Disruptive Reform: Establishing a National Health Innovation Hub

One important innovation in APJ 2013 was the inclusion of seven ‘Disruptive Reforms’, identified as potentially high-impact priority areas for action with ambitious targets and timelines for implementation. One of these reforms is to “establish a world renowned National Health Innovation Hub (NHIH) to drive collaboration between the health system and the enterprise sector leading to the development and commercialisation of new healthcare technologies, products and services, emerging from within the health system and/or the enterprise sector”.

It is envisaged that the NHIH will encourage foreign direct investment, including research and development, in the areas of medical technologies, healthcare systems and services, ICT systems, supply chain and financial services. It should also attract substantial venture capital funding internationally. Specifically, the NHIH aims to promote opportunities in the areas of connected health/silvertech and telemedicine whereby medical and community care can be provided remotely through the integrated use of ICTs, sensors and diagnostic devices linked to healthcare professionals.

Ireland has many of the essential building blocks needed to develop as a global centre in these areas. This includes the necessary key strengths in ICT, life sciences and healthcare sectors to capture a growing share of this market. In 2013, the NIHIH project was still at an early ‘demonstration’ phase – aiming specifically to identify and validate appropriate operational model(s), including location, resourcing and governance arrangements. APJ 2013 foresees its operationalisation in 2014, pending adoption by government of a detailed proposal for its establishment. In addition to the NHIH, a number of other elements of APJ 2013 are closely aligned with efforts to establish Ireland as a global leader in health innovation, such as the establishment of Technology Centres linked to the Government’s priority research areas of connected health, data analytics and pharmaceutical manufacturing.

The OECD could make several contributions to the further development of the NIHIH project in the context of APJ. It completed seven case studies in 2013 on smart ageing and the promotion of welfare technologies (including integrated use of ICTs, sensors and diagnostic devices). These will be published in 2014. This work explores a number of novel initiatives that share the common goal of more rapidly and effectively bringing new products (e.g. robotics, telemedicine) and services (e.g. home care services for older persons) to market. The objectives of this project were to identify what these strategies are, the framework conditions, and what the major perceived opportunities are for efficiency gains in delivering these innovations. The use of technologies in elderly care services, and their potential for improving productivity and improving quality, has also been analysed in the OECD Reports “Help Wanted? Providing and Paying for Long-Term Care” and “A Good Life in Old Age - Monitoring and Improving Quality in Long-Term Care”.

The OECD has also recently reviewed emerging smart models of care and will continue working on this topic, specifically in relation to data governance issues. In May 2013, the OECD published a report on “Strengthening Health Information Infrastructure for Health Care Quality Governance: Good Practices, New Opportunities and Data Privacy Protection Challenges”. The report highlights different approaches taken by countries to balance individual rights to privacy (and therefore, how they regulate informed patient consent) with collective rights to safe and effective health care (and therefore, the sharing and comparison of clinical and other types of data).

The OECD is examining how to make better use of big data and big data analytics to improve health system performance. For example, OECD reviews of health care quality in some 12 countries are exploring the potential of linking medical records with other health system-level transactional data and disease registry information to improve quality of care. The OECD is also examining this issue in the context of work on data systems for dementia care.

More broadly, there is acknowledgement that the current innovation model in health care is inadequate and might not provide the right set of incentives for the right types of innovations with appropriate sharing of risk and rewards. A few countries such as the United Kingdom are looking into new models of paying for genome sequencing and mapping of the human genome – both of which present tremendous opportunities for genetic tests that could help prevent and treat diseases.

In the context of the connected health/silver technology and telemedicine – whereby medical and community care can be provided remotely – the OECD has developed a Guide to Measuring Information and Communication Technologies in the Health Sector. This includes a model survey and indicators to monitor progress in the availability and use of telemedicine. The survey is currently being pilot-implemented in ten countries and would help in monitoring and evaluating performance going forward.

Ireland may also find it useful to compare the NIHIH operational model against similar models established in other OECD countries (for example, health innovation hubs exists in the United Kingdom, New Zealand, Japan, and Italy, among others); and to participate in the pilot implementation of the OECD Guide to Measuring ICT in the Health Sector and establish baseline data against which to benchmark progress.

Finally, Ireland would benefit from reviewing its national health information system for its ability to support innovation in health care and treatments and to compare its progress to that of other countries, such as England, Finland and Canada. In particular, an examination of the legal and policy environment, investments in data, and the accessibility of data for research uses are needed for Ireland to participate with other countries in advancing the use of big data for innovation.

Together, these OECD activities could help support the further development of the NIHIH project and its contribution to the Action Plan for Jobs.