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interview ● Sustainable healthcare Working together to achieve a sustainable healthcare system L Priscilla Lynch talks to Pascale Richetta, Vice President, Western Europe and Canada Operations, AbbVie, about sustainable healthcare systems ife expectancy in Europe has risen by an average of 10 years since 1960, and it is estimated that by 2050, it will average of 82 years. While this is to be celebrated, it poses challenges in ensuring older people live full, active and healthy lives. Chronic illness is a key issue in this respect, which is placing severe strain on healthcare systems, including Ireland. Recently, AbbVie held a special meeting in Dublin, ‘Clock Watching — Healthy Ageing in a Modern Ireland’, on the topic of sustainable healthcare for an ageing population in a time of economic crisis. The invite-only meeting was attended by leading figures in Irish healthcare, including representatives from public and private service delivery, clinicians, patient advocates, academia and policymakers, all keen to address this challenging healthcare issue. The Irish meeting speaker panel included Department of Health Secretary General Dr Ambrose McLoughlin, Charles Handy, the social philosopher and writer, and Ms Pascale Richetta, Vice President, Western Europe and Canada Operations, AbbVie, who discussed how healthcare stakeholders in Ireland could drive sustainable healthcare by working together. “We really need to reconsider how we operate in healthcare. We really cannot stay static. The way I view things is that we should all work together on really driving the transformation of the healthcare system. I think we should count our progress in technology, which can help a lot, but really, as I have seen in other countries, a national collaborative spirit is what can drive change,” Richetta told IMT. European issue The challenge of creating a sustainable healthcare system is not just an Irish one, Ms Richetta pointed out; some 100 million Europeans have a chronic illness. “By working together and working small we can probably achieve big steps. It is clear the sustainability of healthcare systems is a challenge to most nations, particularly in Europe, and the shift in demography is a fact, as is the rise in chronic diseases,” she commented. Richetta confirmed AbbVie is holding similar meetings in other countries in an effort to help address the huge, unsustainable cost of chronic diseases to healthcare budgets. For example, the key outcome from the meeting in Brussels was that innovation has to be at the heart of the major 14 | Irish Medical Times Pascale Richetta, Vice President, Western Europe and Canada Operations, AbbVie changes that must take place to achieve sustainable healthcare systems, she said. Technology Richetta emphasised the importance of achieving the best health outcomes possible and using technology to both drive this and save costs at the same time. “The name of the game is to really shift as much care as we can from diagnosis, treatment and monitoring out of the hospital and into the patient’s home,” she stated. Tommy By rne, Client Principal, Hewlett-Packard Ireland Limited, highlighted the role and contribution of technology to enabling sustainable healthcare systems at the meeting, which Richetta said was very useful. Remote monitoring or telemonitoring are examples of how care can be provided to patients with chronic illnesses in their own home in an effective way and mobile devices offer major opportunities and advantages for the healthcare sector, as do social networks — such as in the case of patients with a particular condition coming together and sharing information. Achieving healthcare improvements whilst being open and transparent in the provision of outcomes data, which can drive improvement, is also vital, Richetta maintained, reiterating that the IT industry could really help on the datasharing front. Patient empowerment was also a critical element of the changes that will be needed, she noted, explaining that as well as the home environment providing the lowest-cost healthcare, it can also provide Project has cut rate of ‘no shows’ from 34% to 5% the most patient involvement. “If we empower patients in the self-monitoring of their health, I think we can achieve a lot and… I think an empowered patient will be much more committed to any interventions and it will increase the success rate of interventions because they will be more compliant, better understand the intervention and see the benefit of intervening early, so I think more empowerment is a win-win situation,” Richetta commented. The pharmaceutical sector can also help by making its products easier to self-administer and tolerate, such as the use of pen injector systems, she added. Early intervention While a number of speakers at the meeting highlighted the importance of primary prevention, Richetta said all forms of prevention, including secondary and tertiary prevention, played a key role, along with early diagnosis and intervention. “The earlier you act on chronic disease, the less costly it will be later on. A wait-andsee approach can be damaging and you can miss the chance to have an early solution for the patient.” tient beforehand, made sure they were more likely to attended their appointment and were also more likely to have all the necessary information to hand. “The results speak for themselves. Previously, there was a 34 per cent rate of no-shows which dropped down to 5 per cent and resulted in increased efficiency within the system. I think by starting small we can really do big things, and while this was just one specialty in one hospital, it is certainly universal and can be translated into many disciplines,” she said. Another successful Irish healthcare partnership project that AbbVie has been involved in is the Fit for Work initiative, which is addressing the impact that musculoskeletal disorders have on the economy and our workforce. Up to seven million lost days at work are recorded each year resulting from musculoskeletal disorders, costing the economy an estimated €750 million a year. However, approaching the problem using a multidisciplinary approach, including patients, GPs, rheumatologists, health insurance companies, occupational therapists and trade unions has resulted in the launch of a major position paper outlining a number of actions to tackle the issue, she explained. The third partnership project Richetta discussed was a premature baby initiative that facilitates the immunisation of these babies in the home setting by a nurse. This is convenient for parents and avoids unnecessary travel and pressure on hospitals. The project, launched in 2008, has been very successful and has treated more than 3,000 babies, leading to the avoidance of 14,000 hospital appointments. Conclusion Dr Ambrose McLoughlin, Secretary General, DoH Referencing the Healthy Ireland report, she said a multidisciplinary approach was key to successful health outcomes and highlighted AbbVie’s work on three projects in Ireland partnering with healthcare stakeholders to find solutions to major healthcare issues. Irish projects Richetta discussed a successful project in the Rheumatology Department at St James’s Hospital, Dublin, that focused on the better use of people and resources to reduce waiting lists and maximise the number of patients who attended their appointments. The project revamped the appointment system, and by contacting the pa- Richetta said she hoped the Dublin Clock Watching meeting had encouraged the Irish healthcare stakeholders it brought together to engage, discuss and work together on creating solutions to ensure Ireland’s healthcare system moves towards a sustainable system that provides the best care for all who need it. Dr McLoughlin told the meeting that the Government wanted to engage in a “true partnership with industry” and see innovation hubs covering medical devices, pharmaceuticals, ICT and other industries on the campuses of all the hospital groups. While Ireland’s healthcare services are currently going through very challenging times, Richetta said there was a real sense of connectiveness in Irish healthcare that not all countries have, as well as a willingness to work together to improve patient care. Concluding, she said it was now clear that healthcare stakeholders do not achieve much by working in isolation, and that it is by working together that meaningful and successful change can be achieved. 02.08.13