There are a number of exciting projects and visible pockets of excellence, and interest is growing in several EU countries, but why are we still a long way from change towards value-based care being implemented at scale in Europe?
The main obstacles are: how traditional health systems are organized, financed and regulated today; and how financial and non-financial incentives are structured. A transformation towards value-based care in Europe is complex. It must be accompanied by transformation in the ways we invest in, organize and incentivize European health care.
I see three important areas in which the EU could contribute to accelerate this transformation:
1. Create a consistent market for data
Health care’s data explosion has the potential to bring unprecedented levels of quality and efficiency to care but has not fully taken hold. Much of the patient data that is now created, for example, is not aggregated and most patient data is stored across health care providers in disparate systems that don’t interoperate. The result is that practitioners find it difficult to exchange information and medical decisions cannot benefit from a patient-centric view.
To solve this, the EU should step up efforts towards a truly functioning digital single market (DSM). Substantial progress has been made in prioritizing digital health, privacy, security and free flow of data with the implementation of the DSM strategy. However, there is still room for variation on rules from one member country to another. The Commission needs to ensure that the legislation such as GDPR or free flow of non-personal data is implemented with the same interpretation across the EU. Efforts must focus on abolishing fragmentation. This is the only way to enable true data sharing across the health care landscape.
2. Help translate pilots into structured change
The EU could also do more to provide incentives for scaling up successful initiatives. The Horizon 2020 program is a great example of the EU’s ability to drive change here — it supports big data solutions that will provide better outcomes to patients at a lower cost. An example could be the ‘BigMedilytics’ program, which aims to apply artificial intelligence to complex datasets from patients, health care providers, health insurers and medical technology providers. But this type of support must be complemented by incentives to scale-up projects if we are to speed up transformation in the way to best serve patients and health systems. The EU should look to ensure a level playing field through the continued funding of innovative health care companies of all sizes.