A lesson from the pandemic: barriers to change may disappear in times of need

COVID-19 has shown us that, in times of need, innovation and change can happen at unparalleled magnitude and speed. From the rapid development and rollout of vaccines to the surge in availability and use of digital and e-health solutions, changes that have been underway for years came to fruition in just a matter of months. The pandemic has also brought about a better understanding of the essential role of data to enable secure and reliable decision-making.

Starting in 2018, in response to growing demand for reliable data to support the shift to evidence-based healthcare, the FutureProofing Healthcare initiative was conceived as an important catalyst and driver for data and science-driven decision-making with the ultimate goal of ensuring future-proofed health.  FutureProofing Healthcareโ€™s panel of experts worked alongside Copenhagen Institute for Futures Studies (CIFS) to develop a Personalised Health Index (PHI) a tool to share easy-to-understand data, drive evidence-based decision-making, and support the standardisation and strengthening of healthcare systems.  

While indexes typically look backwards, telling you how things have been, this first-of-its-kind resource adopted a fresh approach measuring the current status of health systems bringing together in one place the most up-to-date public data so that health systems, policymakers, healthcare professionals, and patients can easily understand a countryโ€™s progression in the journey to sustainable healthcare. The Personalised Health Index not only aggregates data and provides current and future-oriented snapshots of health systems, but it also aims to support future-oriented thinking to enable new technologies and build a common base of knowledge for enabling more concerted decision-making and action. Ultimately, the Index is a shared point of reference for all kinds of stakeholders and citizens that fosters collaboration within and between disciplines and, perhaps most importantly, across borders. At the same time, the Personalised Health Index should support higher levels of societal and technological readiness for the future of health.

Regional Indexes informed by local stakeholders, local experts and local data 

Since October 2020, Europe, Asia Pacific and Latin America have launched their Personalised Health Indexes and a Sustainability Index for Africa also launched in March 2021. These Indexes are being developed using regional data and local experts โ€“ including representatives from patient organisations, health systems, think tanks, and academia and aligned with a framework used by the World Health Organization. 

Each Index is made up of a series of regionally appropriate measures split across four categories, or Vital Signs: Health Information, Health Services, Personalised Technologies, and Policy Context. Measures are based on a broader set of 17 Building Blocks, or key policies, which provide a model of the optimal ecosystem for personalised and digital healthcare. So, Building Blocks detail the desired end state required for a personalised healthcare ecosystem, while the measures provide a snapshot of a countryโ€™s trajectory towards achieving this. 

All data are publicly available, credible and reliable, for example from The World Bank, World Economic Forum, Eurostat, and bolstered with input from local public health authority representatives. Read here for more on how data were selected, measured, weighted, and assessed.

If an Index identifies a challenge, an area for improvement, or best practice learning, the Building Blocks allow decision-makers to investigate that particular challenge or learning, to understand what it means in terms of real-life policy, and what needs to be put in place to deliver improvements.

For example:

VITAL SIGN: Health Services: personalised healthcare happens across all health services and settings, from prevention to diagnosis, treatment, and care for the chronically ill.

Building Block: one Building Block for this Vital Sign is patient-centric care models, where health and healthcare services are structured around the patient, leveraging two-way-communication and new technologies to improve patient health and outcomes.

Measure: key measures include monitoring and assessment of healthcare provision and quality of processes, pathways in place for patient-HCP communications, and patient-centred health infrastructure

Best Practice example: an app allowing patients to communicate with or search for doctors, and digitally store, manage, and share their medical records with HCPs.

The value of these Indexes for public health decision-making

As healthcare evolves from a one-size-fits-all approach to precision public health interventions and personalised treatments, these Indexes are helping to drive discussions with health and policy decision-makers to inform solutions. Whilst challenging for some countries lacking data, insights, or health literacy these Indexes can enable them to learn from best practice and inspire the delivery of data-driven personalised healthcare. 

However, Indexes cannot remain static. They must continuously evolve if they are to benefit society. Since launching in Europe and Asia Pacific weโ€™ve seen huge changes to healthcare delivery in response to COVID. So please, if you are committed to building more equitable, efficient, and future-proofed health systems, take a moment to explore the Index and if you are interested in contributing to future iterations of the Index, tell us. With your help we can address gaps in society, work together towards making healthcare more equitable and fairer. 

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