European Parliament, Brussels 8 June 2017 HEALTH SYSTEMS FOR THE FUTURE: Making EU health systems resilient and innovative Improving the Performance for Primary and Integrated Care Niek Klazinga MD PhD European Parliament, Brussels 8 June 2017

The building blocks of Health Systems . Health Care Services are only one of the determinants of health Health Systems support citizens in realizing their potential health Channeling professionalization to get the workforce for the future De-institutionalizing health care delivery Optimizing use of knowledge and technologies Governing towards value-based performance 11/10/15 WWW.SPARKSPROJECT.EU

Health System Performance Framework OECD . 11/10/15 WWW.SPARKSPROJECT.EU

health measurement has evolved ….. Deaths Mortality and life-expectancy data source: death registries Diseases Prevalence and incidence of diseases medical/clinical perspective data source: administrative & clinical data Disability How health system deals with disabilities DALY, QALYs, SF36 data sources: registries and surveys Wellbeing Things that matter to patients, carers, families & populations Wellbeing, function, pain, Quality of Life Generic (e.g. EQ-5d; SF-12; Picker) and disease specific (HOOS, Oxford….) Validated, sensitive & objective tools Not sure if you want this slide but it does neatly describe the ‘journey’ outcomes measurement…perhaps it could be deployed later? If used, emphasise that there is real science and empirical rigour behind the development and validation of these instruments. They reliably measure what they proclaim to measure [clinicians often criticise them as subjective and soft and unreliable]

Two Major Re-design Challenges Strengthening Primary Care Strengthening Integrated Care: -link PHC-Hospital Care - link PHC-LTC -link PHC-Mental Health -link PHC-Public Health - link Medical Care – Social Care . 11/10/15 WWW.SPARKSPROJECT.EU

Making PHC future proof . New professionals/ task substitution Organizational formats Performance Management based of adequate information systems Using (non)monetary incentives Patients not as clients of services but co-workers 11/10/15 WWW.SPARKSPROJECT.EU

Making Integrated Care Future proof . From disease pathways towards complex adaptive systems responsive to a multimorbid population Adequate IT systems for governance Supportive incentives and governance systems Towards Learning Health Systems focused on outcomes. 11/10/15 WWW.SPARKSPROJECT.EU

n.s.klazinga@amc.uva.nl . 11/10/15 WWW.SPARKSPROJECT.EU