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EF: What do you think 2022 will be remembered for?
KB: We, as Johnson & Johnson MedTech Germany, will remember 2022 as the year partnerships and collaborations with internal and external stakeholders in healthcare have been reinvented, like payers, policymakers, health services providers and patients. In 2020 and 2021, we were in crisis-management mode and communication and collaboration played a significant role to deliver safety measures that were implemented immediately. Germany tried to manage and flatten the curve of Covid-19 to prevent healthcare systems from crashing. We offered immediate support to our customers like our Voluntary Leave Program for employees with a medical background to support healthcare workers at the frontline.
In 2022 the industry is inclined to develop collaborations, work on new ways for healthcare delivery, and accelerate data-driven decisions. 2022 is also about reinventing care delivery. It accelerated many important initiatives and increased the industry’s willingness to tackle the issues brought forward. Digital solutions and the use of data have accelerated. It is now taken more seriously and dealt with more tangibly than before the pandemic.
There was an even stronger need to streamline processes and take the stress from the staff in ORs. On our side, we are leveraging digital tools and solutions to automate and speed up processes and ultimately help hospitals to increase clinical outcomes, economic efficiencies, and staff satisfaction. Our Surgical Process Institute (SPI) is a concrete example of how we develop digital solutions which can make it easier for healthcare professionals to focus on the patient and that reduce the variability of clinical outcomes by implementing automated and digital protocols. In addition: The SPM (Surgical Process Manager, the tool of SPI) is synchronizing workflows digitally, offering real-life learning and making onboarding of new surgical team members easier. So, digitization is all about the purpose - a digital solution is always a means to an end to address a challenge our customers face.
EF: With the recent appointment of Mr. Joaquin Duato as the CEO of Johnson & Johnson, how do you see the future of the company look like?
KB: Mr. Joaquin Duato has extensive experience within Johnson & Johnson. Before being named CEO, he served as the Vice Chairman of the Executive Committee, where he provided strategic direction for the Pharmaceutical and Consumer Health sectors and oversaw both Information Technology and the Global Supply Chain. He strongly believes in the power of technology to accelerate progress in healthcare.
It is all about applied digitalization. Applied digitalization is digitalization with a purpose – and our purpose at Johnson & Johnson has been the same for more than 135 years and we will stay true to it. We believe good health is the foundation of vibrant lives, thriving communities and forward progress. That’s why we have aimed to keep people well at every age and every stage of life. Today, as the world’s largest and most broadly based healthcare company, we are committed to using our reach and size for good. We strive to improve access and affordability, create healthier communities, and put a healthy mind, body and environment within reach of everyone, everywhere. When it comes to the use of technology, J&J aims to harness data science and intelligent automation for insight generation to solve the world’s toughest health challenge and to reinvent how patients are treated.
EF: Can you elaborate on the importance of Germany to J&J MedTech and the Surgical Process Institute?
KB: Germany is definitely one of the key markets for Johnson & Johnson and we have a significant social as well as economic footprint. In Norderstedt, close to Hamburg, J&J MedTech operates one of the largest production facilities within the global J&J supply chain network for surgical sutures and needles and offers professional education for healthcare professionals at the Johnson & Johnson Institute.
From my perspective, Germany has a great reputation for its engineering, the quality of standard it can live up to, the quality of work, and its timelines. Several technical universities have highly specialized teams with great engineers, developers, innovative thinkers, and quality innovations. Germany will continue contributing to innovations in the healthcare sector. We believe that innovation in the hospital landscape has room for improvement.
The Medical Technology footprint in Germany mostly consists of small to mid-sized German-based companies, with 66% of their revenue being generated from exports. Germany can develop and manufacture medical devices and export them to other countries because of the quality and confidence people have in our innovations.
The Surgical Process Institute (SPI) is an innovative German organization that was tackling local unmet customer needs and is a great example which highlights the innovative strength of Germany. It came on our radar through its collaborations with some of our customers in Germany. SPI is also a great example of J&J’s agnostic approach to innovation. Great ideas can come from anywhere - either from in-house developments, external partnerships, acquisitions, or a discovery with our customers for better patient outcomes. We are proud of our strong track record of cultivating innovation and pairing our deep internal know-how with some of the most promising external innovations.
The Johnson & Johnson MedTech German team engages with customers to improve clinical surgical outcomes as it is still a key issue dependent on the procedure. SPI began to explore the different ways to overcome challenges that appear in procedures such as having a wide range of variable results. It is challenging to check everything manually during surgery continuously, so we automated the process with a digital, user-friendly, checklist and integrated it into the Operating Room protocol. With the results, we look for learning agility and a learning function for a standardized outcome. With the collected and processed data, surgeons can use surgical processes that have the best outcomes from the checklists for better surgical outcomes. There is a lot of value gained from the data and the algorithms we run.
EF: Do you think the German market's maturity and readiness to adopt this type of technology?
KB: Physicians are much more receptive now than before the pandemic for two main reasons:
The first reason is the impact of the pandemic as a digital catalyst, and the challenges of managing teams during these times with, for example, staff shortages. Having staff shortages helped surgeons and physicians to embrace technology to help alleviate their workload. During the pandemic, it became clear that we had to look at things from a more integrated perspective to deliver the best healthcare with ease of patient access. It was often necessary to go beyond the usual work scope. This created a lot of understanding and trust between partners for future collaboration.
The second reason is the control that physicians gained by measuring data. Data-driven solutions only work if there is trust and if the input is right. Several people broadened their roles or began collaborating with others, increasing the trust between physicians and healthcare stakeholders.
This is a good starting point for a more integrated approach. It is about being more patient-centric and working together as an integrated whole for the patient's and the system´s benefit. I think that we made a big step forward thanks to the mindset shift that happened over the last two years.
EF: How is the German market adopting innovation, and how do you see Germany as an innovation powerhouse?
KB: I strongly believe that Germany will continue to be a hub for innovation. From my perspective, the hospital landscape and the adoption of innovation and new technology by German physicians could be improved, mostly because Germany has still a high number of hospitals compared to other countries. We should look at different avenues to safeguard patients’ access to care by setting up centres of excellence for more centralized complex care. Complex care encompasses disease areas such as oncology, cardio surgeries, neuro surgeries, and many more complicated surgeries and conditions. It is equally important to further invest in professional education, to make more processes and procedures efficient and to standardize the use of the newest technology.
To influence behavioural change and quality care in hospitals and physicians, a supportive financial system needs to be set up. Hospitals have a special way of reimbursement. In Germany, the DRG systems focus on volume and cost. To stay competitive, hospitals offer their procedures and surgeries at a reduced price. In the financial compensation, I see a big difference between Germany and the Netherlands, where I used to work before I joined the German team. Dutch hospitals are compensated through healthcare insurance companies linked to the quality of published metrics. Hospitals may get more reimbursement for a procedure if they can show that the national complication rate is lower than the national average and lower for a particular procedure. This type of reimbursement model does not exist in Germany. We are currently working on evolving the reimbursement system alongside the trade and medical associations. To give German patients the best, newest, smartest, and least invasive access to treatment options and technology, we need to start paying for quality instead of quantity.
EF: How do we increase technological and innovation adoption in Germany, especially in hospitals and for physicians?
KB: It starts with listening to and understanding customer and patient needs and jointly looking into potential solutions. If there is a positive and proven impact on customers and patients the adoption is more likely. It is about developing solutions that tackle the most pressing needs of hospitals, caregivers, patients and other stakeholders like payors. As a MedTech company, we want to ensure people can live longer, happier, and healthier lives because we have made the procedures smarter, less invasive, and more personalized. Our main aim is to provide patients with the best care possible. We have learned that new technology, innovation, and digitalization highly contribute to this process, which is why it is about the integration process. This process helped us to evolve from a product supplier to a MedTech partner.
If new technology can make surgery less invasive, decrease the patient's recovery time, and improve patient experience, it is something hospitals, and physicians can easily adapt to. The key driver of technology and innovation adaption is the demonstration of the bottleneck that technology is fixing.
There is an impressive example in the bariatric area, where we were able to prove how technology can help caregivers to stay connected with their patients to keep them motivated along the patient pathway and reduce the drop-out rate.
For bariatric surgery, there was an 80% drop-out rate between the first consultation and the final procedure, mainly because of a need for better awareness and engagement. Through our digital solution, patient engagement and patient education initiatives, we were able to decrease the drop-out rate from 80% to 40%. This example shows again how important a holistic approach is and that the investment in prevention is worthwhile.
EF: Is healthcare investment related to value-based care?
KB: In my opinion, first of all, it needs a change of perspective. We need to look at healthcare differently - as an investment, not a cost. Healthcare is clearly an investment welfare driver for society. Healthy people contribute to and make a difference in society. In a nutshell, - a healthy nation is a wealthy nation. As a consequence, we should less focus on costs but instead, health insurance companies, the sector, the government, and people should invest more in health for longevity. As an industry, we need to engage in a dialogue with all relevant stakeholders to drive this message and create awareness.
Going forward, trust is a key element and an end-to-end, holistic mindset. We should move away from the existing fragmented silo-thinking. Often it is better to invest in an area like prevention to save costs in another area of the care pathway. As mentioned before, a quality-driven end-to-end DRG system would very much support this behaviour. We need to adapt our thinking and let categories like “more” or “less” go, but rather develop our thinking further in the direction of "different".
Value-based healthcare incorporates the value we create for patients accompanied by the cost of the respective service. The perceived value of a patient can be derived from an integrated system instead of fragmented silos. We cannot practice value-based healthcare without measuring the quality of our outcomes and results. Quality value-based healthcare requires trust and willingness to collaborate from all relevant stakeholders to make the collective better. Value will come through collaborations and partnerships. Looking into the future, with a value-based mindset the industry can invest more toward innovation and secure Germany as an innovative hub.
EF: What would you like to celebrate in December, as it will be your fourth year leading the German J&J MedTech organization?
KB: There are many things to celebrate, but one of our biggest celebrations will be the positive impact we had on our patients, our customers and our employees. We helped our customers with our products, services and end-to-end solutions to ensure patient treatment and better clinical outcomes.
We are truly committed to sustainability. With our various initiatives we secure to be an employer of choice and we are living our Diversity, Equity and Inclusion values and goals. And regarding Environmental Sustainability we implemented some successful and innovative projects to help healthcare providers reduce their carbon footprint. We are supporting frontline healthcare workers with various initiatives and are training around 17.000 healthcare professionals to ensure the highest standard of care. We are offering various consultancy approaches, e.g. how to tackle diseases like obesity and atrial fibrillation to ensure patient safety. These initiatives are all worth celebrating and it’s great that I can celebrate them with many talented, enthusiastic colleagues, who are contributing to building a sustainable healthcare powerhouse in Germany.