Critical trends impacting health care and public health
Eric de Roodenbeke, Ph.D. is a French national with an extensive international experience in health systems and policies and a strong background in hospital management. Since June 2008 he holds the position of CEO of the International Hospital Federation. Prior to this he has worked a total of 4 years at the World Health Organization and the World Bank leading various health intervention, educational, management and capacity building programs mostly in Africa. He was Director of several French hospitals of different types for an overall period of 10 years. He has also worked at the French Ministry of Foreign Affairs for 10 years both at head quarter and in field projects in Africa.
Eric de Roodenbeke holds a Ph.D. in health economic, a Hospital Administration post graduate diploma and a University diploma in Public Health. He has taught in various masters programs and senior continuous education course and published several books as well as various articles in professional journals.
There are many publications on future of health, and they cover same aspects although coming from different perspectives and giving different emphasis to some or the other trend. Rather than going through a shopping list it is better to articulate theses factors in categories to better reflect on them and figure out what changes should be made in health service delivery and public health interventions to enhance health of the population.
Demand for health services is changing because of demography, epidemiology, climate but also people expectations and the technology revolution. The ageing population as well as the urbanization are creating new conditions for health services including a different approach of care as well as health support breaking silos from the medical field to a broader social response. The health status is also changing with the recognition of the importance of multimorbidity than cannot be addressed as previously through a combined specialty approach and a stronger need to have a health mediator for navigating in the health system. Climate change is already affecting all continents with more and more violent and unexpected natural disasters, but longer-term impact will have major consequences on health and population. People expectations and technologies play together for more empowerment and a drastic change in the providers/patient relation as well as for the expected responsibilities of individuals and the role of the community. Moving toward coproduction of healthcare is much more than a shift in words. For all the demand factors the key question is around how deep our actual knowledge of these trends is, and what is the variation regarding local conditions.
The supply of health services is also fast evolving because of scientific breakthrough, new technologies and change in the scope of work of Health professionals as a result of the two first trends. Among the scientific breakthrough the genomics driving care towards predictive medicine and individualized treatments is opening the door for a paradigm shift that is still at a very early stage. New technologies including nanotechnologies, robotics and of course the multiple variations of e-heath applications are offering a very large spectrum of possible responses to the current challenges for improving health of the population. The combination of these two is drastically affecting the role of health professionals putting at stake the education models and the responsibility between professions. The evolution of Electronic Health records with Artificial Intelligence will be changing drastically the intervention of health professionals and the organization of service providers. For all supply factors the major uncertainty is on technology adoption and capacity to drive change for general interest instead of fighting for own entitlement.
The market forces make the third component on trends of evolution. The critical factors affecting the market forces will be around the resource allocation mechanisms, the level of globalization of the market and increased uncertainty. Resource allocation is not around public health versus healthcare but on how much societies are ready to spend on health versus other expenses and how will it be possible to spend more effectively on health. Globalization is at early stage but is a game changer as it makes health issue more and more international while the global governance is not yet prepared for this. Globalization has also increasing impact on health with migration and booming travel. New disruptive players may also create unexpected big bang in service delivery. Finally, increased uncertainty is also playing a major role in the way organizations are considering their role and respond to the need of population.For market forces the key element is in the hand of policy makers that have the responsibility to shape up the framework in which health service are evolving.
Director General, National Institute of Public Health, Poland
Grzegorz Juszczyk, MPH, Ph.D., is the director-general of the National Institute of Public Health in Poland since October 2017. He is a public health specialist who has worked as a researcher at the Department of Public Health at Medical University of Warsaw in Poland. He received his Master of Public degree in Poland (Jagiellonian University in Cracow) and in the Netherlands (Maastricht University). He has also graduated from the one-year preMBA managerial training.
Dr. Juszczyk earned his doctorate degree in public health from Medical University of Warsaw in 2008. His main research interest concerns health of working population and interventions that may increase healthy life years. Since 2003 he has had, as a consultant, the opportunity to plan, implement and evaluate health promotion activities for employees and their families in more than 200 public and private companies in Poland. He has also supervised the processes of health needs assessment for employees and teams implementing preventive and education activities for more than 1,200,000. In 2013-2016 on behalf of Polish employers he had been a member of the Advisory Committee on safety and health at work (ACSH) by the European Commission.
President-elect, WONCA World
Anna Stavdal is a family medicine specialist, she has worked in clinical practice in the same area of Oslo for 30 years. She is associate professor at the Department of General Practice, University of Oslo. She is an experienced speaker and advocate for family medicine.
Anna is the former chair of the Norwegian College of General Practice, former president of Nordic Federation of General Practice and immediate past president of WONCA Europe.
From October 2018 she is the president-elect of WONCA World, to take office as president in November 2020.(WONCA is the World Organisation of Family Doctors, representing more than half a million family doctors engaged in research, education and professional development in family medicine.)
Superintendent of Taichung Veterans General Hospital and President of Diabetes Association, Taiwan
Prof. Dr. Sheu, MD, PhD, is the superintendent of Taichung Veterans General Hospital in Taiwan and holds several adjunct and consulting professor of medicine at several medical schools in Taiwan including National Defense Medical Center, National Yang Ming University, both at Taipei, Taiwan. He is currently the president of Diabetes Association, Taiwan, as well as the immediate past chair (2016 to 2017) of the IDF-WPR.
Dr. Sheu had led a team in Taichung Veterans General Hospital, located at central Taiwan, as the most prestigious smart hospital in Taiwan. This hospital was the first film-free and paper-free hospital. By employing central dashboard they had shown how to improve quality of diseases control for inpatients as well as outpatients care when back to community. They also develop dynamic visualized control and several lean processes to greatly run operations room efficiently.
Dr. Sheu has authored and co-authored more than 379 original articles in the areas of Diabetes, Endocrinology, Hypertension, Obesity and Coronary Heart Disease. Dr. Sheu and his team had actively participated many international clinical trials, such as TECOS, EXSCEL, REWIND, CREDENCE etc. He has frequently been invited to deliver speech in domestic and internal medical conferences. He also serves as editorial board member and as reviewer for many scientific journals, including Diabetes, Diabetes Research and Clinical Practice, American Journal of Hypertension, Circulation Journal of Biomedical Sciences, Journal of Diabetes Investigation, to name a few.
Deputy Chair, International Network for Health Promoting Hospitals and Health Services; Senior Public Health Academic, La Trobe University, Australia
Sally Fawkes is a senior public health academic at La Trobe University, Australia. She holds a BSc, MBA (Health), and PhD on foresight and international health policy. Sally has been a regular consultant to WHO for over two decades, contributing to initiatives in Asia, the Pacific, Europe and Middle East. Sally was one of the first hospital-based health promotion innovators in Australia. She led HPH portfolios in major teaching hospitals, helped establish the Victorian HPH Network in 2004 and has been advisor on HPH strategy and practice to hospitals, health services and governments in Australia and internationally. Her association with the International HPH Network began at the first conference in Warsaw in 1993. She is serving her third term on the HPH Governance Board, as Deputy Chair. Sally is also Acting Board Chair of VicHealth, the world’s first health promotion body funded by tobacco tax, and executive committee member, Council of Academic Public Health Institutions Australasia. Sally’s research and consulting interests span fields including leadership development; health promoting health systems and SDGs; policy foresight; and governance for urban health and in Healthy Cities. Her publication projects include Public Health Practice in Australia - The Organised Effort (with Lin and Smith), Health Promotion Systems and Strategies in Asia: Preparing for the Asian Century (with Lin et al) and Cities and Health special issue co-editor: Transforming city and health futures: the use of science and imagination (with Fudge).