How Health Care Innovation Spreads

There is now a clear consensus on how to manage the condition through drug treatment, screening, self-management and behavior change. Governments are starting to act.
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Scientist looking at molecular model
Scientist looking at molecular model

A year ago, Simon Stevens, then incoming chief executive of the NHS, stood before an audience of 1,000 international experts, health policy makers and business leaders and declared: "The future is already here, just unevenly distributed." Mr Stevens was speaking at the first World Innovation Summit for Health (WISH) in Doha and his phrase encapsulated an important truth. Most people when they think of innovation think of a new blockbuster drug or state of the art machine. We have indeed had these -- and made huge strides in healthcare in the last century. But spreading new ways of doing things has proved much harder. Only a tiny proportion of health care budgets is used to encourage the take up of new ideas. Health services everywhere face the challenge of coping with aging populations, a growing burden of chronic disease and economic pressures. Without creative answers to these problems that everyone can use the future is grim. Today (Feb 17) at the second WISH in Doha, experts, policy makers and business leaders will meet to assess the challenge posed by rising rates of cancer, dementia and diabetes, assess the latest innovative responses to them and consider how to speed their adoption around the globe. The growing prevalence of cancer is driven by the aging of populations -- and the cost of treatment has soared. The scientific challenge has become a financial one -- how to afford the rising cost of care. The global bill for cancer currently stands at $290 billion (£190 billion), a sum equivalent to the GDP of Hong Kong. In a report to be presented at WISH, an expert panel says there is excessive spending on cancer including unnecessary tests, over-treatment and needless use of expensive technology. Cancer drug prices have risen at four times the rate of inflation, a rate that is hard to justify. Countries that spent the most on cancer care might have been expected to have the best outcomes. But it isn't so. The UK spends more than twice as much as Spain on colorectal cancer yet has a poorer survival rate. The expert panel highlights innovative projects from around the world that are making savings and releasing resources for new treatments. In the UK one example is the deal struck with pharmaceutical manufacturers under which they will refund the cost of drug treatment where it fails to have the expected impact. The rise in diabetes is one of the greatest health catastrophes the world has seen. Rates have soared over recent decades with 2.9 million patients diagnosed in the UK and 4 million projected by 2025. On current trends, one in ten of the world's population -- 600 million people -- will suffer from diabetes in 20 years' time. But there is now a clear consensus on how to manage the condition through drug treatment, screening, self-management and behavior change. Governments are starting to act. Mexico has imposed a health tax on sugar-laden fizzy drinks and Hungary on foods high in salt and sugar. Tax breaks have been offered in Canada and South Africa to encourage physical activity. Calorie labeling is now mandated in US restaurant chains and in the Australian state of New South Wales. These are among the case studies cited by an expert panel in the report on diabetes to be presented to the summit. Dementia is among the most feared of all diseases. Already 44 million people worldwide are living with the condition and the number is projected to triple by 2050. But simple measures can help.

In Finland a trial launched in 2009 showed that adults who were taught to eat healthily, participated in physical activities, received cognitive training and had regular medical checkups over two years did significantly better on tests of memory, problem solving and speed of thinking than their peers who had no intervention. The message is: use it or lose it. The expert panel report on dementia to be presented to the summit will say by these means we could prevent up to 80,000 cases of dementia a year in the UK. Last year the results of a pioneering study on the Global Diffusion of Healthcare Innovation were unveiled at the summit, which examined the adoption of healthcare innovations in eight countries around the world. It concluded that setting out a clear vision, identifying champions of change, engaging patients and clinicians and eliminating old ways of working were among the vital pre-requisites for achieving change. This year the project has been extended to examine actual examples of how innovations have spread, from immunization to elderly care, in eight health systems around the world. The results show that the model developed last year accurately predicted in which countries innovative ideas would take hold.

We now know, in other words, what is needed to accelerate the "distribution of the future". The test for future summits will be whether we can make it happen.

Lord Darzi is a surgeon, director of the Institute of Global Health Innovation at Imperial College London, and Executive Chair of the World Innovation Summit for Health. He was a Labour health minister from 2007-9.

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