The regional work done in ESIC has reached the peer review phase. The aim of the ESIC activities carried out in all model demonstrator regions has been to assist regional policy-makers to test, update and improve their existing policies as well as to boost emerging industries by transformative service innovation. Via the expert analysis and regional self-assessment the summary assessment reports have been finalised by the ESIC consortium. The peer review phase, in turn, encourages policy learning and provides external input into the policy development of the region and leads eventually towards regional policy recommendations.
The ESIC peer review in Luxembourg (5-6.2.2014) took place in the Chamber of Commerce, and was attended by nearly 30 persons representing the ministries, public research institutions, and businesses. The one and a half day event contained a number of speeches, followed by discussions and a workshop session. In his opening words, Mr. Jean-Paul Schuler, Managing Director of Luxinnovation, made a reference to Luxembourg as a region with ability to transform. The Grand Duchy developed from rather a poor agrarian community of the early 20th century to significant iron and steel producer during the latter half of the century. While the resource intensive industry has gradually lost its importance, the financial services have emerged as replacement. At the beginning of the 21st century Luxembourg is looking for yet another transformation.
The Luxembourg large-scale demonstrator approach, presented by Dr. Gaston Trauffler, Luxinnovation, is addressing the challenge of increasing costs of the health care system due to the rise of life-style related chronic diseases while trying to maintain the quality of care. Prevention and the use of personalised medicine as means to adapt to change represent part of the solution combined with better use of data as a way to monitor one’s health.
Data is central element in the Luxembourg LSD strategy as it connects the three dimensions, the patient, the service offer, and the national health care system dimension. Transparency and security of data as well as access to it were among the widely discussed topics of the event. Mr. Raul Mill, Estonian e-health Foundation, demonstrated the possibility of implementing such a system by respecting the main principles of security: all users are authenticated by ID-card or mobile ID; all medical documents are signed or stamped digitally; all actions leave an unchangeable (and unremovable) secure trail; encrypted database allows to remove the confidentiality risk from the technical administrators; and all actions are monitored together with the corresponding counter-measures. The discussions that followed demonstrated that there are less issues with data security in Luxembourg than what was foreseen in the assessment.
The example from the Basque Country, presented by Mr. Josu Hernaiz, highlighted the following challenges that need to be taken into account: changing the health care system is difficult due to highly stable practices, the fragmented care inertia is protected by laws and norms, and there is no substitution effect in service as new models often require extra resources and additional staff. Although technological development may help, it can also lead to unrealistic expectations, while high prices of pilots raise doubts on scaling up costs.
In order to avoid some of the described challenges and implementing a strategy with a pre-fixed goal, Dr. Marja Toivonen, VTT Technical Research Centre of Finland, recommended using the effectual model in Luxembourg. The effectual model does not regard innovation as a linear process as it takes into account the changing resources, interactions and inputs as well as varying engagement of the stakeholders. Hence emphasis should be placed on future oriented joint activities that empower the stakeholders and build momentum for necessary changes. One of the key objectives of the peer review was to better understand the systemic approach to policy development as means to support further transformation through service innovation. Currently the policy mix is still somewhat biased towards technological R&D, and calls for other forms of innovation, such as open innovation, user- and demand driven innovation and service innovation.
The obstacles hampering the implementation of the large-scale demonstrator strategy were tackled jointly in a session facilitated by the ESIC team on day 2. Despite efforts, not all key stakeholders are fully committed. They need to be convinced by providing evidence and information (e.g. costs). Having these actors on board is one of the key prerequisites for starting a gradual change process that can lead into a larger transformation of the Luxembourg healthcare system.
The work done in the ESIC initiative in Luxembourg has gained visibilty also in the local media. Some of the articles will be found via the following links:
Service Innovation in Healthcare (1004 KB)
ESIC assessment on Luxembourg (701 KB)
ESIC assessment on policy mix (578 KB)