Post under construction – watch this post for the final version
Haven’t we been treated with disruptions in healthcare for the past 10 years? Disruptions like those that would change our healthcare systems to deliver routines fundamentally?
When we estimated changes for the future, we thought several developments, and predominantly tech ones, would make healthcare loose its footings and would change for the better.
See some examples of such (future) disruptions by “The Medical Futurist” (TMF). (You might also like to have a view at the TMF Magazine for more.)
Still, we have seen some changes come through like how ehealth applications are making headway to implementation.
There are developments in views about healthcare systems which do address shortcomings. Ideas like “tech” development in care, surely. ’Digitalization’ and “distant care”. Principals of coordination and collaboration, like in concepts of “accountable care” or “integrated care”, or like recently in the Netherlands: “appropriate care” (“Passende zorg”). And from a medical view too: “personalized medicine” (“Gepersonaliseerde zorg“).
Zooming out: large differences in care systems can be noted between state wise healthcare systems and the commercial provision of care by private clinics.
Also, by differences in perspectives like organization, logistics, architecture, shortage of professionals, few willingness and slow actions of cooperation between different health institutes, and, not least, by financial problems with growing volumes of cure and care and rising costs for specific conditions like cancer and chronic conditions.
Every country its own problems.
Rise of threats too due to upcoming diseases or nature disasters, even pandemic(s), or from geopolitical outbreaks on our health conditions. Refer to the general WHO report and/or their specific warning: “Nearly 1.8 billion adults at risk of disease from not doing enough physical activity“.
Let’s not forget the impact of (personal) perspectives of professionals in case by cancer conditions. Recently we acknowledged how the idea “the more specialization by specialists, the more quality of care” (i.e., performing more operations on the same cancer condition will lead to a better quality of care) led to an uneasy contest between hospitals and surgeons over what hospital would be chosen for this ”super-specialization”. In a newspaper article it was said: ”We need to get rid of the idea that one can only be a good surgeon at the ‘upper echelons of the monkey rock’ by just performing ‘major’ cancer operations” only.(1)
Personal, organizational and individual interests are real factors influencing health systems’ outcomes.
A redesign of healthcare system is necessary – but how should it be done?
What are the fundamental developments in healthcare provision that impact the future of health systems, what will be their basic institutions, it structures of processes, and what performances will create (in)effectiveness of provision of care and health outcomes?
These questions and developments inspired me to an ongoing study about the origin and the development of medication and healthcare systems, starting from the 18th century.
How came the characteristics of medication and health systems about? What thoughts, visions and interests motivate(d) the current systems?
What actual changes in thinking will define the future architecture of healthcare systems? What do they look like and in what shape will we recognize the current institutions in the nearby future, like general practitioners, pharmacies, hospitals, emergency departments, rehabilitation, physiotherapy, nursing homes, etc.?
What strategic options will guide the actual stakeholders to define and design their needed developments?
By now I’m completing this study formulating the report. Doing so, I came to surprising insights, like how these characteristics still influence the architecture of current health systems.
I came to reflect on the term of “medication model“: so often used, but only slightly described. Even so, on the term of ” a complex health condition” and about the approach of “multidisciplinary care” in healthcare provision.
All three are starting points to envision new and redefined health systems, as wel as new conditions to the position of the pharmaceutical business and pharmacists.
What changes are relevant to the future effectiveness of the pharmaceutical and health industrial businesses?
The global market developments challenge the position of the pharmaceutical human businesses with different demands, like ways of pricing, patient orientation and ESG (environment, sustainability, and governance) to name a few. Some of these government issues are kind of developments to which the industry has the competence to adapt easily, as history has witnessed.
What is new is the fact that the industry finds itself in an accumulation of characteristics and ways of government which have been acquired during its development since its origin. It has brought the industry in the current beneficial shape, its volume and routines of doing business.
The clarity and diversity of the actual strategic developments and innovations in the healthcare system impact the strategic position of the different pharmaceutical and health industrial companies. What do these mean for the strategic developments, chances and threads to the different companies?
It’s time to reflect and review the business in the coming years to 2040.
To do so, one could lists all factors of influences and views on the actual shape of health care systems. But the principle questions for redesigning the system are the definition of the fundamental competences, technology, intelligence, data, know-how, and capacities(skills), their interrelationship, congruence and their design to create effective and efficient paths of patient-care that could set an effective, efficient and robust system. A system adaptable to expected impact by external interruptions. Of course, all in perspective of health outcomes and quality of care, and patient empowerment, accessibility for all, payable and preventable to predictable conditions of health.(2)
- “In tientallen ziekenhuizen straks geen kankerbehandeling meer” | “De Volkskrant” March 26, 2025, p.18/19; Quote van Peter Go, oud-chirurg en voorzitter van de Ronde Tafel Vaatchirurgie: ”Haal het werkplezier uit de zorg die je geeft. Verbeter die elke dag, ook uit liesoperaties kun je veel lol halen. We moeten af van de apenrots-gedachte dat je pas een goede chirurg bent als je alleen maar grote kankeroperaties uitvoert.”
- Ref.:
-“What has been missing is an overall strategic framework in which these and other ideas can actually be realized”. In: Porter, M.E. and Teisberg, E.O., Redefining Health Care, 2006 p13,14.;
-“In fact, many delivery organizations’ operating systems are not really systems, inasmuch as their components do not work well together in any organized way. they have not specifically to deliver any particular type of care.” In: Bohmer, R.M.J. Designing Care, Aligning the Nature and Management of Health Care. 2009, p.130.;
-“What is the right care? It is an integrated approach to patients’ health needs for the long term. It is care that involves the most knowledgeable physicians and care workers acting in unison to see that patients receive the care their need to be restored to full health.” In: Herzlinger, R.E. Consumer-driven Health Care, Implications for Providers, Payers and Policymakers.2004 p.204.
Post under construction – watch this post for the final version
