Opinion – Paulo Junqueira Moll: Efficiency and sustainability


Per capita spending on health care increases year by year around the world above inflation. The reasons for the phenomenon are several. The consequence, in short, is continued pressure on domestic and corporate budgets, which is a wake-up call for the future of health.

It is imperative, given this scenario, that leaders in the health sector make a commitment to act to mitigate, contain or reduce care costs without jeopardizing quality. I believe that disease prevention and increased institutional efficiency are the best response to this challenge. In article in this leaf, I pointed out the importance of scaling up to dilute costs and make care more accessible. Today, I highlight three vectors that contribute to improving clinical and costing results: organization of care networks, coordination of care and digital transformation.

Patients in general are not health experts. They need to be guided on how to prevent disease. And they deserve precise information about the treatments, how they will be conducted, the institutions involved, the exams and medications, hospitalizations and follow-up appointments that will be necessary. This orchestration must be carried out within and between networks, organized by the coordination of care and enhanced by the revolutions that the digital transformation makes possible.

The organization of networks presupposes sufficient and properly allocated infrastructure and personnel. Networks of diagnostic tests, offices and hospitals need to be organized and interconnected so that the patient can flow through them without redundancy of interventions, quickly and safely, building their healing process. These day-to-day networks bear little operational similarity to each other and, therefore, the focus has to be directed towards their structuring and integration.

With well-structured and integrated networks, clinical intelligence must be put at the service of patients and their entire care process must be described in detail, monitored and coordinated by multidisciplinary teams focused on compliance with the treatment and a more effective healing process. This streamlines the work, reduces the possibility of error, ensures better clinical outcomes and value-based compensation models. Everyone wins — the patient, the health care facility, and the funding system.

The third factor for improving cost-effectiveness is digital transformation. Samples of its transformative power are telehealth, remote diagnostics, electronic medical records and unified patient data repositories. Organizing networks, integrating them and coordinating the care of large numbers of patients is a task that requires powerful and well-modeled digital tools. When data from medical records are interoperable between institutions, the decision-making process of physicians will have better information and there will be a qualitative leap in care in general.

The range of possible actions is wide and there are several movements to increase the efficiency of hospitals, clinics, laboratories and health care providers. We do our part. This is a path that requires commitment, investment and action. The results of this effort will be a more sustainable system, more accessible care, and better clinical outcomes for patients.


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