Ces informations sont publiées uniquement en anglais – une interprétation en français des communications de plénières, lors des matinées, sera accessible.
Session on Covid-19 Monitoring Covid consequences
1. Dr Ayden Tajahmady MD, FR CNAM deputy director of the survey service
https://www.linkedin.com/in/ayden-tajahmady-ba244695/
Consequences of Covid 19 impact on daily practice; how long does it take to catch-up?
If a lot of data exist about the consequences of the Covid-19 pandemic, few is available about the secondary and side effects on the other health issues. This is mapping of cases spread and hospital response, shifts in pathologies as a result of covid as a new risk factor, shortcomings in care and screening of cancer, consequences on deleted surgery, impact of long term survival of some long-term pathologies. The aim of the presentation is not only to have a clean bill of the pandemic, but to be at stake for any new pandemic.
2- Prof. Philippe Coucke, University of Liege, BE,
https://eumass.eu/wp-content/uploads/2020/03/coucke-EUMASS-Brussels.pdf
Covid-19 from crisis to opportunities
Since several years, our health-care ecosystems all over the world are struggling with shortage of economical and human resources, while facing a never-ending increase in demand (essentially linked to the aging population, harboring multiple and complex diseases, but also to the definitely earlier advent of chronic diseases in the “millennials”), and a never-ending raising cost of technology. Both result in a foreseeable lack of sustainability in a very near future.
Recently, the Covid-19 crisis has put a supplementary enormous pressure on our capacity to care. We should not waste the lessons we learned during this global health crisis!
If one wants to make health care data-driven, sustainable and efficient, there is no way out. We have to embrace rapidly and collectively a new ecosystem where “data are king” and shared (data philanthropy) in a secure environment. Artificial Intelligence will be used to optimize and individualize the care process, and abolish once and for all the secular and inefficient “one size fits all approach”. Make no mistake, robotization and automatization will become cornerstones in an ecosystem with limited human resources.
Monitoring health care
3. Pr Etienne Minvielle ; MD, PhD , FR Institut de Cancérologie IGR-Paris,
Monitoring patient in health care settings; targeted therapies, empowerment.
From standardisation to personalisation: a new deal in patients’ demands
With medical and technological advances, medicine is becoming more and more personalised. In addition, patients with chronic diseases express non-clinical needs and demands (e.g. the care of an isolated person is different from that supported by an entourage). This presentation will provide an overview of personalisation applications and their current challenges.
4. Petra Dosenovic Bonca, SLO
"Using population-level administrative health care data to incentivize positive change in patient care across the provider network
Studies based on administrative data are valuable for identifying patient characteristics and healthcare utilization patterns at the population level as well as across the provider network. As such they are both a valuable tool for evidence-informed reallocation decisions of public payers and a basis for meaningful feedback to health care providers based on comprehensive comparative appraisals of patient care. By analysing the quality of care and health outcomes in patients with atherosclerotic vascular disease in Slovenia we aim to demonstrate how routinely collected population-level administrative health care data can incentivise improvements in patient care across the provider network."
Quality, efficiency and ethics in health care
5. Prof.Dr. med. Jürgen Windeler, DE Director of the Institute for Quality and Efficiency in Health Care in Cologne, DE
Efficiency of new drugs introduced in health care
Abstract: In Europe, newly approved drugs undergo further evaluation in the context of their introduction into the health care systems. In almost all countries this evaluation is a prerequisite for reimbursement, often referred to as a "fourth hurdle". In contrast, in Germany beginning in 2010 a system of early benefit assessent of new drugs was established. It comprises the assessment of every new drug except certain orphan drugs with the question of an added benefit compared to the standard of care in Germany. The result of this assessment triggers price negotiations between statutory insurance fund an pharmaceutical company. There is no fourth hurdle.
Results of the assessments will be presented and related to international experience. Some outlook on the ongoing European harmonization process will be given.
6. Prof. Reinhard Busse
Health System Performance Assessment: how well do European countries perform?
Health System Performance Assessment (HSPA) is a cross-country or country-specific process of monitoring, evaluating, communicating and reviewing the achievement of high-level health system goals. It was first promoted through the World Health Report 2000. While several frameworks have been developed since then, they are similar in regard to their performance dimensions, namely “accessibility” and “quality” as intermediate goals as well as “contribution to population health”, “responsiveness/ person-centredness” and “efficiency” as final goals, with equity concerns running cross-sectional. The ability to measure the performance in these dimensions depends on the availability of indicators, which are valid and for which reliable data exist (preferably across countries). For example, the EU-SILC surveys provide data on “unmet need” for accessibility, OECD for certain quality indicators, Eurostat on “avoidable mortality” or Commonwealth Fund surveys on responsiveness. The presentation will briefly explain the background and concept and HSPA, and then provide longitudinal data on a range of European countries to explore how well their health systems perform.
7. Prof. Frederieke Schaafsma, NL Occupational medicine, Amsterdam UMC
Better work focused care for workers with chronic conditions.
The number of workers with chronic conditions are growing fast in the Western world. Most of these workers prefer to keep their job as long as possible and are hesitant to ask for assistance at an early stage. Besides the disease specific health problems, many also deal with fatigue and cognitive functioning problems. As the majority of modern working environments require high level information processing, even mild cognitive functioning problems increase the risk for sick leave and job loss. This limits effective occupational health advice and guidance in how to adjust the current work situation so that a healthy work life balance can be maintained.
Preventive care to reduce job loss in workers with chronic conditions needs better multidisciplinary collaboration between clinical and occupational health care with more personalized focus on job retention. There is also a need for better instruments to assess the cognitive load of job demands, with more sensitive and objective measurements for the assessment of cognitive fatigue. We should also evaluate what interventions and support systems can then be put in place to prevent workers with chronic conditions and with these type of complaints to go on sick leave.
8. Lene Aasdahl MD. PhD. Researcher NO Department of Public Health and Nursing, University of Technology and Science (NTNU)
Effects of occupational rehabilitation on return to work
In Norway there is long tradition for inpatient occupational rehabilitation for sick listed individuals. However, there has been little research done on evaluating the effect of this treatment on return to work. The Hysnes project, which started in 2010, was a large project with several randomized trials evaluating inpatient occupational rehabilitation. The project included an evaluation of different lengths of treatment, adding a workplace component, and adding follow-up after the program. Long term results (up to 7 years) from the different randomized trials on return to work will be presented, as well as the results of the economical evaluation.
Sick leave
9. Kaat Goorts PhD KU Leuven, BE
Sick leave, attrition and injury reduction; civilian and military paragdigms
In many countries, the duration of sick leave will be determined based mainly on the diagnosis of the patient. However, research has previously shown that other factors, such as psychosocial factors, have an impact on the duration of the disability period as well. A more comprehensive, holistic approach of sick leave is necessary to understand the complex interactions between factors that influence the spectrum of choice of an employee to take sick leave. Paradigms seems to shift from purely biological to biopsychosocial, towards an ecological model. More insights are gathered using modern techniques.
In the military world, sick leave can lead to attrition from high-performance functions. Because of the scarce resources, and the high cost to train these employees, attention is shifting from curative measures towards the reduction of injuries and attrition using holistic approaches such as the total force fitness model.
In the current presentation, sick leave and attrition are put in a different light. How can military approaches be applied to civil structures, what can we learn from each other and how did paradigms shift over the years?
10. Jan Hoving NLAssistant Professor Amsterdam UMC –
Implement of Cochrane Work in real-life practice of insurance medicine / Core Outcome Set (COS) for Work Participation
Over the past decades, intervention research, investigating the evidence for occupational health interventions, has seen a dramatic increase in studies and publications. Although the number of intervention studies and systematic reviews on topics like the prevention of sick leave and return to work is growing, advancements in the measurement of work-related outcomes in these intervention studies are lagging behind. Cochrane Review authors therefore consistently recommend improvements in the definition and standardized use of these work-related outcomes.
Recognizing the need for international consensus on the measurement of work outcomes in intervention research, an international consortium of researchers, supported by Cochrane Work and Cochrane Insurance Medicine, started several studies within the research program ‘COS-For-Work’ (www.cosforwork.org).
The presentation will highlight several studies leading up to the development of a Core Outcome Set for Work, including practical examples showing some of the challenges of having stakeholders agree on something as vital as work outcomes. The presentation will also include the Core Outcome Set itself and its implications and implementation.
Work disability management
11. Prof. Alex Collie, PhD, AU Head of Insurance Work and Health Group at Monash University
Work disability management
A systems view of work disability prevention: Some new insights on an old problem
For nearly 40 years we have viewed occupational rehabilitation and work disability prevention mainly through a biopsychosocial lens. For example, there is abundant evidence that the determinants of work disability include features of the injured/ill person, their workplace relationships and employment circumstances, the nature and quality of healthcare, and the design and administration of insurance and legislative systems. Similarly, effective work disability prevention programs address determinants across these multiple domains. More recently, evidence of the critical importance of work disability systems on worker outcomes has emerged. This presentation will summarise this evidence and how a systems view of work disability prevention can support advances in treatment and rehabilitation. Professor Collie will present work across four main areas that support the importance of system effects in work disability: (1) Comparative policy studies which provide evidence of variation in health service provision and work disability duration between systems with different policy features: (2) Naturalistic, population-based evaluations of system reform which demonstrate the dramatic impact that system changes can have on access to care and on worker outcomes; (3) Qualitative studies of worker, healthcare provider and case manager experiences of work disability prevention that identify system features as critically important to worker recovery and return to work; and (4) Computational models that enable visualisation and estimation of policy and practice impacts across and between work disability systems.
12. Professor Mika Kivimäki, FI University College London (UCL) and University of Helsinki,
Does working beyond the statutory retirement age have an impact on health and functional capacity ?
"In response to the rapid population ageing and worsening economic dependence ratio in European countries, governments are seeking ways to extend working careers and minimize early exit from labour force. Multiple lines of recent research have sought to address these challenges. In addition to studies on the work-health associations, artificial intelligence and data-driven approaches have been used to develop reliable, scalable and easy-to-use risk prediction algorithms for work disability. The aim is to construct risk scores which have a high detection rate combined with a low or moderate false positive rate as those could be used in occupational settings to inform targeting of preventive intervention. In addition to identifying employees at risk of work disability and factors that affect early exit, an emerging line of research seeks to increase understanding about factors that may motivate employees to continue working after they have reached retirement age and to evaluate the impact of extended work careers on health and functional capacity in old age."
13. Professor Jean Sibilia, FR ,UNISTRA, Medecine Faculty
The University in the global health crisis
Covid-19 pandemic has revealed a global health crisis.
This crisis has demonstrated our collective inability to cope with a global viral pandemic.
What will happen tomorrow when a world population of almost 8 billion people will be threatened by new microbial or climatic attacks?
The university is under pressure to affirm its social responsibility which is to uphold values but also to train quality health professionals in sufficient numbers. We must therefore examine together the current issues. How to train and participate in an optimal organization of the health system while sustaining a strong capacity for research and innovation?
How to ensure a role of stakeholders in university health community for the common good?
How to take the assumed step towards a more predictive and preventive medicine?
Therefore, it is necessary to challenge the place of each stakeholder because any health system needs effective evaluations and flexible regulations.
It is legitimate to strengthen the role of social security and its medical experts in our solidarity system. By the way, we must address the function and missions of these doctors in an original partnership with the university. This is a new model of cooperation that the impending emergency situation forces us to consider. We must contribute, with conviction, to a great momentum of renewal and solidarity, all together !