EU healthcare systems must adopt new strategies to build resilience for the future

COVID-19 is a reality that all sectors of society must adapt to. In the health field, as the pandemic persists and the ‘new normal’ evolves, there are important measures that can be taken to ensure that European healthcare systems increase their efficiency and build greater resiliency for the future.

Current healthcare systems are based on assumptions about care delivery that do not match present realities. It is time to reinvent care delivery models to take chronic disease management out of the hospital and into the patient’s home. This includes the adoption of digital solutions to ensure continuity of care for high-risk patient groups, with the added benefit of freeing up much-needed hospital resources.

The pressures of the pandemic have strained existing inefficiencies in the healthcare system, particularly in chronic care management, which is more challenging to tackle. Unfortunately, the number of chronic disease sufferers is expected to grow. How can we ensure more resilience from our healthcare systems to better manage chronic care patients? How can we also manage the consequences of the pandemic: high infection risk, morbidity, and mortality as well as recession, budget restraints, and limited resources?

The number of patients with chronic kidney disease is projected to reach 14.5 million and the mortality associated with it is expected to rise by a factor of two, advancing this illness from number 16 in the global burden of disease in 2016 to number 5 by 2040 if no action is taken. At current levels, treatment for chronic kidney disease represents 2% of many countries’ healthcare budgets, with dialysis costing EU budgets €14 billion per year.

This population is particularly vulnerable during the ongoing pandemic. The European Renal Association-European Dialysis and Transplant Association recently published alarming data on the high mortality in dialysis and transplant patients across Europe caused by COVID-19. Furthermore, several regional studies have highlighted the higher number of COVID-19 infections in dialysis patients treated in hospitals whilst the number of infections in patients treated at home was significantly lower.

Care for chronic kidney disease traditionally favours in-hospital therapy even though highly efficient solutions for delivering treatments at home already exist. That is why, as COVID-19 cases increased and the healthcare system began to come under strain, some authorities chose to accelerate the deployment of in-home dialysis with remote patient care.

In some regions of Italy, nephrology societies and regional authorities were able to assist patients in switching to home dialysis, enabled by digital health tools, including remote patient management. This way, patients and their care teams were able to maintain a safe continuity of care. The UK National Institute for Health & Care Excellence was also quick to respond, issuing rapid guidelines for the delivery of dialysis services during COVID-19 encouraging the use of home therapies and digital consultations.

This transition from the hospital to the home during the pandemic yielded two clear benefits. It freed up capacity in hospitals and protected vulnerable patient populations by reducing potential exposure whilst leveraging available digital solutions to offer optimal care management. Significantly, on the longer term, another benefit for healthcare systems will be an increase in both resilience and cost-saving. With this in mind, how do we accelerate this paradigm shift of incentivising funding of patient-centric and resilient care delivery models enabled by digital solutions?

It is time for the hospital-centric perspective to evolve towards a patient-centric approach. We must leverage the lessons learned throughout the pandemic to accelerate some of the changes in treatment flows and reform our healthcare systems for the future. Set to start in January 2021, the Advancing American Kidney Health Initiative will seek to fundamentally change the clinical care models of chronic kidney disease, focusing on promoting its awareness and incentivising home therapies over in-centre dialysis, with the goal of significantly increasing the number of new patients receiving in-home dialysis or transplant, reducing costs and improving outcomes.

Now, more than ever, all stakeholders in the healthcare sector must unite to deploy the solutions that will improve care pathways for chronic diseases through innovative policies that focus on patients’ needs, optimise the use of healthcare resources and, ultimately, foster the resilience of our healthcare systems. We remain committed to working with partners in the health community to implement such solutions.