EVENT SUMMARY: HFE & My City-Lab “Profiling the health worker of the future”

Profiling the health worker of the future: digital skills, innovation and collaboration to meet the new demands of care

On 18 June 2019, Health First Europe as partner of My City-Lab project organised a workshop, entitled “Profiling the health worker of the future: digital skills, innovation and collaboration to meet the new demands of care” within the EHMA 2019 Annual Conference in Espoo (Finland). The lively exchange of views among policymakers, academia, worker organisations, student associations and industry aimed to define the perfect profile of health worker of innovative models of care, such as the one promoted by My City-Lab project, as well as to identify systematic changes in the education and organisation of the health workers needed to implement new models of care. My City-Lab is an initiative financed by the European Regional Development Fund (ERDF) which aims to better integrate the innovation of laboratory medicine and mobile digital solutions into health care systems.

The final goal is to facilitate access to laboratory tests as part of a collaborative approach to ambulatory care of chronically ill individuals, as well as to contribute to the dynamic monitoring of patients with chronic diseases. A city-lab site will soon open in Brussels, its workforce should reflect the changing health care eco-system: patient-centred, connected and collaborative.

The brainstorming session, moderated by EHMA President, Federico Lega, saw the contribution of worker organisations, student associations, patients’ representatives, industry, policy makers and health care management experts from all over Europe. They brought into the debate their unique perspective over the challenges of health management and education and the core competences of the workforce of innovative and patient-centred health care models, such as the one promoted by the City-Lab project.

Health care is highly labour intensive and one of the largest economic sectors in the EU – accounting for approximately 17 million jobs (8% of all jobs). Population growth, ageing societies, and changing disease patterns are expected to drive greater demand for well-trained health workers in the next 15 years. As stressed by Melina Raso, Health First Europe Executive Director, implementing new model of integrated care (as the one promoted by My City-Lab Project) requires a radical transformation of skills and core competences of the health workers.

On this note, Loukianos Gatzoulis from Directorate-General for Health and Food Safety from the European Commission gave a thoughtful overview of the changing demand of care and the role of new technologies and models of care to effectively address this change. Ageing, multimorbidities, complex needs require new approaches, aiming at integrating of health and social care as well as at providing an adequate number of well-trained professionals. These challenges require new model of care, shifting from “silo-specialisation” towards a multi-disciplinary approach, where health care workers can safely share patients’ data across settings, effectively collaborate in care plan and work in partnership with social workers.

Laboratories can play a vital function in building health care integrated systems and in the care continuum, by bridging the gap between different settings and the patients, ultimately breaking those silos. Most of the medical decisions are based on test results, by investing in data processing, analytics and talented health care workforce, medical labs and primary care settings can bring stakeholders together and ensure timely, evidence-based decisions. Health care professionals can be the drivers of this shift towards this new and 2 integrated model of care.

Therefore, European health care systems should create the right conditions to promote this new model of care, more integrated, preventive and closer to the patients.

(1) A first condition to shape this new model of care is to rethink the relationship between patients and health care professionals: primary care and lab professionals have a great role to play in re-centring care around the patient, fostering partnership with the patients and the care givers, who see and share the same information. Looking at the bigger pictures of the triangle of health care professionals, patients and technology providers, their relations need to be assessed and re-organised in a way that fit the future of care. In this frame, the role of education is essential to connect the dots of the triangle and meet the new technological challenges.

(2) Secondly, appropriate resources should be in place to tackle workforce shortage and promote primary care and laboratory settings. As highlighted by Bert Van Caelenberg from EUROFEDOP, heath care remains an issue of financial resources: some European countries do not have the resources to retain their health care workers who leave for better economic prospects. Not every country can reward graduates equally, so medical professionals leave. EU member states should look deeper into the challenges of workforce shortage and brain-drain and assess how those impact on personal lives, on patient safety and quality of care in each country. Better social security systems, increased wages and equal working condition across borders shall ensure health care providers are where they need to be.

(3) Lastly, but most importantly: health care decision-makers should identify and foster the core competences of the worker of the future. During the debate, participants identified a wide-ranging list of competences needed for the workforce of innovative primary settings and medical labs, such as:

• Soft skills (from partnering to communication) and ethical competences
• Digital skills e.g. basic ICT knowledge, online interaction competences, data collection and monitoring skills, service competences and guiding skills in digital environment
• Management skills, leadership as well as multi-actor service co-development competences
• Flexibility

Above all, the majority of the participants recognised partnering skills as the key competence for the whole health care workforce.

Partnering skills can be defined as the ability to apply a collaborative relationship between settings, professionals as well as patients. The end purpose is to work towards shared goals and deliver practical solutions to system challenges or complex and chronic health conditions. The health care worker of the future shall use partnership as a learningmechanism that teaches how to better deliver and coordinate care across settings and over time. With respect to digital skill profiling, it is crucial that health care workers of integrated and city lab models possess sufficient skills and knowledge to make the best out existing digital solutions and bridge the gap between settings. As presented by Tanja Valentin (MedTech Europe), digitalisation allows two main things: it shrinks time (for example on text results) and connects the dots, the players and the key information in a new way, both essential elements to build an integrated health care system.

Nevertheless, participants agreed that the training of the health care professionals might not keep pace with technological developments. The latest survey presented by Marta Simoes from European pharmaceutical students’ associations (EPSA) shows that 75% of pharmacists claim to have no or almost no education on digital health, while 90% of them believe that digitalisation of health care shall change the pharmaceutical curricula and profession for the better, those training combining theory and practices as well as promote inter-professional collaboration. As stressed by Outi Ahonen, Senior Lecturer of Laurea University of Applied Science, health care professionals can be bold and innovative in reforming practices if only they have the right education to make it happen, from informatics to media literacy.

The debate saw also the contribution of Walter Sermeus from Leuven Institute for Health care Policy and Anu Söderström from the Council of Occupational Therapists for the European Countries (COTEC) who stressed digital solutions’ value in order to shift to sustainable and better connected model of care, nevertheless technologies in itself cannot tackle the challenges of the workforce, it is only a tool that health care settings shall use in the most effective way.

With respect to flexibility as a one of the core skills, Lasse Lethonen, representing the Expert Panel on effective ways of investing in health, introduced the concept of task shifting within and between health care settings, concept which is illustrated in the Expert Panel’s opinion on task shifting in health care systems. The Expert Panel’s opinion argues that tasks can and shall be shifted within health care settings, from health workers to patients and their carers, to machines, and to other health workers. Those shifts imply that those involved must be convinced of the rationale for change, flexible in changing tasks and settings and strongly supported in implementing it. Professionals other than physicians, e.g. nurses, medical laboratory professionals, pharmacists, can undertake substantially expanded roles compared to what has traditionally been the case, with the adequate trainings to carry out their function in integrated teams with informationsharing.

The ultimately message of the debate was that Europe shall invest in integrated models and city-lab settings to transform care to better tackle ageing society, changing patterns of diseases, new technologies and decentralisation of organisational structures. Health care workers and management have the chance to lead this transformation, only their vision and expertise can shape the health care systems of the future. In order to make this happen, they need to be placed in a leading role, involving them in decision making and giving them the right tools and trainings to meet the new challenges of health care delivery.

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City-Labs is a project financed by the European Regional Development Fund (ERDF) which aims to integrating the innovation of laboratory medicine and mobile health. The scope of the project is to facilitate access to laboratory tests as part of a collaborative approach to ambulatory care of a chronically ill individual, as well as to contribute to the dynamic monitoring of patients with chronic diseases, always fostering sustainability.