Breaking down silos in healthcare

Jan Foster finds out more about breaking down silos with Bleddyn Rees from the European Connect Health Alliance.

Bleddyn Rees is an experienced commercial lawyer, but quite an unusual one! He spent three and a half years on secondment as the General Counsel of the Commercial Directorate of the UK Department of Health. Bleddyn then built an international healthcare legal practice for ten years at an international law firm gaining insight into a range of very different healthcare systems and cultures.

In the last five years he has focused on digital healthcare including disruptive technologies and innovation and the role they could play in creating sustainable health and social care systems. Bleddyn spoke at the Health Europe conference on the 25 May 2016 and I spoke to him to find out more about his organizations’ approach to building relationships across Europe and breaking down silos.

Could you give us an overview of the origins of European Connect Health Alliance and its purpose?

European Connect Health Alliance (ECHAlliance) started life as a think tank in previous existence, but was formed as a social enterprise four years ago as a result of Brian Connor (the Chair) getting frustrated that healthcare systems weren’t reforming.

Our purpose as an organization is to enable transformation in health and social care systems to make them sustainable, by ensuring services are efficient and outcomes improve.

Brian, at the time, was working in Chinese healthcare, when he realized that influencing policy was not enough. So we turned the think tank into an action tank. Our purpose as an organization is to enable transformation in health and social care systems to make them sustainable, by ensuring services are efficient and outcomes improve.

This means, in essence, the holy grail of both driving down prices and improving quality. We don’t measure impact of what they achieve, because it’s is not our role to evaluate, that’s down to the organizations which are partners and stakeholders in the ecosystems. Instead, we actively promote best practise solutions – which is based on evidence.

How we achieve this transformation is through ‘ecosystems’ – where groups of stakeholders from across healthcare sectors regularly meet and are challenged to find solutions to issues which impact upon them all.

It is about people regularly coming together, representative of their organizations, but in a neutral environment where they can have the space to look at collaborative working towards solutions.

What ecosystems are there and where?

Each country or region has its own challenges and is organized structurally very differently and are at varying stages of evolution

There are over 30 established ecosystems currently. Each country or region has its own challenges and is organized structurally very differently and are at varying stages of evolution – so it’s hard to compare them against each other.

For us, it is pleasing that as it is a difficult concept to communicate, the ecosystem approach has now got a pull happening across Europe of people wanting ecosystems for their areas, and people are approaching us now for help in establishing them.

They can see the value in breaking down silos – between teams within same organizations, government department to government department, central to local government, health sector to social care, private sector to public to voluntary sector. Ecosystems build personal relationships between all the stakeholders, and the speed at which they can move depends on many factors.

Europe, for us, is a geographical area not a political area; we also have an ecosystem in New York, and the reality is the concept is global, especially where digital health is strong. There is a Chinese Health Alliance also.

The organization is the facilitator; we have the process which we take people through in establishing the networks. We start by looking for a sufficient number of like-minded people who want to collaborate.

ECHAlliance is quite high profile in Europe, especially at European Commission events, and is involved in a number of EU projects.

ECHAlliance is quite high profile in Europe, especially at European Commission events, and is involved in a number of EU projects. Our own members increasingly make the introductions to us, as a ‘Connector’ who can facilitate collaboration, a trusted honest broker. As we are not the ‘system’, we can say the difficult things, be honest and say the tough stuff.

Can you cite an example you have seen where something innovative has happened which can be (or has been) replicated elsewhere in Europe, despite differing healthcare systems?

In Northern Ireland – 18 months ago – the Chief Pharmacist gave a presentation at ecosystem about drug adherence. They had calculated as a cost of it they were spending £112 million per annum on emergency cases, directly as a result of people not completing courses of drugs.

He asked for help and ideas to address this. At the event, we held round table discussions to solve the issue – bear in mind, these are all voluntary stakeholders pitching in ideas. What happened as a result was we created a specification for procurement by DOH, saved them 2.5 years in procurement process as it was a collaborative specification.

To take things further than just Northern Ireland, we used the presentation and explained what happened in 4/5 other ecosystems, which gave rise to one of three working groups now looking at medicine optimization – these are groups of experts in the field. So the result was a transfer of knowledge overnight between ecosystems, and ongoing collaboration around scope of work.

What do you perceive to be the main barriers to healthcare systems being more innovative in delivery?

There is lots of research done around barriers, some technical e.g. public procurement; but I would have to say; people, culture and change management. People are also the solution to all of the barriers…

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