Young Expert Panel on Person-Centred Care
Brussels, 20th June 2014
Imagine that your recommendations could have an impact on the lives of 500 million people. Imagine that the governments of countries across Europe rely on your scientific expertise to advise them on the toughest questions about the present and the future of health care. Well, that group of experts already exists and it is called the Expert Panel on Effective ways of Investing in Health (1).
The European Union seeks modern, responsive and sustainable heath care systems but the challenges to achieve these goals are enormous due to ageing populations, a shift to chronic diseases and the consequent incremental costs. Additionally, better informed and demanding European citizens demand health systems that fulfil all their individual needs. All of these things are intrinsically positive, however health systems as they were constructed in the second half of the 20th century are not necessarily prepared to respond to these new challenges.
The gap between the expectations of citizens and stakeholders in terms of what comprises a modern health care system and reality seems to be narrowed at least partially by a transition to person-centred care, but what it consists of and how it will be achieved remain questions to be answered. That was the motto for a Brussels gathering of seventeen Young Forum Gasteiners comprising young health professionals from different countries and backgrounds, to reflect, discuss and propose disruptive ideas that could change the way we currently organise health care to make it more developed, responsive, sustainable and person-centred.
The workshop was supported by MSD and hosted at Microsoft Headquarters where we were surrounded by the latest technology available in an inspiring building, and thus in the perfect environment to have fruitful discussions about person-centred care. We were warmly welcomed by Elena Bonfiglioli (Senior Director, Europe, Middle East and Africa from Microsoft) who told us that 80% of health workers have mobile based tasks but only 10% have access to mobile technology in their work place. Elena asserted that with rising health costs, cloud computing and seamless access to technology (single sign-on) are absolute preconditions to realising efficiencies. She moved on to explaining the concept of the quantified self (the use of technology to gather data about yourself) that holds interesting prospects for the future of healthcare delivery.
Then, the workshop began, moderated by Nick Fahy, who guided us expertly through the different activities. Firstly representatives from the European Commission´s DG Sanco (Tapani Piha, Head of Unit, e Health and Health Technology Assessment) and Jan Muyldermans (Secretariat, Expert Panel on effective ways of investing in health) were invited to give us overview presentations of how the Expert Panel on Effective Ways of Investing in Health works, namely, its purpose, strategic objectives, composition, mandates and working procedures.
You can imagine that such an expert panel is subjected to heavy scrutiny from all the health stakeholders in Brussels. Therefore ensuring transparency and disclosing potential conflicts of interest are key considerations for the European Commission. The standard procedures to evaluate potential conflicts of interest of the members of the expert panel are very exhaustive and frequent. A key message was delivered: in the matter of conflicts of interest you must be transparent and evaluate each case taking into account the context of the work to be done.
After an enlightening plenary discussion highlighting a range of country examples of whether person-centred care is working or not in participants´ home countries, we were divided into four groups according to our professional background and interests (researchers, practitioners, policymakers and an mHealth interest), and faced with the first task of the day: to discuss key issues to consider on person-centred care and the lessons we could take from them, and then present these findings in plenary. Despite being background-focused, several common themes emerged from the group presentations. One of them was definitely the lack of a commonly accepted definition of person-centred care. Another consistently raised issue was the quality of the evidence that is used to shape the definition and recommendations for effective person-centred care. This evidence is often biased and lacking scientific quality. Training and education both for patients and health professionals on issues such as health literacy and person-centred approaches was another point of commonality.
During lunch, we were offered the possibility to get to know the working environment at Microsoft, as well as to obtain an insight into recent innovations aimed at improving patient care. A few Young Gasteiners tried the patient simulator, where they interacted with a virtual patient and had to decide what to do in a medical emergency, competing to see if they could stabilise the patient “against the clock”.
After a productive plenary discussion reflecting on the availability and quality of the evidence on person-centred care, we moved to the second part of the workshop. Each group focused on preparing a presentation on a set of recommendations to be made for a panel of invited experts. We were given advice on how to draft the recommendations, and how to present them to an expert panel. And what an expert panel we were presenting for: Boris Azais (Director of Public Policy Europe and Canada of Merck Sharp and Dohme), Josep Figueras (Director, European Observatory of Health Systems and Policies), Stephen Leyshon (Deputy Programme Director – Principal Advisor in Patient Safety, DNV GL), Bernard Merkel (Formerly Directorate General Health Consumer Affairs, European Commission) and Peter O’Donnell (Associate Editor, European Voice).
After such an intense day of discussion we came back home with the idea that person-centred care is a path worth exploring, although work is needed to reach a consensual definition and gather more sound evidence about the effectiveness of the interventions aimed at centring the care at the person in question.
There are no “silver bullets” to solve the problems of today´s health care systems but person-centred care might be the best way to integrate an approach incorporating the social determinants of health in health systems.
André Peralta Santos, Young Forum Gastein
Sofia Ribeiro, Young Forum Gastein
We would like to acknowledge Louise Boyle from the International Forum Gastein for organising the workshop and for reviewing this text, MSD for providing financial support, Microsoft for hosting the workshop, Nick Fahy who guided us through the programme and the invited experts, who kindly agreed to evaluate our presentations and give us feedback.
1) Commission Decision 2012/C 198/06 – Creation of the Expert Panel