How to rebuild health systems for a healthier Europe

The COVID-19 emergency is exerting a significant impact on public health systems across Europe. Evidence is emerging showing the real impact of the infection on mortality and morbidity, also in the longer term. But the most prominent impact from the pandemic manifested broadly with the disruption of routine healthcare service delivery and with the unexpectedly rapid shift towards new models of service demand and offer.

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COVID’s impacts ripple throughout health

At a global level, during the acute phase of the pandemic, health care delivery decreased by 37%.¹ This means that numerous services and interactions had to be significantly reduced, including doctor visits (42%), hospitalisations (28%), diagnostic (31%) and therapeutic services (30%).¹ On one side, limitations to treatment access have created a backlog that systems must now address; on the other side, some individuals are refraining from seeking care due to fear of infections, or just poor health-related behaviour. In fact, the pandemic exposed and exacerbated existing health inequalities and related disparities in people’s ability to take care of their own health.

Now, as we recover and attempt to mitigate the consequences of the pandemic, there’s an unprecedented opportunity to reshape health systems to deliver value-driven, digitally-enabled services that will help achieve better health and wellbeing for the entire population. To grasp that opportunity, decision-makers will have to prioritise actions and investments in key fields.

The question is now, what did we learn from the pandemic, and how can decision-makers apply those lessons to 'build back better'?

Those are the questions that the report “Health Systems after COVID-19”² from PwC and the European Federation of Pharmaceutical Industries and Associations (EFPIA) seeks to answer. Above all, the report recognises that the pandemic has created multiple challenges that have had an adverse impact across all components of healthcare systems, from service delivery, to technology and innovation, and financing.

Interlinked trends

The challenges faced during the pandemic can neither be viewed separately nor tackled individually. They are interlinked by nature, and attempts to address one of them will affect other components of healthcare systems. Therefore, the response to the crisis needs to take place at the health system level, with key decision-makers and stakeholders converging to address the four systemic trends the report identifies:

• Enabling prevention and early care: The COVID-19 pandemic increased the urgency of strengthening prevention and early care to relieve healthcare providers from the preventable fraction of disease burden that characterises our ageing population. To achieve that requires strengthening and updating tools, products and interventions for early care. Just as important is the ability to rethink today's fragmented patient pathways to build them around the patient.  And these could be encouraged by payment models that incentivise patient- and outcome-centred models across all settings of care.
• Planning ahead: Decision making in healthcare has tended to be reactive and short-sighted. That needs to change in the direction of approaches assessing and seeking for longer-term health outcomes. Relevent research and investment are requiered, as well as the use of real-world data and artificial intelligence to understand future healthcare needs. New approaches to clinical trials – such as remote patient interactions – will be important to ensure that these vital drivers of new scientific knowledge are not derailed by future crises (as was the case during COVID-19).
• Reaping the benefits of digitalisation: Accelerated adoption of digital healthcare delivery was one of the positives to emerge from the COVID-19 crisis. Leveraging the momentum is essential and will require investments in digital infrastructure and, in particular, a focus on data governance to ensure maximum system interoperability, both within and between national health systems. Incentives for healthcare professionals (HCPs) could also help drive greater digital health participation. That means reviewing the reimbursement models for digital health and how they are integrated into HCPs’ day-to-day activities.
• Focusing on people and outcomes: Rebuilding trust in healthcare is an essential task for all healthcare systems as they emerge from the pandemic. Building them back better means designing around people and what they need. HCPs must be equipped with new skills, especially around digital, to best respond to patients. And patients themselves need empowering tools and information to process health-related information, understand their own health better and adopt behaviour that improves it.