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Healthcare Delivery Dynamic Briefing Generated 29 January 2020 for Marco Antonio Gonzalez


Healthcare Delivery Co-curated with University of Southern California (USC) Last review on Mon 28 August 2017

About This dynamic briefing draws on the collective intelligence of the Forum network to explore the key trends, interconnections and interdependencies between industry, regional and global issues. In the briefing, you will find a visual representation of this topic (Transformation Map – interactive version available online via intelligence.weforum.org ), an overview and the key trends affecting it, along with summaries and links to the latest research and analysis on each of the trends. Briefings for countries also include the relevant data from the Forum’s benchmarking indices. The content is continuously updated with the latest thinking of leaders and experts from across the Forum network, and with insights from Forum meetings, projects communities and activities.

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Executive summary Global healthcare delivery systems are being developed in a fast-changing environment that is spawning both technological advances and ethical challenges; while developments like precision medicine create exciting opportunities, uncertainty and risk remain. Inequality, in terms of healthcare access and utilization, remains a global concern. Policy-makers have the difficult task of formulating evidence-based rules that can move the needle on related issues, including a troubling shortage of skilled healthcare workers. This briefing is based on the views of a wide range of experts from the World Economic Forum’s Expert Network and is curated in partnership with Dana Goldman, Kukla Vera and Stephanie Hedt, respectively the Leonard D. Schaeffer Director’s Chair, External Affairs Director, and Policy Communications Associate at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California (USC).

1. Healthcare Human Capital Global imbalances between available skills and market needs are affecting healthcare delivery.

2. Healthcare Technology New tools are curing previously fatal diseases, and making chronic disease more manageable.

3. Value-Based Healthcare More efficiency is needed to deliver full value for what we spend on health care.

4. Access to Care Despite some improvement in facilitating global access to health care, serious gaps remain.

5. Promise of Precision Medicine Data and new technologies are enabling the delivery of more targeted health care.

6. Healthcare Data Advances in data collection and analysis are driving evidence-informed healthcare strategies.

7. Health Policy Increasing global connectivity and life expectancy are creating new policy needs.

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Healthcare Human Capital Global imbalances between available skills and market needs are affecting healthcare delivery In the US, about 2.3 million new health care workers will be needed by 2025 in order to adequately take care of the country’s ageing population, according to a report published in 2018 by staffing consultancy Mercer, while in the United Kingdom, the National Health Service is suffering from a severe shortage of nurses - with one part of England able to recruit just one nurse per every 400 vacancies, according to statistics published in 2018. While a lack of funding and poor pay have hurt the NHS’s ability to recruit, the result has negatively affected the quality of care and even threatened lives. Worldwide, an imbalance between available skills and market needs is having a tangible effect on healthcare system productivity and innovation. As political and business leaders assess a shifting disease burden landscape, the global shortage of health workers remains one of the biggest related challenges. In 2013, the World Health Organization projected that by 2035, the global shortage of health workers would increase from 7.2 million to 12.9 million. The constant migration of qualified health workers to countries that may have better working conditions or career opportunities has meanwhile left people in some regions with unequal access to health care, according to the WHO. The World Health Assembly adopted a Global Code of Practice in 2010, which aims to establish and promote ethical international recruitment of health personnel and to strengthen health systems; as of 2016, nearly one quarter of member states were considering changes to laws or policies to conform with code recommendations, and 70% reported that migrant health workers enjoyed the same legal rights and responsibilities as domestically-trained personnel. Ideas that have been proposed to help ease the burden on health care workers and health systems around the world include more flexible scheduling, efforts to specifically attract younger, more tech-savvy workers who might otherwise take jobs at firms like AirBnb or Google, and broader training and development programs that can expand a worker’s skills repertoire. Until adequate solutions for staffing issues emerge, the costs will be heavy in terms of both quality of care and financial well-being; in the US, the cost of so-called “travel nurses” who move from place to place to temporarily fill empty but essential positions doubled between 2014 and 2017, to $4.8 billion, according to Staffing Industry Analysts. Related insight areas: Global Health, Migration, Education and Skills, Ageing, Workforce and Employment, Future of Health and Healthcare

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Latest knowledge RAND Corporation

Frontiers

Access, Quality, And Financial Performance Of Rural Hospitals Following Health System Affiliation

Modulation of Social Cognition via Hallucinogens and “Entactogens” 03 December 2019

28 January 2020 Social cognition is a fundamental ability in human everyday lives. Deficits in social functioning also represent a core aspect of many psychiatric disorders. Yet, despite its significance, deficits in social cognition skills are insufficiently targeted by current treatments. Hallucinogens and entactogens have been shown to have the potential to modulate social processing. This article reviews the literature on the influence of hallucinogens and entactogens on social processing in controlled experimental studies in humans and elucidates the underlying neurobiological and neuropharmacological mechanisms. Furthermore, it identifies current knowledge gaps and derives implications for hallucinogen-assisted treatment approaches as well as the development of novel medication for trans-diagnostic impairments in social cognition.

Health system affiliation was associated with improved financial performance for rural hospitals but that it also could reduce local access to certain services and was not associated with improved health care quality for the two measures examined. World Economic Forum

DAVOS 2020 | An Insight, An Idea with Deepika Padukone and Tedros Adhanom Ghebreyesus 21 January 2020 Join a conversation between Deepika Padukone, internationally acclaimed actor and Crystal Awardee, and Tedros Adhanom Ghebreyesus, Director-General of the World Health Organisation.

VoxEU

Here’s how to improve access to healthcare around the world

Trump’s trade war cost Republicans congressional seats in the 2018 midterm elections

15 January 2020

26 November 2019

World Economic Forum

Digital technology, inclusive innovation and progressive partnerships can transform primary healthcare services for all.

Just over a year ago, congressional Democrats took majority control of the US House of Representatives. This column examines the relationship between local exposure to President Trump’s trade war and US voting patterns, and suggests that the producer-side consequences of the trade war may have been responsible for five of the 40 seats lost by Republicans in the 2018 midterm elections. The combination of the trade war and attempts to repeal and replace the Affordable Care may have cost the Republicans as many as 15 House seats.

World Economic Forum

Personalized healthcare and better population health? Here's how digital can help achieve that 07 January 2020 The digitalization of healthcare can bring big benefits to patients, but only if the industry adopts emerging technologies in the right way. United Nations

DR Congo: How to Beat Ebola 07 December 2019 In the struggle against the Ebola virus in North Kivu, in the Democratic Republic of the Congo, a wide array of specialists and volunteers ensure that Ebola patients get the care and information they need as well as the vaccine if they are eligible. The World Health Organization, WHO, has been strongly involved in the response to the epidemic since it started in August 2018, as part of the action organised by the Ministry of Health of the DRC with many local and international partners.

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Healthcare Technology New tools are curing previously fatal diseases, and making chronic disease more manageable Health technology innovation has given us basic tools like the electronic medical record, as well as futuristic developments like robotic surgery and precision medicine (which makes use of a patient's genetic profile and environment in order to diagnose and provide treatment). While biomedical research is offering up new medicines, devices, and mobile applications that can cure once-fatal diseases and more effectively manage chronic disease, many parts of the world still lack access to even the most basic healthcare. According to World Health Organization Global Health Observatory data, more than half of the deaths in the African Region during 2015 were the result of maternal, neonatal, and nutritional conditions. Expanding access to care and health technologies across the globe remains a challenge; the use of mobile technology presents intriguing related opportunities. The overall “mHealth� market was worth an estimated $23 billion by 2017, according to SNS Research, and is expected to grow significantly. In sub-Saharan Africa, which bears the highest disease burden in the world, and where mobile phone penetration rates have increased significantly in recent years, only 15% of the population has access to private health care, according to a report published by Deloitte in 2014, while more than 80% of private health care payments are made out of pocket.

Related insight areas: Chemical and Materials Industry, Fourth Industrial Revolution, Future of Food, 3D Printing, Precision Medicine, Advanced Materials, Batteries, Biotechnology, Internet of Things, Artificial Intelligence and Robotics

In response, mobile operators in sub-Saharan Africa have begun to better position themselves to facilitate health payments that are made via mobile devices, according to the Deloitte report; in Kenya, for example, the operator Safaricom has partnered with insurer Changamka Microhealth to enable health care payment via the M-PESA mobile money service. Meanwhile the deployment of socalled eHealth is also expanding. According to a report published by the World Health Organization in 2016, by 2015, 70% of European Union member states had national eHealth policies or strategies, and nearly all of them had financial support specifically for implementing these efforts. However, in 2018, the European Commission published a communication on the digital transformation of health and care, which cited slow and varied uptake of digital health solutions within the EU to date, and identified three areas for improvement: secure access to health data across borders; better access to advanced research; disease prevention and "personalized" health care (another term for precision medicine); and digital tools for citizen empowerment.

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Latest knowledge World Economic Forum

Frontiers

9 striking images from the 2019 Wellcome Photography Prize on health and humanity

Study Progress of Radiomics With Machine Learning for Precision Medicine in Bladder Cancer Management

24 January 2020

28 November 2019 These images 2019 Wellcome Photography Prize show how lives are lived around the world on topics ranging from depression to poor hygiene.

Bladder cancer is a fatal cancer that happens in the genitourinary tract with quite high morbidity and mortality annually. The high level of recurrence rate ranging from 50 to 80% makes bladder cancer one of the most challenging and costly diseases to manage. Faced with various problems in existing methods, a recently emerging concept for the measurement of imaging biomarkers and extraction of quantitative features called “radiomics” shows great potential in the application of detection, grading, and follow-up management of bladder cancer. Furthermore, machine-learning (ML) algorithms on the basis of “big data” are fueling the powers of radiomics for bladder cancer monitoring in the era of precision medicine. Currently, the usefulness of the novel combination of radiomics and ML has been demonstrated by a large number of successful cases.

World Economic Forum

3 challenges to make sure tech benefits human progress in health 21 January 2020 There is no doubt that disruptive innovation can lead to unprecedented breakthroughs in treating disease and improving healthcare. Frontiers

Evaluation of a Virtual Reality Percutaneous Nephrolithotomy (PCNL) Surgical Simulator 14 January 2020

LSE Business Review Percutaneous Nephrolithotomy is the standard surgical procedure used to remove large kidney stones. PCNL procedures have a steep learning curve; a physician needs to complete between 36 and 60 procedures, to achieve clinical proficiency. Marion Surgical K181 is a virtual reality surgical simulator, which emulates the PCNL procedures without compromising the well-being of patients. The simulator uses a VR headset to place a user in a realistic and immersive operating theater, and haptic force-feedback robots to render physical interactions between surgical tools and the virtual patient.

Jeroen Tas: ‘If we don’t look at the big picture, we can tweak ourselves to oblivion’ 19 November 2019 When he bought large orders of light bulbs for his Winter Palace, the Russian Tsar became a high-profile customer of Philips, the Dutch multinational corporation founded in 1891 to produce just that: light bulbs. But the company never limited itself to one line of products. In the 20th century, Philips became a household name, with its brand name stamped on a […].

World Economic Forum

How to bring precision medicine into the doctor's office 16 December 2019 The barriers to introducing genetic testing to everyday healthcare include a gap in expertise and a lack of genetic counsellors. The Conversation

Human genetic enhancement might soon be possible – but where do we draw the line? 03 December 2019 Ideas from economics might help us decide the most ethical way of using gene editing technology for human enhancement in the future.

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Value-Based Healthcare More efficiency is needed to deliver full value for what we spend on health care The $8 trillion global healthcare sector is beset by costs that are rising at about twice the rate of global GDP growth, and by reimbursement mechanisms that are resulting in substantial waste and underinvestment, according to Value in Health Care, a report published in 2018 by the World Economic Forum in collaboration with The Boston Consulting Group. In response, many industry leaders are embracing so-called value-based healthcare, which prioritizes improved health outcomes without increasing cost, and utilizes systematic measurement to customize intervention and treatment pathways (efforts for a patient based on defined resources). One particular related effort cited in the report is the Atlanta Heart Failure Pilot in the US, which focused on congestive heart failure (a condition that affects about 6 million people in the country, half of whom die within five years of initial diagnosis). Total costs associated with the disease are expected to rise to nearly $70 billion by 2030, from $30.7 billion in 2012 - and there has been significant variation in related outcomes. Lessons from the Atlanta pilot included the need to build a clear case for change, and to enlist strong and visible publicsector leadership.

Related insight areas: Precision Medicine, Fourth Industrial Revolution, Information Technology, Ageing, Global Health, Future of Economic Progress, Artificial Intelligence and Robotics, Future of Health and Healthcare, Digital Economy and Society

In many parts of the world, ageing populations have added pressure on healthcare systems. In response, efforts to better realize value for this expanding population of patients are underway. According to a report published by the consultancy BDO in 2018, new business models and new types of investment will be needed for value-based elderly care, which facilitate a focus on prevention and rehabilitation - while boosting innovation. Increasingly, hospital stays for the elderly are being replaced by increased outpatient care and recovery either at home or in a nursing home. In the meantime, efforts must be made to develop the professional workforce needed to accommodate ageing populations and their health needs. According to a discussion paper published in 2016 as part of the National Academy of Medicine’s Vital Directions for Health and Health Care Initiative, the number of board-certified geriatricians in the US at the time was estimated at 7,500, or less than half of what was needed - due to factors including a financial disadvantage related to working in fee-for-service systems, where geriatricians must provide more time-intensive care for patients who are on Medicare (a national health insurance program) or both Medicare and Medicaid (a program for those with limited income).

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Latest knowledge World Economic Forum

Scientific American

This is how we make cancer care sustainable and available for all

HIV-Positive Babies Fare Better When Treatment Starts at Birth

23 January 2020

27 November 2019

More equitable access to treatments to greater diversity in clinical trials can help us tackle the global impact of cancer.

Although not practical in many areas, the approach reveals clues to how the immune system battles the infection.

National University of Singapore

Circle of Blue

Linguistic markers of dementia

Climate Change Magnifies Health Risks at Every Stage of Life

20 January 2020

14 November 2019 Professor Bao Zhiming from NUS English Language and Literature explains the possibility of linguistic markers for dementia, which can serve as tools for early diagnosis, and for developing linguistic therapies.

Floods, droughts, and warming temperatures are already increasing illness and disease risk and may pull back previous health gains, benchmark Lancet Countdown report finds. By Brett Walton, Circle of Blue More people exposed to wildfires. Water temperatures that are more conducive to the growth of Vibrio bacteria, which are responsible for cholera and other debilitating […] The post Climate Change Magnifies Health Risks at Every Stage of Life appeared first on Circle of Blue .

Circle of Blue

After Plumbing Code Setback, Georgia Health Officials Refocus Legionella Prevention Effort 14 January 2020 New working group mulls regulatory options for dealing with America’s deadliest waterborne disease. By Brett Walton, Circle of Blue It’s back to the drawing board for the Georgia Department of Public Health as health officials seek to develop rules to prevent the growth in building plumbing of bacteria that cause a deadly lung infection. A […] The post After Plumbing Code Setback, Georgia Health Officials Refocus Legionella Prevention Effort appeared first on Circle of Blue . International Finance Corporation

Affordable Imaging Services Offer Better Healthcare Options in India 06 January 2020 A novel public-private partnership in India’s Andhra Pradesh state helped provide better tertiary healthcare services and quality diagnostics to 100,000 patients per year, transforming the state’s public healthcare market. Project Syndicate

Six Tax-Based Ways to Tackle US Inequality 17 December 2019 Some of the leading candidates for the 2020 Democratic presidential nomination have proposed radical measures to reduce inequality, such as a wealth tax. But there are many other progressive tax policies that would be both easier to enforce and more likely to get a Democratic candidate elected.

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Access to Care Despite some improvement in facilitating global access to health care, serious gaps remain At least half of the world’s population cannot obtain essential health services, and large numbers of households are pushed into poverty every year because they have to pay for health care out of their own pockets, according to a report published in late 2017 by the World Bank and the World Health Organization. About 800 million people spend at least 10% of their household budgets on health expenses, according to the report, and for nearly one in eight of those people the expenses are high enough to push them into extreme poverty - defined as living on just $1.90 or less a day. Physical environments can dictate diverse healthcare needs that change over time, while population trends related to demographics, disparities, and culture can shape system access, regulation, and utilization. Ageing populations in Europe, Japan, and the US, for example, are re-shaping healthcare systems. According to a review of Japan’s health system published by the WHO in 2018, Japan’s “demographic dilemma” requires drastic reform of healthcare and long-term-care systems; health expenditures for those aged 65 and above in Japan is 4.3 times higher than for other age groups, according to the report, and the majority of costs are being covered by the working class population through taxes and medical insurance premiums. In order to better address the needs of its greying population, Japan introduced Long-term care insurance in 2000, to support the elderly and promote independence (between its implementation and 2013, the number of elderly certified as requiring care under the program doubled to 5.69 million, raising questions about its sustainability). In Germany, where the population is also ageing at a dramatic rate, foreign workers are being more aggressively recruited to staff homes for the elderly; hundreds of thousands of additional workers are estimated to be required to fill gaps. The 2017 report from the World Bank and WHO that warned of uneven access to care also contained some encouraging elements. For example, the report noted that the number of people able to obtain key health services such as immunization, family planning, and bed nets to prevent malaria has actually increased during the first years of the 21st century. However, these developments have been uneven across the world, according to the report, with areas like sub-Saharan Africa and South Asia suffering from significant gaps in availability. Related insight areas: Global Health, Ageing, Environment and Natural Resource Security, Youth Perspectives, Public Finance and Social Protection, Sustainable Development, Future of Economic Progress

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Latest knowledge Frontiers

Frontiers

The Slippery Role of Induction Chemotherapy in Head and Neck Cancer: Myth and Reality

Specialized Therapeutic AssessmentBased Recovery-Focused Treatment for Young People With Self-Harm: Pilot Study

23 January 2020

06 December 2019 Chemoradiotherapy as an alternative to surgery can be offered to patients affected by loco-regionally advanced head and neck cancer (HNC). Induction chemotherapy is a valid option, supported by few positive trials, but its real efficacy is still a matter of debate. The standard regimen for induction chemotherapy in Europe is a combination of docetaxel (75 mg/m 2 ) and reduced dose doses of cisplatin (75 mg/m 2 ) and 5-fluorouracil (750 mg/m 2 day, for five consecutive days) (TPF). It is less toxic and more effective than the historical therapy PF (cisplatin 100 mg/m 2 and fluorouracil 1,000 mg/m 2 /day for five consecutive days). However, in some studies treatmentrelated mortality has been reported to be as high as 6%.

Background: Suicide is the second leading cause of death in young people worldwide. Self-harm is the strongest predictor of death by suicide. There is increasing evidence that psychological therapies are efficacious in treating selfharm in adolescents. However, studies so far have predominantly focused on highly selective groups of adolescents and have investigated interventions that require intensive training and considerable expense. Methods: We conducted a pilot study of a novel psychological therapy package, Specialized Therapeutic Assessment-Based Recovery-Focused Treatment (START) that consists of Therapeutic Assessment followed by treatment in one of three modules, depending on adolescents’ needs and preferences: Solution Focused Brief Therapy, Cognitive Behavior Therapy (CBT), or Mentalization Based Treatment.

Observer Research Foundation

Deepening Delivery: How Healthcare is Changing the Politics of Development | Raisina Dialogue 2020

Peterson Institute for International Economics

16 January 2020

Trump's trade war cost Republicans congressional seats in the 2018 midterm elections

Over the past decade, the world has made significant progress towards achieving universal health coverage (UHC) through improved political and policy commitments, led by countries like China and India. While many transitioning health systems try to leapfrog binding constraints by leveraging technology, issues like access to quality medicines remain challenges for large populations.

26 November 2019 Just over a year ago, congressional Democrats took majority control of the US House of Representatives, flipping 40 previously Republican seats. [1] New evidence suggests that President Donald Trump’s trade policy played a role. In his first two years in office, Trump introduced a series of highly...

The New Humanitarian

Inside Idlib’s bombed-out hospitals and clinics 13 January 2020 A rare glimpse at how northwest Syria’s civilians are struggling to find healthcare in the midst of a long war. Science Daily

Cancer drugs could potentially treat COPD 06 January 2020 New research has shown the potential for clinically available cancer treatments to treat chronic obstructive pulmonary disease (COPD).

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Promise of Precision Medicine Data and new technologies are enabling the delivery of more targeted health care Through the harnessing and analysing of genetic data, precision medicine promises to improve health outcomes and decrease costs. Precision medicine, also referred to as personalized medicine, could for example cut down on unnecessary costs tied to unnecessary and expensive diagnostic procedures. According to a report published in 2016 by healthcare software company Orion Health, 30% of our health is determined by our genome (all the genetic material in a cell), and the cost of sequencing a genome was expected to fall from $1,000 per person to $10 per person by 2020. Yet, the infrastructure required for using genomic sequencing to genuinely benefit patients remains embryonic. Issues yet to be adequately addressed include a lack of widespread availability of the necessary sequencing technology and attendant storage, of expertise required to use this new technology at the patient level, of the sufficient development of related economic models, and of evidencebased research that supports widespread adoption. There are serious ethical issues presented by the growing prevalence of precision medicine. The genomic and other biological data in a person’s medical record for the purposes of treatment could be misused, for example, and expose patients to privacy violations or worse. In addition, the genomic information in someone’s medical profile could also, theoretically, be used to subject that person to discrimination or make it difficult or impossible for him or her to obtain certain types of insurance. The so-called secondary use of a patient’s data for research purposes also raises the potential for privacy violations, without adequate safeguarding. Another significant potential ethical issue to consider is the impact of granting someone advance knowledge that they have an untreatable condition through the use of precision medicine - and thereby potentially hindering the person’s quality of life. Policy-makers and business leaders need to work together to develop responsible rules for the use of precision medicine, which is poised to become far more prevalent. Governments are investing significant amounts in related research and development; in China, for example, the government made precision medicine part of its five-year plan for 2016-2020, which should involve related investments worth more than $9 billion. Related insight areas: Values, Fourth Industrial Revolution, Mental Health, Human Enhancement, Future of Health and Healthcare, Precision Medicine, Biotechnology

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Latest knowledge Frontiers

Harvard Business School Working Knowledge

The Contribution of Sociocultural Factors in Shaping Self-Reported Sickness Behavior

Medicare for All or Public Option: Can Either Heal Health Care? 02 January 2020

24 January 2020 A public insurance option could use its scale to hold prices down, but only if the approach avoids the financing gimmicks that are undermining Medicare, say Regina E. Herzlinger and James Wallace.

Sickness behavior is an evolutionarily conserved phenomenon found across a diverse range of animals involving a change in motivational priorities to theoretically maximize energetic investment in immune function and recovery. Typical components of sickness behavior include reduced sociability and activity, changes in diet, and depressed affect. Importantly, however, sickness behavior appears to be subject to other demands of life history in animal models, including reproduction and offspring survival. Thus, “feeling sick” is often context dependent with possible effects on morbidity and mortality.

London School of Economics and Political Science

Why there is a ‘right’ kind of trauma in Uganda 31 December 2019 Treatments for post-traumatic stress disorder (PTSD) and trauma play an important role in advocacy for financing in global mental health, called upon frequently by nongovernmental organisations (NGOs) and governments to scale up mental health interventions. Our research in northern Uganda has analysed the social impact of such interventions addressing PTSD, and the social ramifications of introducing trauma discourses and conceptions of suffering based on Euro-American notions of the ‘traumatised individual’.

Frontiers

Effectiveness of a Prevention Program for Gender-Based Intimate Partner Violence at a Colombian Primary School 21 January 2020 Intimate partner violence, particularly against women, is widely studied owing to its high rates, based on transnational data. Colombia, where this form of violence is considerably common, is no exception, and such violence is occurring more and more often in increasingly younger couples (10−14 years old). Further, risk factors such as wide acceptance, the justification of intimate partner violence, extremely rigid traditional gender roles, and poor socio-emotional skills play a crucial role. In accordance with this reality, a gender-based intimate partner violence prevention program was designed, implemented, and evaluated for primary school children in Colombia based on a review of successful preventive programs and an identification of the main predictors of intimate partner violence.

Frontiers

Microstate Changes Associated With Alzheimer’s Disease in Persons With Down Syndrome 28 November 2019 Down syndrome (DS) is associated with development of dementia due to Alzheimer’s disease (AD). However, due to considerable heterogeneity in intellectual function among persons with DS, it is difficult to assess whether a person with DS has developed dementia due to AD (DSAD). EEG spectral power has previously shown very promising results with increased slowing in DS-AD compared to DS. However, another technique called microstates may be used to assess whole-brain dynamics and has to our knowledge not previously been investigated in either DS or DS-AD. The aim of the current study was to assess whether microstates could be used to differentiate between adults with DS, and DS-AD. We included EEGs from 10 persons with DS and 15 persons with DS-AD in the analysis.

The Conversation

In defence of ‘imprecise’ medicine: the benefits of routine treatments for common diseases 09 January 2020 Precision medicine is all the rage, but it may only be effective at treating less common diseases.

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Healthcare Data Advances in data collection and analysis are driving evidence-informed healthcare strategies Medical researchers are increasingly make use of so-called DNA biobanks, or troves of genetic and medical record data that can be analysed relatively quickly thanks to increased computing power - in order to identify genes that are linked to specific health disorders. The Vanderbilt University Biobank in the US, for example, stores blood and tissue samples from roughly 2.8 million participants, and DNA samples from about 270,000 people; according to a blog post published by the Mayo Clinic in 2018, the effort could help identify ways to intervene sooner, and to offer earlier treatment for patients at risk of developing disorders. However, there are serious ethical questions to consider in relation to the widespread collection of data like genetic information: who should be authorized to gain access to someone’s personal genetic profile, for example, and how can genetic privacy be best protected. The private company 23andMe, for example, offers people the chance to both have their genetic information analysed, and to submit that data for the purposes of company research - raising concerns both about doing so without consulting with a trained medical professional, and about providing sensitive information like this to a private entity. The use of big data techniques, or the efficient sifting through massive, complex data sets in order to garner insights, is becoming increasingly prominent in the world of health care in ways that go beyond the use of genetic information. The growing use of wearable devices, for example, provides a means to directly connect things like glucose monitors to digital apps, which in turn can provide healthcare providers with ways to monitor an individual’s glucose profile over time. In addition, the combination of wearable devices and the Internet of Things, which can string multiple everyday devices together via an internet connection, creates a broad range of possibilities in terms of collecting and analysing data in order to study the health implications of daily habits, or monitor the elderly. However, there are important related legal and ethical issues. In The Fitbit Fault Line, an article published in the Yale Journal of Health Policy, Law, and Ethics in 2016, the author argued that because employers were beginning to collect and use employee health data mined from wearable devices in new and barely-regulated ways, it presented an opportunity to consider how best to legally protect these employees from the potential misuse of this data. Related insight areas: Precision Medicine, Fourth Industrial Revolution, Workforce and Employment, Future of Health and Healthcare, Internet of Things, Information Technology, Digital Economy and Society, Internet Governance

14 Healthcare Delivery Briefing, January 2020


Latest knowledge World Economic Forum

Frontiers

The Next Super Bug | DAVOS 2020

Machine Learning to Study Social Interaction Difficulties in ASD

22 January 2020

29 November 2019 Drug-resistant infections are undermining modern medicine; vaccine hesitancy is driving a resurgence of preventable disease; and we can be sure that another epidemic is on the horizon. How can we mitigate the risk and impact of pressing global health security challenges? .

Autism Spectrum Disorder (ASD) is a spectrum of neurodevelopmental conditions characterized by difficulties in social communication and social interaction as well as repetitive behaviors and restricted interests. Prevalence rates have been rising, and existing diagnostic methods are both extremely time and labor consuming. There is an urgent need for more economic and objective automatized diagnostic tools that are independent of language and experience of the diagnostician and that can help deal with the complexity of the autistic phenotype. Technological advancements in machine learning are offering a potential solution, and several studies have employed computational approaches to classify ASD based on phenomenological, behavioral or neuroimaging data.

VoxEU

Pay-for-performance in insurance markets 19 January 2020 As health spending continues to rise globally, pay-forperformance can be an attractive policy tool for promoting high-quality services at lower costs. But there are concerns that it weakens the finances of poorperforming hospitals in low-income areas. This column examines the efficiency and equity consequences of the introduction of pay-for-performance in the Medicare insurance programme in the US. It finds that after the payment reform, high-quality insurers selected healthier enrollees, shifting the distribution of high-quality insurance to the healthiest counties and worsening regional disparities in healthcare access.

RAND Corporation

Federally Qualified Health Center Strategies for Integrating Care with Hospitals and Their Association with Measures of Communication 27 November 2019 Health centers differ in the use of strategies to integrate care with hospitals. Overall, integration activity is associated with better communication.

RAND Corporation

Medicaid Coverage Expansions and Liability Insurance 14 January 2020

Circle of Blue

As Legionnaires’ Disease Cases Surge, Lawsuits Pile Up

This article offers some of the first rigorous evidence regarding the impacts of health coverage expansions targeting the low-income population on use of the tort system, as proxied by insurance payouts.

07 November 2019 Can legal liability prompt action where regulation has yet to catch up? The post As Legionnaires’ Disease Cases Surge, Lawsuits Pile Up appeared first on Circle of Blue .

Frontiers

New Frontiers for Molecular Pathology 04 December 2019 Lung cancer remains a serious oncological problem worldwide. The delayed diagnosis and a prevalence of advanced stages in up to 70% of cases at recognition are still observed. Thanks to targeted therapies and immunotherapy a significant progress in achieving prolonged survival in some lung cancer patients is reported. A precise histopathological diagnosis, especially the recognition of adenocarcinoma, and a progress in the methods of clinical staging underlie the proper qualification of patients for a tailored therapy. The deep molecular characteristics of lung cancer in liquid biopsy, for example blood, bronchoalveolar lavage fluid (BALF), cell suspension from needle aspirates, are currently available.

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Health Policy Increasing global connectivity and life expectancy are creating new policy needs Successfully transforming the delivery of healthcare will require evidence-based policies that address access and outcomes, while recognizing the importance of innovation and the right incentives. A nimble approach is needed, in order to meet current challenges, and those that the future will certainly bring. Because of the increasing interconnectedness of countries and communities, policy-makers must rethink how nations and organizations prepare for, and work together, to respond to both health emergencies and epidemics, and to the rise in antibiotic-resistant bacteria. Pandemics are now occurring with greater frequency, due to factors including increasing urbanization (the number of city dwellers will increase by 2.5 billion by 2050, according to the United Nations), more frequent global travel (the number of international tourists is expected to reach 1.8 billion by 2030, compared with roughly 25 million in 1950), and to the effects of climate change. Global health policies should be developed that ensure a robust infrastructure is established, in order to meet the next crisis with adequate resources for research and sufficiently brief response times. The HIV/AIDS epidemic provides just one example of how effective global health policies require continued diligence in promoting innovative therapies, supporting patients, and continuing to improve prevention strategies and the monitoring of the spread of disease.

Related insight areas: Global Health, Climate Change, Cities and Urbanization, Agile Governance, Aviation, Travel and Tourism, Global Governance, Future of Health and Healthcare, Sustainable Development

In most parts of the world, life expectancy is increasing as a result of better public health measures, nutrition, sanitation, medical practices, and technological innovation. According to the Global Coalition on Aging, the number of people in the world aged 60 or older will reach 1 billion by 2020, and 2 billion by 2050. This will create new demands on systems that are already stretched to capacity as they accommodate populations with diverse health needs including chronic diseases, age-related conditions, and disabilities. Addressing this will require new models of care and payment reform, robust data collection to analyse the outcomes and consequences of novel methods, and structural solutions for workforce development challenges. Alongside issues of capacity are related concerns about pricing and access. While medical advances have the potential to substantially improve health around the world, these benefits can only be truly realized if access is broadly available. Otherwise, disparities will only increase. One potential solution may be alternative payment models, which could serve to alleviate short-term budget issues and ensure availability, while still encouraging new research.

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Latest knowledge World Economic Forum

SpringerOpen

Gavi at 20: Lessons Learned from the World's Leading Vaccine Alliance | DAVOS 2020

Entrepreneurs’ imprint: survival and sustainable development of private aesthetic plastic surgery hospitals in China

22 January 2020

31 December 2019 Since its creation in 2000 in Davos, Gavi, the Vaccine Alliance, has immunized 760 million children and saved more than 13 million lives, making it one of the most successful public-private partnerships to date. How can Gavi continue its impressive run and what lessons are to be learned to solve other inequalities?.

Recently, the private aesthetic plastic surgery industry in China is developing rapidly and has become the fourth largest service industry of the country which contributes to 1.2% portion of the national GDP a... The New Humanitarian

London School of Economics and Political Science

On women, the laws of war, and the Rolling Stones: In conversation with Red Cross chief Peter Maurer

The Case for Systems Engineering in GCC Healthcare Policy

19 December 2019

16 January 2020

Maurer opens up on the behaviour of states, ICRC’s “structural problem” with women in management, and use of the word “Rohingya”.

President Barack Obama received a report titled ‘ Better Health Care and Lower Costs: Accelerating Improvement through Systems Engineering (SE) ’ by the President’s Council of Advisors on Science and Technology. The report marked the culmination of healthcare’s longstanding relationship with Systems Engineering to unravel and optimise the complex patchwork of operations in the US healthcare system. Bolstered by measurable improvements attributable to SE in US healthcare, developing healthcare systems in the Gulf Cooperation Council (GCC) stand to gain the most from specially suited SE tools for comprehensive healthcare reforms.

RAND Corporation

Specialty Care Access for Medicaid Enrollees in Expansion States 27 November 2019 In a survey of community health center medical directors in 9 Medicaid expansion states and DC, nearly 60% reported difficulty obtaining new specialist visits and multiple access barriers on behalf of their patients. London School of Economics and Political Science

London School of Economics and Political Science

When planning healthcare reforms, policymakers should remember that bankruptcy can act as an implicit form of health insurance.

Decolonising ethics frameworks for research in Africa 08 January 2020

01 November 2019

In summer 2019 I interviewed health practitioners and activists about the state of HIV/AIDS in South Africa and the roles of global intellectual property rights, Big Pharma, morality and branded and generic medications. The most important and difficult aspect of fieldwork preparation was the ethical review process – a mechanism for external accountability, which is engulfed in rich debates .

For many in the US, the ability to file for bankruptcy can act as a form of health insurance, as households who already have little to lose can rely on them. In new research, Youngsoo Jang models different potential healthcare reforms, and finds that those which provide young and low-income households with more access to healthcare services are more likely […].

17 Healthcare Delivery Briefing, January 2020


References 1. Healthcare Human Capital

4. Access to Care

Access, Quality, And Financial Performance Of Rural Hospitals Following Health System Affiliation, RAND Corporation, www.rand.org DAVOS 2020 | An Insight, An Idea with Deepika Padukone and Tedros Adhanom Ghebreyesus, World Economic Forum, www.youtube.com Here’s how to improve access to healthcare around the world, World Economic Forum, www.weforum.org Personalized healthcare and better population health? Here's how digital can help achieve that, World Economic Forum, www.weforum.org DR Congo: How to Beat Ebola, United Nations, www.youtube.com

The Slippery Role of Induction Chemotherapy in Head and Neck Cancer: Myth and Reality, Frontiers, www.frontiersin.org Deepening Delivery: How Healthcare is Changing the Politics of Development | Raisina Dialogue 2020, Observer Research Foundation, www.youtube.com Inside Idlib’s bombed-out hospitals and clinics, The New Humanitarian, www.thenewhumanitarian.org Cancer drugs could potentially treat COPD, Science Daily, www.sciencedaily.com Specialized Therapeutic Assessment-Based Recovery-Focused Treatment for Young People With Self-Harm: Pilot Study, Frontiers, www.frontiersin.org Trump's trade war cost Republicans congressional seats in the 2018 midterm elections, Peterson Institute for International Economics, www.piie.com

Modulation of Social Cognition via Hallucinogens and “Entactogens”, Frontiers, www.frontiersin.org Trump’s trade war cost Republicans congressional seats in the 2018 midterm elections, VoxEU, voxeu.org

2. Healthcare Technology 5. Promise of Precision Medicine 9 striking images from the 2019 Wellcome Photography Prize on health and humanity, World Economic Forum, www.weforum.org 3 challenges to make sure tech benefits human progress in health, World Economic Forum, www.weforum.org Evaluation of a Virtual Reality Percutaneous Nephrolithotomy (PCNL) Surgical Simulator, Frontiers, www.frontiersin.org How to bring precision medicine into the doctor's office, World Economic Forum, www.weforum.org Human genetic enhancement might soon be possible – but where do we draw the line?, The Conversation, theconversation.com Study Progress of Radiomics With Machine Learning for Precision Medicine in Bladder Cancer Management, Frontiers, www.frontiersin.org Jeroen Tas: ‘If we don’t look at the big picture, we can tweak ourselves to oblivion’, LSE Business Review, blogs.lse.ac.uk

The Contribution of Sociocultural Factors in Shaping Self-Reported Sickness Behavior, Frontiers, www.frontiersin.org Effectiveness of a Prevention Program for Gender-Based Intimate Partner Violence at a Colombian Primary School, Frontiers, www.frontiersin.org In defence of ‘imprecise’ medicine: the benefits of routine treatments for common diseases, The Conversation, theconversation.com Medicare for All or Public Option: Can Either Heal Health Care?, Harvard Business School Working Knowledge, hbswk.hbs.edu Why there is a ‘right’ kind of trauma in Uganda, London School of Economics and Political Science, blogs.lse.ac.uk Microstate Changes Associated With Alzheimer’s Disease in Persons With Down Syndrome, Frontiers, www.frontiersin.org

Acknowledgements 3. Value-Based Healthcare Cover and selected images throughout supplied by Reuters. This is how we make cancer care sustainable and available for all, World Economic Forum, www.weforum.org Linguistic markers of dementia, National University of Singapore, news.nus.edu.sg After Plumbing Code Setback, Georgia Health Officials Refocus Legionella Prevention Effort, Circle of Blue, www.circleofblue.org Affordable Imaging Services Offer Better Healthcare Options in India, International Finance Corporation, www.youtube.com Six Tax-Based Ways to Tackle US Inequality, Project Syndicate, www.project-syndicate.org HIV-Positive Babies Fare Better When Treatment Starts at Birth, Scientific American, www.scientificamerican.com Climate Change Magnifies Health Risks at Every Stage of Life, Circle of Blue, www.circleofblue.org

Some URLs have been shortened for readability. Please follow the URL given to visit the source of the article. A full URL can be provided on request.

18 Healthcare Delivery Briefing, January 2020


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19 Healthcare Delivery Briefing, January 2020


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Profile for Marco A. Gonzalez

Healthcare Delivery in Strategic Intelligence of WEF  

Co-curated with University of Southern California (USC) Global healthcare delivery systems are being developed in a fast-changing environme...

Healthcare Delivery in Strategic Intelligence of WEF  

Co-curated with University of Southern California (USC) Global healthcare delivery systems are being developed in a fast-changing environme...

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