Measuring patients outcomes will make our healthcare system more sustainable

What's your name and what position do you hold?

David McGarry, Value Based Healthcare Lead, Roche Products (Ireland) Limited

What are your day to day responsibilities?

As our Value Based Healthcare (VBHC) Lead in Roche Ireland I work with local, global, and across-country teams to design, shape and implement healthcare solutions that make Value Based Healthcare a reality for patients in Ireland.

Value Based Healthcare is a patient centered approach that rewards and focuses on improving outcomes that matter most to patients in relation to the cost of care. VBHC brings value for all healthcare system stakeholders and presents a unique opportunity for industry to strengthen collaborations with healthcare systems around a joint vision of improving patient outcomes and system efficiency.

What is your professional background?

I have a degree in Computer Science from Griffith College Dublin, a Lean Green Belt from the University of Limerick, a Masters in Management from UCD Smurfit School of Business and a Value in Health Measurement Certificate from Harvard Executive Education.

I’ve worked for Roche for over two years leading Value Based Healthcare initiatives across many disease areas.

What, in your view, has been the lasting impact of the pandemic on healthcare delivery?

What the COVID-19 pandemic has shown us is that access to fast and accurate diagnostics in all diseases is critical to patients and healthcare systems - and not just during a pandemic. It has shown us that as a global community, we can move mountains.

For Roche, it meant getting a high-volume molecular test to market in 38 days, compared to the typical timeframe of 18 months. It showed that we could accelerate development of multiple new and innovative tests and digital solutions to help us understand the SARS-CoV-2 virus and how to better contain and prevent the disease. It showed us we could ramp up our infrastructure through significant investment, allowing us to manufacture and deliver our diagnostic solutions around the world quickly.

For the wider population the pandemic brought about a greater adoption and awareness of point of care diagnosis with antigen testing and the importance of data and remote patient monitoring becoming evident, both very important shifts towards patient centric care and VBHC.

As an industry and as a population we all learnt a lot during the pandemic and we are embracing those lessons to help healthcare institutions transform the way diseases can be prevented, detected, managed and monitored, which can help people live longer, healthier lives.

What will be the leading trends in healthcare in the coming years and how will patients and providers need to adapt?

Healthcare is evolving at a rapid pace. With the increased usage of novel digital technologies, there has been a large increase in the amount of healthcare data being collected. Ultimately, the goal is for this data to become accessible across entire healthcare systems and to patients, which would lead to improved quality of care and cost-efficiency.

Healthcare data provides many opportunities for growth, leading the way is developing digital solutions for personalized clinical decision support and patient/population management.

To adapt these solutions we need to see the elimination of old and less efficient legacy platforms and the adoption and development of innovative technologies that can properly handle sensitive data including the collection, storage, usage and sharing of this data to ensure interoperability and collaboration across a plethora of different industries.

We also need to learn from the patient as they lead the way in developing healthcare trends. Patients are moving from being passive stakeholders waiting for a symptom to appear before asking for medical help to becoming proactive, engaged, and empowered. New tools are at our disposal: analytics, artificial intelligence, smartphone apps, portable diagnostic devices, and variable sensors. This creates new tensions and new challenges but also presents a new opportunity to improve the relationship between patients and providers and for industry to keep pace with patient needs.

What are the latest and the most interesting digital health solutions that can enable Value Based Healthcare to become a reality?

Academic and economic interest in Value Based Healthcare is growing. At the core of this methodology is the standardised measurement of outcomes and costs. Healthcare data is therefore key to generating value by unlocking meaningful insights that can help transform healthcare systems and patient care. In the near future we may see growth in the adoption of Outcome Based Platforms which facilitate value based contracts.

We’re also expecting to see greater adoption of patient outcome and symptom monitoring tools. There are a number of examples that demonstrate the benefits of patients routinely reporting symptoms and validated quality of life measures using digital tools. These digital tools have enabled patients to take an active role in their disease management and as a result have been shown to have direct benefits to patients, hospitals and society.

One great local example of this is the HeartCare@Home programme for heart failure patients. The programme, created in collaboration with Centric Health, HSE Digital Transformation and Roche Diagnostics is designed to monitor, support, appropriately intervene, and improve the quality of life of patients with heart failure throughout Ireland from the comfort of their own homes with the aid of digital monitoring tools.

What do you think are the key challenges are in the digital transformation of the health service

Currently, the Irish health system lacks the digital infrastructure to support the convergence of different data streams to successfully implement VBHC at a national level. The system requires formal coordination and management of data from multiple organisations and individuals to truly impact and improve the patient journey.

The power of data will continue to advance patient care for critical diseases, and powerful digital platforms and applications will be essential to further enhance this process.

If we could pool rich, multi-sourced, contextualized data, and then apply technologies such as AI to interpret it, it would improve efficiency and accelerate optimal use of healthcare resources to deliver rapid, broad and sustainable access to life-changing innovations.

Though transformation does not happen overnight, it will help the healthcare sector deliver on its short-term needs while accelerating its long-term goals to significantly improve patient care.

References

Basch et al. Overall survival results of a randomized trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment, Journal of Clinical Oncology, Volume 35, Issue 18_suppl, 2017 Abstract, https://ascopubs.org/doi/abs/10.1200/JCO.2017.35.18_suppl.LBA2

Demedts et al. Clinical implementation of value based healthcare: Impact on outcomes for lung cancer patients, Lung Cancer, Volume 162, 2021, Pages 90-95, ISSN 0169-5002, https://doi.org/10.1016/j.lungcan.2021.10.010.

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