Read the Conversation
Meeting highlights:
- Samuel's growing role in Air Liquide Healthcare by prioritizing the patient at the centre.
- How Air Liquide supported the transition of homecare support in Diabetes almost 25 years ago.
- The importance of matching the appropriate technology to the right patient and creating an ecosystem of support so patients can benefit from the therapy.
- Air Liquide innovating through value-based healthcare contracts for Diabetes in South Africa, Spain, and other countries to measure clinical and patient-reported outcomes.
- Air Liquide's growth opportunities in Africa through innovative technologies to improve population health.
EF: Having worked in Air Liquide Healthcare for over a decade, what have been the highlights of your career, and what are your current priorities?
SC: My position with Air Liquide Healthcare has changed over the past ten years. I have worked in Canada and the Northern countries in various capacities. Putting the patient at the centre has been fundamental to my many experiences at Air Liquide. However, when it comes to Diabetes, we try to modify this and state that we put people at the centre to take an even more person-centred approach. That would seem somewhat general in any pharmaceutical or medical technology company. Still, for Air Liquide, the specific was that we have been providing home healthcare by visiting people in their homes from the beginning. You can only imagine how personal that is.
Not only do we visit people in their homes, but we also work closely with them. For example, in action or other respiratory therapies, people may be in bed with an oxygen supply or in the comfort of their homes. We meet people where they are, whether for respiratory therapies or Diabetes. We have a very personal relationship with many of the people we serve since we work alongside them. We began by examining ways in which we may improve. We questioned what would be best for the people we see daily and how we could best create relationships with them. Finding the best available technology to aid in their treatment and learning how to support them using these life-improving tools are the first steps in managing Diabetes. However, individuals must also be trained in its use to utilize technology fully.
Since various people have different needs, we should be able to meet them where they are by providing them with a range of therapies and training them to use these other technologies. Over the past few years, that has truly been our focus. That's also where we began; we began working on Diabetes in 2000, which was about 25 years ago in France. We supported the system's transition of Diabetes care from the hospital to the home. We worked with the healthcare authorities to create a way for people to receive remote support for their daily needs rather than hospitalization.
This is a significant change, and when we expanded operations beyond France in 2013, we used the same strategy of matching the appropriate technology to the right patient and creating an ecosystem or support system around it so that the patient could benefit from therapy. This allowed the patient access to the technologies while ensuring the appropriate support level was provided. Well-based healthcare has transformed in the last 2 years. We understood that in addition to choosing the best technology and setting up the appropriate support, we also needed to gauge the impact we were having because of the volume of data we could now access thanks to these kinds of technologies and the evolving needs of individuals. It is often overlooked in the system. As you are aware, in clinical studies, many variables are measured.
When it comes to the actual market settings or application of these medical technologies, private players are only used to supply the necessary technologies and support. We recognized that perhaps we should take things a step further after our previous experiences working with people, visiting them in their homes, and maintaining personal relationships with them. This was brought about by the awareness that, for the healthcare system to continue funding these innovative technologies and the related support, it would also require evidence of the efficacy of these therapies from private players. Value-based healthcare basically comes down to the ability to define clinical outcomes, or more accurately, patient-reported outcomes, set a goal, and then commit to guiding others toward that objective and be able to receive some sort of reward or compensation if they succeed.
EF: Could you elaborate on the importance of Air Liquide Healthcare and the impact its diabetes program is having on the growth opportunities in Africa and the surrounding regions?
SC: The concept that some new therapies and technology can enhance people's lives and improve clinical outcomes is becoming more widely accepted. This is advantageous for society and them, as numerous health economic studies have shown that funding these therapies will positively affect and lower costs across a wide range of healthcare system components. In South Africa, immense prospects exist for growth through innovative technologies, enabling the population to enhance their overall health.
We are more interested in the sustainability of adopting these new technologies than in short-term double-digit growth. Numerous companies have attempted to implement CGM programs, for example, to supply medical devices; nevertheless, the approach taken may not be as comprehensive as it ought to be, and it may not truly offer sustainable access to these new technologies and treatments. To us, that is the most important thing. We chose to launch these efforts in South Africa because it was a great place to start and because there was a fantastic team there with a wealth of expertise. We currently have many patients, and we will investigate any opportunities to grow throughout the region and invest the necessary funds to get there.
We also have a presence in Saudi Arabia, and further regional growth is possible. Making the most of our current footprint is important; we want to provide access to more people. In South Africa, we collaborate with insurance providers and healthcare authorities to ensure they understand the value added to these treatments and technology and the potential benefits to the larger society. A particular aspect of the worldwide diabetes epidemic that interests us is how much South Africa has set the standard; it is a flagship country in diabetes treatments. They have successfully started value-based healthcare contracts and pilot programs with regional players. They have successfully introduced value-based healthcare models or solutions with a creative perspective. In this way, they set an example for numerous Air Liquide Healthcare subsidiary countries in treating Diabetes.
EF: What are the key strategies to implement the new treatments you are incorporating into sustainable programs, and what is essential to their success?
SC: Working with patients, clinicians, and payers to identify pain points and determine what will relieve them is what we are attempting to accomplish in South Africa. After completing and defining this, we will address that need and offer a suitable solution. After a small number of patients and one or two clinics demonstrate that the system can be successfully implemented and integrated into the healthcare system, the system is tested and piloted under a particular framework before being scaled up.
The integration component of the healthcare pathway is very important because, if it is only implemented as an extra layer of access to the healthcare system without being properly integrated with the hospital staff, there is very little chance that patients will have the best possible overall experience. This is because the patient will have multiple points of contact within the hospital, including the doctors, a hospital nurse, and freelance nurses, resulting in a somewhat fragmented experience. Personalizing and integrating care is crucial for us since it guarantees sustainability and creates opportunities for mutual benefit between the two components.
The second element is that the overall cost must make sense for the payers and the healthcare system. For this reason, we involve payers from the beginning and work with them to identify the optimal solution that will meet their needs. If a sustainable reimbursement mechanism or coverage exists for 12 people, you can be certain it will work for 12,000. The goal from the beginning is to ensure it can be expanded to as many people as possible.
EF: What lessons have you discovered to promote cross-market collaboration, allowing you to transfer knowledge from one market to another?
SC: Certain things are quite transferrable, and conditions are generally the same in South Africa, the UK, Germany, or France. It is easy to translate the standard of diabetes care from one country to another. Suppose we know the effectiveness of a support program centred around hybrid group therapy, for instance, in the UK or South Africa. In that case, we can be certain that it will have an extremely similar impact in another country. The challenge arises, however, when healthcare systems differ.
In South Africa, the healthcare system consists of both public and private sectors. Private insurance companies finance many treatments and programs. A national reimbursement system exists in countries such as France. In the UK, regional units are used. Germany has statutory health insurance. Therefore, there are differences in how we introduce these technologies and programs to other countries due to the differences in the financial, healthcare, and funding landscapes. That will be the main challenge and limitation to replication and knowledge transfer.
EF: Do you have any last remarks you want to impart to the readers?
SC: To demonstrate our strong commitment to transforming diabetes care and our ability to implement these new technologies, I would like to draw attention to the significance of the value-based healthcare strategy and the fact that we are currently entering into contracts for value-based healthcare in Diabetes not only in South Africa but also in Spain and other countries. We can attain clinical and patient-reported outcomes and develop systems around them with the help of these technologies. That is our strategic aim and goal, and I am excited that it is starting to happen—not just as a pilot but also on a bigger scale.
