“Health Innovation is easier in Europe than in the USA, but lower for the fear to fail”

-What is the state of health of the health system in Europe?

Probably we are in a changing paradigm time, a thinking time about the sustainability of the current model: the aging population, chronic diseases, pharmaceutical expenditure, cost of new treatments, evaluation of the technologies, coordination of policies, portfolio of services... they are some of the elements to be analyzed.

-What does Health Innovation mean?

According to international standards, innovation is the introduction (and promotion) of a product, service, or a new or significantly improved process which, in the case of healthcare organizations, seeks to obtain a better result, a value added, in terms of health or economic, in the prevention of illness or the maintenance and restoration of health. The healthcare innovation, therefore, aimed at improving the function of a product or organization, must respond to the needs and health problems of the population, but also of the health system.

-According to your presentation at the meeting in Leeds, cities need to make a change in the concept of “health sector” in the city as a previous step towards innovation. What is this change and which elements should be taken into account?

What we proposed was the need to understand the health sector and its agents not only as a sector that aims at improving population health, research and training, but also as a strategic sector from the point of view of economic development and, therefore, it requires that the agents have their own strategies as agents of local economic development. Due to its characteristics, the economic impact of a hospital in a city, for example, can be achieved by very few organizations. Thus, strategies of both, hospitals and cities, need to be incorporated. We must begin to see the health sector as a structuring sector of the economic activity and, at the same time, as a transformer sector capable of generating multipliers of activity and returns that very few sectors can produce.

-Is it already being transformed the health care system of cities? How long is it experiencing this transformation? This change is sought or found?

We could say that change is underway. Healthcare institutions are increasingly starting to be more present in the cities strategies. There is no single or best approach, there are different local situations and, consequently, several models.

-Which role belongs to the local government, companies, citizens... to make the health system run and move towards innovation?

It is evident that, if we want all this working, there must be a local ecosystem that fosters the development of relationships between the different economic agents, training, equipment... It must have an appropriate regulatory environment, sensitivity in front of the innovative projects and everyone has their roles and responsibilities.

-How to convert the health system in a dynamic sector, engine of growth for the city?

Innovation in health in Europe is easier than in the United States because legislation and requirements for new products are clearer. However, the degree of innovation is lower mainly due to the fear of failure. The existence of this enabling environment is key, thus we need to create it or encourage its emergence.

-Speaking of "business" with the health sector does not sound very good, however inevitably innovation links with business development. Is it still needed a lot of awareness in this regard?

Surely more adjusted terms as the sector is evolving would be "value propositions", "orientation to results"... We often speak of innovations, product, process or management in the health sector. There is not always a chance to developing business in the Health sector, however, in some cases we often hear about "business models" to introduce innovations. For example, who would benefit from a change in a surgical procedure that allows for a reduced recovery period? Who would get the most benefit?

-What does an optimal health system look like? What and how should it be achieved?

It must have six key elements: universality, equity, efficiency, integrated care, flexibility and citizen participation in its planning and management.

-One of the solutions to gain agility, comfort and efficiency is the integration of health and social services; or the use of ICT services that ensure the availability and security of the information related to the health system. What do you think?

What other improvements should be incorporated in the current health system? Mobility, personalization, the big data, 3D, new models of care, etc., they are some concepts that will shape the future of the sector. What is quite clear is that innovation has increasingly informational features and value will be increasingly placed on this point. Safety and accessibility must be compatible.

*Ramon Maspons is coordinator of Innovation in the Health Information, Assessment and Quality Agency (AQuAS) of the Health Department of the Government of Catalonia.