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Q&A With Michael Ackland: The Ageing Population

Michael

Michael Ackland, CEO, Australia & New Zealand at GE Healthcare

Michael Ackland, CEO for GE Healthcare, Australia & New Zealand, talks about how GE Healthcare plan to address the medical needs of an ageing population.

 

With an ageing population, and a predicted three-fold increase in the incidence of neurological diseases such as Alzheimer’s worldwide by 2050, could you give me a brief outline as to the activities GE has been involved in (particularly in the Asia Pacific region) to address these issues?

GE Australia recently signed a five-year, $20 million strategic alliance with the Commonwealth Scientific and Industrial Research Organisation (CSIRO). Part of the funding will extend a research program to help early detection of Alzheimer’s disease – volunteers are taking part in the Australian Imaging and Biomarkers Lifestyle Study of Aging (AIBL). The study commenced in 2006 and since then, over 1000 people aged 65 years and above have participated. The study aims to discover which biomarkers, cognitive characteristics, health and lifestyle factors determine subsequent development of symptomatic Alzheimer’s disease.

Recent Australian research using Positron Emission Tomography (PET) scans indicates that by the time a person is diagnosed with Alzheimer’s, they have been on a pathway towards development of the disease for up to 20 years.

By partnering with institutions like CSIRO who are collaborating with The National Ageing Research Centre, Austin Health, Florey Institute of Neurosciences and Mental health all located in Melbourne and Edith Cowan University (ECU) and McCusker Alzheimer‘s Research Foundation in Perth, we hope to get closer to finding a clinical treatment for Alzheimer’s disease.

 

Since the introduction of Medicare in 1975, Australians have been used to a Commonwealth-funded universal insurance scheme that provides free services in public hospitals, subsidises private patients for hospital services and pays for many medical services outside hospitals. Do you think this healthcare model is relevant and up to the job considering the changing demographics of the Australian population?

Medicare has supported a very successful universal healthcare system, however private insurance covers around 30% of costs, and out of pocket is already the fast growing funding sources for healthcare costs, so yes it is under stress.

Public hospital funding is currently “block” funded, that means funding is not directly linked to either activity or outcomes, but is effectively negotiated. This is about to change dramatically to activity based funding in all states. While not outcome based, there are performance considerations to this funding allocation and this will dramatically increase performance transparency in public hospitals.

Many critics have argued for a single-funded model of healthcare to drive co-ordinated care as well as a sustainable change in the healthcare system promoted by a clinician-driven change. What is your view on these ideas put forward?

There is considerable push and need for coordinated care. Chronic disease cost and prevalence makes co-ordinated care probably our biggest need. A single funder model would support this, I agree.
As well as a funding model, there are other pieces that need to be put in place to support co-ordinated care… data connectivity, integrated health records etc.

But most importantly, we need to support innovative healthcare professionals and providers on the ground. Those who want to drive new co-ordinated models of clinical practices. We need to support “grass-roots” development of new pathways at the same time as coordinating funding models and data connectivity.

All three are important and won’t succeed alone. I am not sure that the single funder model needs to come first.

 

One possible direction is the idea that the older generation will need to take more responsibility for their own care. This can be done with ‘home health’ technology such as e-doctors, medical consultations via high speed internet connectivity, portable scanners etc. How viable do you think this direction is considering the reluctance of many older patients to embrace this kind of care?

Through the Care Innovations program we have conducted many very successful pilots of home care. Our experience is the older generation embraces new technology… and the inclusion and support they get from it with open arms. Patients want this… patient uptake will not be and isn’t the issue.

The challenge is making this work for Healthcare providers, and to integrate it into existing models of care. Funding mechanisms need to support it. I believe that is coming, but has been a constraint in the past. 

The other challenge is creating clinical champions who want to drive it… this requires clinical support. Patients are keen however we need the right funding and the right healthcare professional support.

 

There is a fear that technology in healthcare, although might increase efficiency and reduce costs, will prove detrimental in the quality of healthcare and eliminate the intuition/bedside manner of doctors that older patients respond to. Do you think technology can really replace this human aspect of healthcare?

Technology will put more information and power in the hands of customers (patients) and the decisions healthcare professionals make will be more transparent than ever before. Technology will dramatically change the role and the requirements of our healthcare professionals.

Done well, technology should add to the quality of the decisions made and the service provided… it will never replace the human aspects of healthcare delivery.

 

With an ageing population comes an opportunity to take advantage of this burgeoning market. However this will require innovation across many sectors. As someone who has spoken previously about the lack of recognition of Australian innovation what broad changes would be needed in the way innovation is approached?

The Healthcare sector is filled and divided by many silos including hospital departments and professional specialisations. The key to innovation is breaking down these silos. We see some great examples of this in research and in clinical practice such as oncology. More broadly I believe it is still a constraint to truly thinking differently about healthcare delivery.

We regularly talk to Healthcare providers about how they can innovate internally better and two messages are consistent. The first, don’t try to solve for everything; innovation is any change which has a positive impact, so small changes are good. Start small and build momentum. Secondly, empower and involve your healthcare professionals. We all respond to suggestions for change from people we believe understand us, passionate innovative healthcare professionals are the best drivers of change, our job, and the job of the healthcare industry, is to support and empower them.