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Careum Congress 2010

The power of patients

Citizens, consumers and patients are playing an increasingly significant role in healthcare. On the one hand, the healthcare community is calling for people to become actively and capably involved in keeping themselves healthy and managing chronic conditions within an ever more complex healthcare system and to participate in the growing healthcare market. On the other hand, patients themselves are developing new forms of empowerment and mutual support, for instance by making use of new information technology, online platforms and social networks in a creative way.

At this congress, Careum – together with national and international partners – presented a wide variety of patient-oriented innovations in healthcare, in health policy and on the healthcare market.

The Careum Foundation contemplates the healthcare system of the future

Around 300 participants and numerous speakers from both Switzerland and abroad gathered at the Careum Congress from 11 to 12 November 2010 to look into the healthcare system of the future and the role of the patient. This Careum Congress was the first congress in Switzerland to bring together all parties involved in the healthcare system to explore and examine this topic.

The main conclusion drawn from this two-day event was this: Patients are active players rather than objects of the healthcare system.

With this congress, the Careum Foundation has been focusing its activities on a new key area with the aim of firmly establishing self-management programmes for chronically ill people and their patients in Switzerland. Through patient education, the foundation wants to generate innovative and groundbreaking impetus and play an active part in developing this. The Careum Congress 2010 marks the first important milestone in this process.

Patient education with a focus on chronic illness

Chronic conditions make up 86 % of all illnesses. Many of these conditions also pose a problem in that patients have no access to support programmes and their needs are not taken seriously enough. Efforts need to be made to ensure that patient empowerment becomes a matter of course in future – in the healthcare system, it is the patient who should really take centre stage. In the words of José Martin-Moreno, Director of the WHO in Europe: "There is still a long way to go before patients and doctors become equal partners."

Self-management is key

One thing that was clear from the numerous presentations and discussions is that patient self-management, combined with technological advances and the possibilities of transferring information via the Internet, must be a key factor in shaping the healthcare system of the future. Jim Phillips, Director of the British Expert Patients Programme, illustrated the problem with this analogy: "You can't force a garden to come into bloom, all you can do is create the right basic conditions for it. The same goes for patient self-management." The British studies indicate a cost savings ratio of three to one: for every Swiss franc invested in self-management, the healthcare system saves three.

Is the patient a customer in the healthcare system?

There were in-depth discussions at the congress on the topic of viewing the patient as a customer in the healthcare system. With new information channels available online, patients are becoming increasingly better informed, which gives them a basis from which to make decisions. However, free choice depends on the service provider and the patient being on an equal footing. However, Stefan Etgeton from the Federation of German Consumer Organisations does not think this is something that can be taken for granted yet in the healthcare system. All parties involved, including health insurance companies, service providers, politics and industry – along with the patient organisations – should come together around the same table. After all, as Swiss National Councillor Felix Gutzwiller was keen to make clear, "the age of regarding doctors as gods in lab coats is over".

What about costs?

Peter Littlejohns from the UK's National Institute for Health and Clinical Excellence (NICE for short), described the issue of costs in the healthcare system in pragmatic terms: "The budget in the healthcare system is always limited. Every franc spent on one patient cannot be used to help another." What is clear, however, is that patient education and organisation can reduce costs. This has been demonstrated time and again by various projects. People with health problems who take part in empowerment programmes can take a more self-assured approach to dealing with their illness and become less reliant on the services of the healthcare system.

Is there a patient revolution under way?

"Patient empowerment is a revolution driven from the bottom up – by the people. We can't approach this in a top-down way. It has to be a bottom-up revolution," commented Martin Denz, President of the European Health Telematics Association.  Patients are much better informed and will be more discerning in future. The healthcare system needs to be democratised and fundamental restructuring is required to ensure that it lives up to their demands. The Careum Congress clearly highlighted this process.              

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