What you measure is what you get
Sweden has the best health care in the world. A well-known statement, but is it really true? Yes and no according to a newly published report ”Why compare when we know that we are best?” by Forum for Health policy.
There is no doubt that Sweden does rank high internationally. Quality, low costs, unique registries are just a few of many areas where the country gets the highest scores. But other comparisons also highlight the main challenges; the access to good health care depends on where you live, the flaws in service level and patient safety.
World class? Well, the truth lies somewhere in between. And it depends on how and what is measured. The effort should be to identify key success factors – what is really important to measure – and compare with the right health care centras on the global arena. The data has to be presented correctly in order for the conclusions to be useful for the decision makers. In other words what you measure is what you get. Used in the right way measurements can boost the Swedish health care which, in many areas, already is considered world class.
Value-based, patient-centered care in focus
A breakthrough. This is how value based health care is often described. The goal with this new way of organising the health care is to lower health care costs and improve quality and outcomes. In other words it requires restructuring how health care delivery is organized, measured, and reimbursed. Once implemented it can lead to quicker recoveries, fewer readmissions, lower infection rates, and fewer medical errors, to name a few. It is all about creating value for all parties involved in the treatment chain.
In the centre of it all we find the patient. It is the patient’s needs that is the single most important driver of change. This requires informed patients interested in actively taking part in their treatment and recovery.
So is it a fad or the future? The latter if you take a quick glance at the main university hospitals in Sweden, with Sahlgrenska University Hospital director Barbro Fridén standing on the front line advocating the benefits.
The era of e-health continues
They say digitalization is the solution to many of the challenges causing headaches for the health care both in Sweden and globally. It is also one of the most discussed topics of 2015’s edition of the Almedalen week.
Indeed, new information systems can do wonders to a sector that has struggled to modernize itself. Not only can it create a more efficient environment allowing medical professionals more time to focus on the patient, but it also enables better knowledge transfer between different care levels. The patient is said to benefit in many ways, out of which an increased quality of care possibly is the most important.
To summarize, the idea is simple. But one needs to be careful when introducing new information systems so that we do not end up having countless modern, innovative systems across the country that do not communicate with each other.
How to prevent competence-waste
The past year the debate about competence waste among those waiting for or recently received residence permits in Sweden has intensified. Sweden struggles with lack of qualified doctors while hundreds of foreign born doctors who live in the country are unemployed. An equation that does not make sense. This was discussed at a seminar organized by University of Gothenburg in Almedalen along with a large number of seminars on similar topics.
One needs to bare in mind that the efforts made are good, but far from enough. The main problem is the long application process which for many of the doctors feels like a waste of time. It is often compared to sitting in a waiting room, not knowing when your name is going to be called. There is no simple mathematic formula that can solve this, but the aim is to find a ”fast track”-model that will enable hospitals across the country to make use of the competence among immigrants quicker than before, without compromising on the quality of medical knowledge. This requires a closer dialogue and collaboration between the county councils and the Swedish Board of Health and Welfare.
Hopefully progress will be made during the year to come, but it is predicted to remain a hot topic at the 2016 edition of the Almedalen week.
Equal care, does not mean same for all
The access to health care of highest quality should be equal, regardless of where you live. That is not the case in Sweden today. Politicians across the country address this problem and strive towards a common goal, still they struggle to find a solution. Maybe that is why this is one of the most discussed topics in Almedalen this year as well.
It is clear that there is no one fits all solution. And the solution has to be broken down in different parts. Significant efforts are made within the areas of e-health, the collaboration between different care levels and the new patient law. All these will in time lead to a more equal care. But a lot remains to be done, and critics say that it is time to speed up the process.
– One needs to bare in mind that equal care does not mean the same care to everyone. It is about offering high quality health care adapted to individual needs to patients all over the country, says Agneta Karlsson, State Secretary to the Minister for Health Care, Public Health and Sport at a seminar about myths about equal and person-centred care organized by University of Gothenburg.
The long queues to certain treatments – how to break the evil spell?
The new patient law gives patients the power to seek out-patient care at the preferred hospital, not necessarily the closest one. A few months have passed since the law was introduced, the consequences remain to be discovered. One thing is sure though, as the competition tightens, the pressure on care providers increases. Not only do they need to offer good treatment, but also a high service level.
So, how does this affect the queues to certain treatments? Some say that this will shorten the queues. But most of the decision makers say that it is to early to evaluate the possible effects.
– We are currently shifting from seeing the norm as a patient that will be in touch with the health care once or twice during their life, to a patient with cronic diseases that require life-long treatment, says Gabriel Wikström Minister for Health Care, Public Health and Sport.
A cultural shift takes time. In the meanwhile, new national guidelines that will serve as support for employees to make informed medical decisions will be introduced this upcoming fall. This will draw attention to certain medical areas, such as chronic diseases, which is welcomed by organizations representing these patient groups.
So far, the patient law does only comprise the possibility seek out-patient care elsewhere. Is the next natural step to include the in-patient care as well?
– I hope so. At least those medical areas that have national guidelines should be, Jonas Andersson (Liberal party), member of the Regional Executive Board and chairman of the Health Care Committee in Region Västra Götaland concludes at a seminar about prioritization of patients standing in line for care organized by Dagens Medicin.
That was all for this year’s wrap-up. Thank you all colleagues at Region Västra Götaland and Västsvenska arenan for a great collaboration. And to all of you who Sahlgrenska I.C. got the opportunity to discuss health care export with last week – lets stay in touch.