The significance of impact in healthcare

Impact measurement in the healthcare industry involves quantifying and analysing the effects of healthcare interventions, products, policies and projects on the environment, economy and society. It provides critical information to decision-makers and stakeholders, helping them maximise value, increase access and equity to healthcare, and drive strategic planning and resource allocation¹.

Impact measurement is crucial in facilitating the transition from the current “sick-care” model to a precision, preventive and predictive future healthcare model. There is a shift towards ensuring that people remain healthy enough to reduce their reliance on healthcare services unless absolutely necessary. An increased emphasis on factors that promote health could mean fewer resources dedicated to care delivery.

Traditionally, treating an illness usually occurs in isolation and often fails to address any of the social and contextual factors that contributed to it. Healthcare stakeholders are now paying close attention to these drivers of health, namely the social determinants of health. These non-medical factors, such as food security and working conditions, influence health outcomes and shift focus towards preventative rather than curative interventions that could help drive meaningful, sustainable change that impacts the health of individuals and their communities.

Impact measurement aids in monitoring health transformation strategies, particularly in regions with high population growth rates and ageing communities. It ensures policymakers maximise outcomes across the care continuum by investing in the appropriate programmes¹.

Standardisation, data quality and cross-industry collaboration 

Healthcare companies are merely reporting on output metrics such as key performance indicators (KPIs), instead of reporting on pure outcomes. KPIs are essential for evaluating and monitoring the performance and operations of services; however, they are ineffective at measuring the broader impact, including the socioeconomic impacts of these initiatives. In addition to this, KPIs are both inward and backward looking. They provide no insight into the future impact of interventions.

Measuring and reporting healthcare outcomes presents several key challenges:

1. Outcomes are highly nuanced across different healthcare sub-sectors, and they are influenced by multiple factors spanning the entire continuum of care.
2. There is a lack of standardisation regarding which metrics should be measured and reported. For example, the disclosure of clinical outcome measures by healthcare providers in South Africa is still at the provider's discretion, with no consistent standards for the type of measures or frequency of reporting.
3. The quality of source healthcare data available needs significant improvement, which is closely linked to the lack of standardisation.

Assessing the impact of a particular medication on health outcomes for individuals with chronic diseases further illustrates these challenges¹:

• Chronic diseases rarely occur in isolation. Patients often have multiple coexisting conditions, requiring the use of various medications simultaneously, with unique combinations varying across individuals.
• Age is a crucial factor influencing outcomes. Patients within the same age category but with different ages may experience divergent outcomes, even for the same chronic condition.
• Establishing a counterfactual baseline is difficult—determining what the outcomes would have been without the medication is challenging to quantify accurately.

Despite these obstacles, progress towards quantifying outcomes is achievable. Cross-industry stakeholder collaboration is fundamental to facilitate information sharing across the entire care continuum. Underpinning these efforts are the principles of transparency and accountability, which must be embraced by all stakeholders within the healthcare industry.

The 2030 sustainable development goals (SDGs) set out by the United Nations rely on access to essential medicines as a cornerstone of reducing mortality due to non-communicable (SDG 3.4) and communicable disease (SDG 3.3). Pharmaceutical companies bear a large part of the responsibility of improving access to medicines with pressure from investors and other stakeholders. The Access to Medicine Foundation publishes a report every two years on the 20 largest global pharmaceutical companies and their performance and ranking against how they’ve improved access to medicines in low-and middle-income countries (LMICs). The three main categories assessed are²:

1. Governance to access
2. Research and development
3. Product delivery

There is still much work to be done in ensuring equitable access to medicines particularly in vulnerable populations. Improving access is critical to ensure that medicines reach the people who need them the most. In order to do this, a deeper understanding of the market needs to be undertaken with specific focus on meeting the disease burden and health system needs.

In an era of evolving healthcare models focused on precision, prevention and prediction, impact measurement has become pivotal. By quantifying the effects of interventions, products and policies across environmental, economic and societal dimensions, impact measurement empowers stakeholders to maximise value, increase access and drive equity in healthcare delivery.

While challenges persist, such as the nuanced nature of outcomes across sub-industries, the lack of standardised metrics and data quality concerns, these obstacles can be overcome through concerted efforts. Cross-industry stakeholder collaboration, underpinned by transparency and accountability, is crucial for facilitating information sharing along the continuum of care.

By advancing the quantification of healthcare impacts, stakeholders can allocate resources effectively, monitor health transformation strategies and adapt to the needs of ageing populations and regions with high growth rates. This shift towards embracing impact measurement is essential for achieving the United Nations’ Sustainable Development Goals and improving access to medicines, particularly in low- and middle-income countries.

Ultimately, impact measurement serves as a catalyst for transformative healthcare, enabling a transition from the traditional "sick-care" model to a future focused on maintaining public health, preventing diseases and promoting holistic well-being. By aligning efforts and leveraging data-driven insights, stakeholders can drive meaningful, sustainable change that positively impacts individuals and communities worldwide.

^References

^{1. PwC Middle East. 2023. Transforming Healthcare Through Impact Measurement. N.p.: PwC. https://www.pwc.com/m1/en/media-centre/articles/transforming-healthcare-through-impact-measurement.html.}

^{2. The Access to Medicine Foundation. 2022. “2022 Access to Medicine Index.” 2022 Access to Medicine Index. https://accesstomedicinefoundation.org/resource/2022-access-to-medicine-index.}