WHPA forum on collaborative practice
2012 Forum of the World Health Professions Alliance WHPA was ‘collaborative practice'
WHPA Forum 2012 focuses on collaborative practice
"I believe that today's discussions will allow us to consolidate strategies and approaches to face today's health care challenges," FDI President Orlando Monteiro da Silva told a group of health professionals assembled in Geneva on 20 May.
He was chairing the morning session of the 2012 Forum of the World Health Professions Alliance WHPA—a coalition of dentists, physicians, physical therapists, nurses and pharmacists, representing more than 25 million health professionals worldwide. The subject of the day's meeting, which brought together nearly 40 professionals, was ‘collaborative practice'
Debate ranged over a wide variety of fields including collaborative practice as a means of cutting waste, improving efficiency and lowering costs, sustainable health care and the green economy and health promotion and prevention as an investment in the future. It also looked at general questions on health and the economy health—is health care a motor or a drain on the economy?
"It is only by exchanging views, that we can reach a true understanding of the special circumstances and various experiences of our colleagues," said Dr da Silva.
The morning session focused essentially on case studies of collaborative practice. In her presentation, Prof Marilyn Moffat, President of the World Confederation, analysed the various contributions from health and social services, as well as family and community, in the care and rehabilitation of a single patient.
She highlighted how WHO's International Classification of Functioning, Disability and Health (ICF), a framework for collaborative practice, can yield positive results in areas such safety, client satisfaction and access to services.
The second speaker, Prof Michel Buchmann, President of the International Pharmaceutical Federation (FIP), provided an example of how a hospital-based integrated health service delivery system is making significant contribution to long-term adherence to treatment by chronically ill patients. He outlined how this system is now being expanded into over 50 community-based pharmacies.
Better care, better health, better value
Two currents of opinion emerged in the ensuing debate. On the one hand, the focus should be on value with health care viewed as an investment and collaborative practice as a means of achieving high quality care, excellence of service and positive outcomes rather than a means of cutting costs.
On the other hand, some participants felt that health professionals should face up to the fact that there is a lot of waste in health systems: in political terms, the best argument for collaborative practice is in the greater efficiencies and better outcomes it achieves.
It was generally agreed that health professionals should develop a vision incorporating guiding principals for collaborative practice and expand the concept of care to include well-being and patient empowerment: "I want to be the CEO of my own health care," in the words of one participant.
For its part, WHPA could contribute by developing collaborative events between the different health professionals and projecting its vision of collaborative practice through member bodies at national level.
Health care and the economy
The afternoon session, chaired by Dr José Luiz Gomes do Amaral, President of the World Medical Association, focused essentially on the health system and the economy. Dr Cecil Wilson of the American Medical Association pointed out that, despite the recession, the United States health sector continues to grow.
He highlighted the positive impacts of the country's 668,000 office-based physicians in terms of generating jobs and generating federal and State tax revenues.
Health care transformation
Guest speaker: Dr Olivier Raynaud, Senior Director, Global Health and Healthcare Sector, World Economic Forum, agreed that the heath sector was a factor in economic growth and development. He nevertheless cautioned against allowing growth in health care costs to exceed economic growth.
The health sector needs to be viewed less in terms of fundamental rights and be placed at the heart of economic growth. "The current recession highlights the need for transformation in health care, guided by economic considerations," said Dr Raynaud.
He highlighted the need for transparency in the health care sector, a greater focus on high quality health data and information and greater collaboration not just between health professionals but between health and other economic sectors.
He warned that a failure by health professionals to be the agents and drivers of a transformation in health care could result in decisions taken on their behalf.
Participants in the debate that followed called for innovative models of health care adapted to developing country settings as well as the introduction of the concept of the health ‘footprint', integrating prevention, and factored into social and economic policy.
For his part, FDI Counsellor Gerhard Konrad Seeberger, reiterated concerns about the implication of the current financial crisis on national and international associations.
He underlined specific formats for collaboration from the dental profession, in particular in the field of prevention—"not only a health priority, but also an economic priority"—"and its potential in early detection and diagnosis. Further, he pointed to the dental profession's long experience in patient recall and data collection, dental records being on occasion the sole recourse for identification, for example after accidents or natural disasters.
Improving access to health care during tough financial times
Rosemary Bryant, President of the International Council of Nurses, focused on the key role of the nursing profession as key to equity and sole access to health care in many parts of the world and its potential to transform health services.
"Nurses are the glue that holds medical services together," she said, adding that health innovations could include expanding role of nurses in other areas of medical practice. She cautioned against the danger of fragmented health services and patients falling in the gaps. "To be CEO of your health care you have to be health literate, which is not always the case," said Ms Bryant.
The final debate of the WHPA Forum, facilitated by Prof Phil Schneider (FIP) and Dr Marilyn Moffat (WCPT), cautioned against healthcare transformation going too far too fast: the way forward must be understandable, acceptable and within a framework of competency in the medical team;
The focus should be on responsibilities, roles and competencies and how to best integrate medical work to improve health outcomes. The design of healthcare IT should be the result collaboration between health professionals to ensure that information on the patient needs flows between providers, including a wider group of people involved in general care of the population.
Debates at the one-day WHPA forum could well result in the production of two position papers:
- Collaborative practice – opportunities for all: guiding principles.
- A conceptual framework for greening health services: leading health transformation around the world to assure sustainable health services delivery.