Topics discussed ranged from ongoing cutbacks in funding for healthcare services, and integration of clinical care to growing use of genetic testing in support of precision medicine
DATELINE: Sydney, NSW, Australia—There were 200 leaders in healthcare, medicine, and pathology gathered here last Wednesday to explore a hot topic: the unfolding disruption to healthcare in Australia. The themes of the conference will be familiar to Dark Daily readers across the globe.
These themes included:
• Inadequate funding to pay hospitals, physicians, and medical laboratories, given the steady increase in demand for healthcare services throughout Australia.
• Expanded use of genetic testing and next-generation gene sequencing as medical laboratories acquire the instruments and expertise necessary to make such tests available to physicians.
• How primary care physicians are responding to the demands of an aging population, the increased incidence of chronic disease, and the potential to use information technologies to improve patient care.
The conference was organized as a collaboration of three important laboratory medicine organizations. They were:
• Australasian Association of Clinical Biochemists (AACB);
• Australian Institute of Medical Scientists (AIMS); and
The Dark Report was a fourth organizer of the conference, which was titled “Disruption in Healthcare: Pathology Leadership and Innovation.” Abbott Laboratories (ABT:NYSE) also was a major supporter of the conference, which organizers intend to became an annual event.
Disruption in Healthcare a Global Phenomenon
Another notable fact is that this conference took place on International Pathology Day, which was recognized worldwide this year on November 18.
The conference opened with a keynote address by your Dark Daily Editor, Robert L. Michel. He presented evidence to show that disruption in healthcare is a global phenomenon. More specifically, the healthcare systems of most nations are dealing with the serious twin problems of skyrocketing demand for healthcare services that outpace the ability of healthcare systems to pay for these increased clinical services.
Next to take the podium was Gerard Foley, MD, a general practice physician who is the CEO of IPN Medical Centres, headquartered in Sydney. He continues to see patients at the Mosman Practice on Sydney’s Lower North Shore.
Family practitioners and medical laboratory professionals in the United States would find many of the trends happening in primary care in Australia to be remarkably the same as in the United States. “The number of solo GPs has halved in the last decade,” Foley explained. “Currently 50% of GPs now work in practices with five or more doctors and 18% of GP practices are owned by corporate entities.”
Important Role Pathology and Clinical Labs Play in Primary Care
Improved coordination of patient care is happening in Australia. “In a pilot program that launches in 2017, general practices can elect to become Health Care Homes with voluntary patient registration,” Foley stated. “This pilot will involve 200 primary care practices and about 65,000 patients.”
In the United States, over the past decade, patient-centered medical homes (PCMHs) have been the fastest-growing segment of primary care. Foley noted that general practitioners provide 85% of the care in Australia, yet represent only 15% of the nation’s total spending on healthcare.
During his presentation, Foley called attention to the important role pathology and medical laboratory testing plays in primary care. “Among GPs, there is an increase in protocol-driven lab test ordering,” he said. “For the same reason, this is causing a decline in the number of duplicate lab tests. Both are favourable trends that contribute to more cost-effect care.”
Australian Laboratories Embrace Data and Genomic Sequencing
Foley further pointed out that GPs in Australia are becoming more intensive users of health data and that this creates opportunities for innovative pathology laboratories. “Data is becoming more important, particularly as chronic disease registries become more important in daily practice,” noted Foley. “Data is required to support population management and GPs are working to develop better risk stratification tools, and pathology testing has a role in many of these tools.”
Of course, no single trend is on track to be more disruptive to healthcare and medicine than genetic medicine and next-generation gene sequencing. This topic was addressed by Marcel Dinger, Chief Executive Officer of Genome.One, Head of the Kinghorn Centre for Clinical Genomics (KCCG), and conjoint Associate Professor at St. Vincent’s Clinical School of UNSW Australia.
KCCG was one of the first sites in the world to implement the HiSeq X Ten genome sequencing platform. With 15,000 whole human genomes already sequenced, Dinger and his team are working at a volume of nearly 18,000 whole human genomes per year.
“Initially, clinical genomics will impact three key areas,” stated Dinger. “They are:
1. Rare and inherited disease diagnosis;
2. Cancer, with molecular stratification to guide treatment (precision medicine); and,
3. Health management via predisposition testing (e.g. cardiac disease and cancer), carrier testing, optimization, and avoidance of adverse drug reaction.”
A Robust First Conference!
Presented above are just a few of the highlights from the inaugural year of “Disruption in Healthcare: Pathology Leadership and Innovation.” Because conference participants included government health administrators, physicians, healthcare leaders and consultants, clinical biochemists, and other medical laboratory scientists, the networking and conversations throughout the day were robust.
Dark Daily readers interested in seeing all the details of the program can visit the conference website HERE. (Or copy this URL and paste it into your browser: http://disruptioninhealthcare.com.au).
Our next stop is New Zealand for medical laboratory meetings in Auckland on the North Island and Christchurch on the South Island. Pathology and medical laboratory medicine has followed an interesting path in this nation over the past decade and so there may be much fascinating news to report.
Your Dark Daily Editor,
Robert L. Michel
2016 Disruption in Health Care: Pathology Leadership and Innovation Conference
Australasian Association of Clinical Biochemists (AACB)
Digital Disruption—Opportunities for Innovation and Growth
International Quality and Productivity Center (IQPC)