line-height: 150%;"><span style="font-family: Calibri;">This
study contributes to knowledge by elicitating the need to combine the
engineering tradition of design as problem-solving with the tradition of design
as enquiry. The applicability of engineering design processes in an
indisputably complex domain, such as integrated ID services, also helps clarify
of the concept of complexity within engineering design. Methodological
contributions are made by developing and applying a research framework for
exploratory design research and by demonstrating the utility of engineering
design tools outside engineering. Furthermore, this study also provides
important insights for the healthcare management literature by suggesting an approach
to distinguishing complicateness from complexity, demonstrating the value of
contributions of currently marginalised stakeholders and showing the
applicability of a mathematical technique for pre-structuring service user
involvement. <o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="margin: 0cm 0cm 6pt;">
<span lang="EN-GB" style="font-size: 10.5pt; line-height: 150%;"><span style="font-family: Calibri;">The
research is guided by a framework developed specifically for exploratory design
research into the care service domain. An initial exploratory study
investigates design-related issues faced by the local service and to which
degree engineering design is applicable. The predominantly qualitative data is
analysed in diagrammatic form. It emerges that the formal, structural aspects
of the organisation are complicated and suited to an engineering design
approach. However, complex informal aspects, such as customs or personal
relationships, surround the formal structure and are beyond the current scope of
ED design processes but can be addressed by approaches in the design as enquiry
tradition. Four issues are identified which will require amendments to the ED
design process: organisational settings, knowledge management, the lack of a
clear role, and neglected stakeholders. <o:p></o:p></span></span></div>
<span lang="EN-GB" style="font-family: "Calibri","sans-serif"; font-size: 10.5pt; line-height: 150%; mso-ansi-language: EN-GB; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;">The
exploratory study is followed up by a detailed study which uses a Delphi
approach to investigate whether the confusion about the role of specialist
services is a general problem in the ID field. It further characterises key
stakeholder groups in ID services in terms of their expertise and level of
agreement or disagreement. The findings outline requirements for new design approaches
that bridge the traditions of design as enquiry and design as problem-solving.</span></div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-24605097980587680052013-06-27T13:25:00.002+02:002013-06-27T13:25:21.148+02:00Very interesting article about patient demand for life-extending interventions ...<div dir="ltr" style="text-align: left;" trbidi="on">
... and how those who know what these interventions really mean, physicians, have a completely different opinion:<br />
<br />
<a href="http://thesocietypages.org/socimages/2013/06/24/how-do-physicians-and-non-physicians-want-to-die/">http://thesocietypages.org/socimages/2013/06/24/how-do-physicians-and-non-physicians-want-to-die/</a></div>
Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0tag:blogger.com,1999:blog-1662296565157431451.post-40562557220006383492012-02-13T15:47:00.000+01:002012-02-13T15:47:25.817+01:00Anatomy of an unsafe abortion (repost)Another of these stories which brings home the point that all those decisions we are making about health systems are ultimately about people's lives:<br />
<br />
<a href="http://drjengunter.wordpress.com/2012/02/11/anatomy-of-an-unsafe-abortion/">http://drjengunter.wordpress.com/2012/02/11/anatomy-of-an-unsafe-abortion/</a>Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com1tag:blogger.com,1999:blog-1662296565157431451.post-54253378092954125722011-12-14T12:25:00.000+01:002011-12-14T12:30:21.115+01:00Health Systems Strengthening - what others thoughtJocalyn Clark blogged about my workshop on PLoS Medicine:<br />
<a href="http://blogs.plos.org/speakingofmedicine/2011/11/25/what-is-health-systems-strengthening/">http://blogs.plos.org/speakingofmedicine/2011/11/25/what-is-health-systems-strengthening/</a><br />
<br />
I also received a summary of the feedback forms and people really enjoyed the day, particularly the two part format with an overview of the theory in the morning and experiences from the field in the afternoon. And almost everyone said what they learned will affect their practice :) Really chuffed and happy that people found the workshop useful. Thanks again to my speakers and Anne Radl for her support - I wouldn't have been able to do this without you :)Eva-Maria Hempehttp://www.blogger.com/profile/18193872547551481749noreply@blogger.com0