Demographic Change, Healthcare Innovations and Policy

Speakers:

Andreas Gotthardt, Director and CEO, Medicatoria Foundation, Barcelona

Ariel D. Stern, Professor for Digital Health, Economics and Policy at Hasso Plattner Institute, Berlin

Eric Sutherland, Senior Health Economist, OECD, Paris

The International Center for Insurance Regulation (ICIR) hosted a further Digital Insurance Forum on November 20, 2024, focusing on the topic of challenges for the healthcare system caused by demographic shifts with an emphasis on the role of technological progress. The forum featured Andreas Gotthardt (Director and CEO, Medicatoria Foundation, Barcelona), Ariel D. Stern (Professor for Digital Health, Economics and Policy at Hasso Plattner Institute, Berlin), and Eric Sutherland (Senior Health Economist, OECD, Paris), who discussed recent developments and issues regarding demographic shifts, particularly aging populations and workforce shortages. With a focus on leveraging digitalization, the discussions highlighted both systemic inefficiencies and innovative solution approaches to ensure equitable and sustainable healthcare provision.

Introductory Remarks
Eric Sutherland opened the discussion by addressing the economic challenges tied to healthcare investments. He pointed out the difficulty of translating these investments into measurable value and the heavy administrative burdens that overwhelm healthcare workers. Many doctors, he observed, are overburdened with tasks that could be streamlined with digital tools. Instead of fearing job replacement by artificial intelligence (AI), Sutherland identified the bigger issue as inefficient tool development that excludes healthcare professionals from the design process. He outlined three ways digitalization could transform healthcare: (1) increasing service efficiency, (2) enhancing diagnostic and treatment capabilities, and (3) advancing prevention, especially in managing chronic diseases. Although health data represents 30% of global data, much of it remains untapped. Sutherland urged a shift from analogue approaches to networked systems to harness this potential.

Andreas Gotthardt explored the critical issue of equitable healthcare access amid demographic changes, emphasizing the challenges of aging populations and workforce shortages. He highlighted widening gaps in care and underscored the need to strengthen systems by training more qualified professionals. Gotthardt also advocated for integrating digital workflows to optimize resource use and reduce inefficiencies, noting that effective digitalization can alleviate staff burdens while improving service delivery. He placed particular emphasis on prevention as a central pillar of healthcare reform, arguing that combating chronic diseases linked to unhealthy behaviour could ease system pressures. Prevention, he suggested, is not only a medical necessity but also an economic and societal opportunity to cut long-term costs and enhance overall health outcomes.

Ariel Stern turned attention to the gap between current healthcare policies and modern technological advancements. She noted that many frameworks fail to account for innovations like AI and precision medicine, leading to inefficiencies and missed opportunities for improvement. Additionally, outdated hospital structures hinder the adoption of new tools, perpetuating reliance on inadequate traditional practices. Stern called for comprehensive reforms to align healthcare policies and business models with technological capabilities. She emphasized the importance of frameworks that encourage the integration of AI, data analytics, and other tools to boost patient outcomes and operational efficiency. Stern further advocated for innovative insurance models to address the costs of advanced treatments, enabling healthcare systems to adopt cutting-edge technologies effectively for better and more accessible care.

Panel Discussion and Q&A
The panel discussion explored several critical issues raised during the forum, beginning with the implications of AI and digitalization on healthcare inequalities. Eric Sutherland cautioned that without a focus on scalability and inclusivity, AI risks exacerbating digital divides. He emphasized the importance of ethical innovation that benefits all populations and avoids reinforcing existing disparities, particularly across borders.

Education emerged as another key theme in adapting to healthcare digitalization. Sutherland stressed the need for continuous training for healthcare professionals to use digital tools effectively, alongside public education campaigns to reduce fears surrounding technology in healthcare. Andreas Gotthardt highlighted that precision medicine depends not only on technological advancements but also on robust infrastructure investments. He noted that many medical curricula fail to address digital tools adequately, leaving healthcare professionals ill prepared and fostering apprehension about new technologies among both practitioners and patients.

Outcome-based payment models were identified as a cost-effective innovation in healthcare financing. Ariel Stern discussed how digital tools could facilitate personalized patient monitoring and provide valuable insights into patient behaviour, reducing unnecessary visits to doctors. These tools, she explained, could also help insurance companies optimize their outreach through personalized messages that encourage healthier behaviours. Stern argued that such approaches could enhance patient outcomes while promoting more sustainable healthcare systems.

Administrative reforms and their potential to improve healthcare delivery were also discussed. Gerrit J. v.d. Brink posed the question of how reducing bureaucratic burdens—such as the Dutch government's initiative to cut administrative tasks by 50%—might influence healthcare systems. Eric Sutherland responded that these reforms could significantly improve efficiency and care quality by allowing healthcare workers to dedicate more time to patient care. Such changes, he argued, would enhance patient experiences while contributing to more adaptable and resilient healthcare systems.

Summary
In summary, the forum highlighted the transformative role of digitalisation in addressing the challenges of demographic change. Eric Sutherland emphasised the need for better data collection and utilization to drive innovation while ensuring scalable and inclusive solutions to avoid widening digital divides. Andreas Gotthardt stressed the importance of investing in infrastructure and integrating digital workflows to tackle workforce shortages and improve efficiency. He also highlighted the value of preventive care in reducing chronic diseases and ensuring long-term healthcare sustainability. Ariel Stern called for aligning healthcare policies with modern technologies such as AI and precision medicine. She advocated for forward-thinking reforms and innovative business models to enable healthcare systems to leverage these advancements. The discussions underscored the need for collaborative strategies that combine digital transformation, policy adaptation, and infrastructure investment to create resilient and equitable healthcare systems.