IPIHD private session on leapfrogging presentation-07 april2014

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BCG Provided insights and framework for leapfrogging improvements for healthcare systems.

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IPIHD private session on leapfrogging presentation-07 april2014

  1. 1. Health Systems Leapfrogging in Emerging Economies IPIHD private session, Washington DC Presentation 7 April 2014 This project is supported by The Boston Consulting Group (BCG)
  2. 2. IPIHD & World Economic Forum joint private session Project: Health Systems Leapfrogging in Emerging Economies Timing 15.00-15.10 15.10-15.40 15.40-15.50 15.50-16.00 Agenda Welcome and introduction Innovators' perspectives on enablers and barriers of leapfrogs Q& A session Closing remarks Speakers Dessislava Dimitrova, World Economic Forum Shelly Batra, Operation Asha Ting Shih, ClickMedix Gunther Faber, One Family Health Moderator: Martin Silverstein, The Boston Consulting Group Open floor Martin Silverstein, The Boston Consulting Group Dessislava Dimitrova, World Economic Forum IPIHD private session on leapfrogging-presentation-07April2014-v4.pptx 2
  3. 3. In year I, we developed a matrix to systematically categorize and explain leapfrogs Health system 0 1 2 3 4 5 Prevention and Health promotion Service delivery Medical products/technology Workforce Information Financing Leadership/Governance 6 A B C Technology Innovation types Operating model change Behavior change Ecosystem including agriculture, environment, infrastructure, urban planning Health system categories or building blocks Note: These categories are based on the WHO's six building blocks of health systems, first introduced in WHO, "Strengthening Health Systems to Improve Health Outcomes: WHO's Framework for Action", 2007. The initial category names were slightly adapted in WHO, "Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and their Measurement Strategies", 2010. IPIHD private session on leapfrogging-presentation-07April2014-v4.pptx 3
  4. 4. Three examples today mapped onto our leapfrogging matrix Enablers Categories Prevention & Health promotion Service delivery Medical products/ technology Workforce Information Financing Leadership/ Governance A Technology B C Behavior change 0 1 2 3 4 5 6 Operating model change Operation Asha Shelly Batra, Founder and Chief Executive Officer 2 ClickMedix Ting Shih, President One Family Health Gunther Faber, Founder and Chief Executive Officer 1 3 Source: IPIHD Innovator profiles, BCG analysis Primary space of intervention: each innovator participates Secondary space of intervention: some innovators participate IPIHD private session on leapfrogging-presentation-07April2014-v4.pptx 4
  5. 5. Unused slides
  6. 6. Leapfrogging matrix: Definitions Health system categories Innovation types Prevention & Health promotion: measures inducing behaviors that counteract occurrence of medical conditions through education, nutrition and demand creation Service delivery: health interventions delivered and infrastructure established to diagnose, treat and care for patients Medical products/technology: selected products used to diagnose, treat or care for patients (including medication, vaccines, and technical devices) Workforce: all people engaged in actions whose primary intent is to enhance health Information: production, analysis, dissemination and use of information on health determinants, health system performance and health status Financing: provision of resources to pay for medical products and services consumed Leadership/Governance: systems and processes regulating and exercising oversight of healthcare activities 0 1 2 3 4 5 6 Technology: novelties in the application of scientific knowledge to healthcare activities and products Operating model change: modifications in the organizational setup and process design of healthcare activities Behavior change: modification to the conduct of individuals (patients, workforce, etc.) acting within the health system Sources: WHO, BCG analysis A B C IPIHD private session on leapfrogging-presentation-07April2014-v4.pptx 6
  7. 7. Matrix for leapfrogs and new opportunities: Major themes Health system categories Innovation types Prevention & Health promotion Service delivery Medical products Workforce Information Financing Leadership/ Governance 0 1 2 3 4 5 6 A Technology B Operating model change C Behavior change A holistic approach to prevention and health promotion can bring health considerations into every aspect of people’s' daily lives. (Example: Health Promotion Board in Singapore) Telemedicine can improve the quality of care for remote communities by leveraging centrally-located expertise. (Example: Fortis and GE Healthcare tele-ICU in India) Strengthening supply chains for medical products, for example through supply chain integration, can make products more accessible and affordable to low-income populations. (Example: "Deliver" Project by USAID) Empowered community health workers can promote health and provide primary care, supported by and acting as a gateway to more qualified health workers. (Example: Pesinet child health programs in Africa) Defined global standards for measuring health outcomes can allow meaningful international benchmarking and sharing of best practices (Example: International Consortium for Health Outcomes Measurement ICHOM) Micro-insurance products can increase access to care for low income populations while limiting exposure to financial risk. (Example: Hygeia Community Health Care in Nigeria) Using social marketing employing proven commercial marketing techniques to promote can improve individuals' health choices. (Example: Greenstar social marketing for family planning in Pakistan) Insights from behavioral sciences can be used to effect behavior change in both the demand and provision of medical services. (Example: Abdul Latif Jameel Poverty Action Lab study on immunization incentives in India) Incentivizing the workforce to prolong equipment longevity through careful handling, regular maintenance, and safe re-use of devices sold as single-use products. (Example: re-using steel clamps at CARE hospitals in India) Increasing workforce awareness of financial considerations can reduce costs by promoting transparency and rewarding suggestions for process improvements. (Example: Physician cost awareness policy by Narayana Health in India) Providing food labeling to help consumers better make more health-conscious choices (Example: Traffic light" nutrition labeling in the United Kingdom) Rewarding health insurance buyers for healthy lifestyles by adjusting premiums to measurable exercise activities and consumption habits can improve health and cut costs. (Example: Discovery insurance group in South Africa) Mobile technology can be used to prevent disease and create demand for health care via mobile-phone based health education programs and counseling hotlines. (Example: Project Masiluleke in South Africa) Care can be moved from hospitals to homes by smart phone technology enabling remote support and tracking of therapy adherence. (Example: Helius software tool by Proteus Digital Health in the United Kingdom) Refocusing medical product innovation on value to create products balancing quality with cost can increase access to care for low-income populations. (Example: Philips' infant warmer; QIAGEN CareHPV Test) Clinical decision support (CDS) software can empower health workers to improve the quality of the services they provide. (Example: Diagnostic software used by "MinuteClinic" walk-in clinics in the United States) Mobile technology can be harnessed to communicate to broad population segments, especially in rural and low-income areas. (Example: Kenya Integrated Mobile MNCH Information Platform ) Smart cards for health insurance buyers can streamline administration, facilitate data collection and mobility, and improve the quality of service delivery while preserving patient privacy. (Example: RSBY biometric smart card in India) A nationwide, integrated electronic health record system can improve quality and efficiency of care by avoiding data silos. (Example: Electronic Health Record System in Estonia) Imposing excise taxes on unhealthy products (foods, tobacco, alcohol) vsn discourage unhealthy consumption habits (Example: Sugar tax in Norway) Intersectoral governance can bring health considerations into all aspects of public policy making in a holistic manner. (Example: National Committee on Public Health in France) Proven Sources: BCG analysis, desk search, expert interviews, project partner organizations theme Nascent theme IPIHD private session on leapfrogging-presentation-07April2014-v4.pptx 7
  8. 8. Matrix for leapfrogs and new opportunities: Concrete examples Innovation types Technology Health system A B Operating model change C Behavior change categories Singapore Health Promotion Board: Invest in the maintenance of public health through a holistic approach, bringing health considerations into every aspect of people's daily lives. Fortis & GE Healthcare tele-ICU: Reorganize delivery of critical care by connecting remote ICUs with centrally located intensivists through telemedicine USAID "Deliver" Project: Provide technical assistance to streamline medical supply chains in emerging economies, increasing availability and affordability of medical products Pesinet: Deploy community health workers with limited expertise to detect and monitor childhood diseases with remote assistance from physicians International consortium for health outcomes measurement: Define global standards for measuring health outcomes and foster better decision-making Hygeia Community Health Care (HCHC): Provide low-income populations in Nigeria with affordable health insurance covering essential treatments French National Committee on Public Health: Create an inter-ministerial committee to act as a steering body in coordinating health policies across all ministries concerned Greenstar: Conduct social marketing to raise public awareness for reproductive health, leveraging private healthcare providers to act as franchisees Abdul Latif Jameel Poverty Action Lab study on immunization in India: Provide non-monetary incentives for parents to immunize their children, thereby overcoming cognitive biases CARE hospitals: Improve equipment longevity and reduce waste by re-using devices sold as single-use products if medically safe Narayana Health cost awareness policy: Incentivize physicians to take financially prudent decisions and make suggestions for cost savings and process improvements. "Traffic light" nutrition labeling in the UK: Simplify food labels to avoid obesity by helping consumers better understand Discovery Group: Reward health insurance takers for healthy lifestyles through lower premiums and other benefits Project Masiluleke: Leverage mobile technology for HIV/AIDS and TB prevention through phone-based counseling and text message-supported self-testing. Proteus Helium system: Administer hypertension therapy remotely via smart phone technology, moving care from service points to homes Philips infant warmer: Provide reliable, easy-to-use, and cost-effective infant thermo-regulation to reduce neonatal mortality in low-income countries AMREF e-learning for nurses: Overcome workforce shortages and infrastructure problems by training and certifying nurses remotely Kenya Integrated Mobile MNCH Information Platform: Provide pregnant women with mobile phone-based health information to promote safe pregnancy and ensure access to maternal care Changamka: Offer mobile phone-based insurance services to bring health insurance to low-income communities Estonian Medical Health Record System: Create a nation-wide, integrated electronic health record system to improve the quality and efficiency o f diagnosis and treatment Project Masiluleke Norwegian Generalized Sugar Tax: Charge excise tax on unhealthy food (also: tobacco, alcohol) to discourage unhealthy consumption habits Prevention & Health promotion Service delivery Medical products Workforce Information Financing Leadership/ Governance 0 1 2 3 4 5 6 Sources: BCG analysis, desk search, expert interviews, project partner organizations Proven example Nascent example IPIHD private session on leapfrogging-presentation-07April2014-v4.pptx 8

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