Sunday, Sep 18, 2022 • 21min
3. What's Needed To Improve The World's Healthcare Systems, With Aleksandra Torbica
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Professor Aleksandra Torbica is a Bocconi Professor and expert that has worked alongside politicians, financiers, and academics to create effective health and healthcare policy. We talk to her about careers in health, crafting policy that bridges between disciplines, and system thinking.
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Aleksandra Torbica
Virginia Stagni
Samuel
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Transcript
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Virginia Stagni
00:04
This is The Talent Show, a new podcast series from
FT
Talent, a hub of innovation from the Financial Times
hosted by under thirties for the under-thirties around the world. This first series is in partnership with Bocconi University
, a leading higher education institution of business and managerial advancements. I'm Virginia Stagni and this is the guide you need to drive innovation and change.Share
00:34
Today we're focusing on thinking in systems while looking at the world of health by talking with an expert that has worked alongside politicians, financiers and academics to create effective health and
healthcare
policies.Share
00:46
This is for any listener who wants a career in health, is curious about crafting policy that bridges between disciplines, and those interested in the growing field of system thinking. Here is our conversation with Aleksandra Torbica, professor in the department of Social and Political Sciences at
Bocconi University
.Share
01:09
Aleksandra is great to have you here. Thank you so much for being with us.
Share
Aleksandra Torbica
01:13
Thank you Virginia. It's a great pleasure.
Share
Virginia Stagni
01:15
We have been part of the
FT
Talent Challenge together with Bocconi University
. You met some of our challengers and bright students from all over the world that ask you so many questions about the future of the health care system.Share
01:26
The very first point that I would really love you to explain to our listeners today is more about you. I think it's not one of the first career choices to enter in the health and
healthcare
world and basically, how did you become so close and so passionate about health and health care?Share
Aleksandra Torbica
01:45
Thank you. Thank you Virginia.
Share
01:47
To be honest, as long as I can remember I was passionate about health and health related issues and I always knew that in one way or another I would end up in this sector and build my professional career in health,
healthcare
related areas because I haven't, you know, haven't had a super clear idea of exactly where my career path will bring me over time.Share
02:11
So I started from a very narrow view on health and health care, thinking that it's only about medicine and medical doctors and medical profession and this was some somehow exclusive of this discipline and by studying more, growing up and exploring more I learned that health is much more than medicine related issue, that health is the crucial, it's the pillar of all other activities, economic, social activities of individuals in the community.
Share
02:43
And unfortunately, I think that's a really, really clear concept to everyone. And now also thanks to the pandemic that we have have been experiencing globally.
Share
02:53
So over the years this passion started from a very, you know, close niche about medicine related issues and, you know, looking into the drug development, so related more to the producer side of the
healthcare
technologies.Share
03:07
But then I got really interested in these complex interactions between health and other socioeconomic components that actually influence health and how health can influence them.
Share
Virginia Stagni
03:19
And Aleksandra, you make a very clear distinction between two words, what's behind the reasoning that you're using every time you define health and
healthcare
?Share
Aleksandra Torbica
03:28
Well, health and
healthcare
are two different of course related concepts, because the health of an individual and a community or a population as a whole is influenced by many different factors among which healthcare
is one of them.Share
03:43
So having a good functioning
healthcare
services, access to appropriate drugs, access to hospitals, doctors, technologies, innovation and so on which is the component of healthcare
is only one of many other determinants that impact people's health.Share
04:02
So indeed over the last 20 years, I have been more focused on the
healthcare
component in the sense that how we can improve the functioning of healthcare
system to maximise the health of a population, knowing that health is also the determined by other factors.Share
04:19
And again through pandemic experience more than ever, it has become so clear what these other factors are and how the health of humans is connected also with other type of health, those of animals, those of our planet, and how the factors like peace and security, food supply, access to clear water, education, income, access to correct information, social behaviour, how all of this influence the level of health of individuals and populations which are beyond having a good functioning
healthcare
system which can only do the part of the story.Share
Virginia Stagni
04:57
Absolutely. I think this is such an important point because it leads quite nicely to what we are seeing. It's very interesting for generally the
FT
Talent and the Financial Times
audience. But it is all the relations that we have between policy making and all these complex systems, one of which is definitely the healthcare
one.Share
05:16
And secondly, one other point I think is about technology. I would like to ask you Aleksandra, what is your perspective when it comes to the collateral damage to the environment that of course technologic innovation sometimes is causing, but as well technological innovation is improving?
Share
05:31
How can policy in a certain way balance all these tensions that we see in innovation, potentially both hurting and helping our goals for better health and
healthcare
system?Share
Aleksandra Torbica
05:45
It's a rather complex, I would say a million dollar question because indeed finding this balance is very, very challenging.
Share
05:52
I think that the first step, and this is something that we have been arguing for the work that we have done in the Pan-European Commission for Health and Sustainable Development is to define and acknowledge this interconnectedness between the human health, animal health and planet health. Under the framework of one health concept.
Share
06:10
Which is not a new concept, it's something that has been around for decades, but it was more academic issue that scholars have been debating about, but in the policy making, in the real world, in the real life decisions, we haven't seen so many examples of actual application of this concept.
Share
06:27
So, by embracing the concept of one health, in which the barriers between environment, animal and human health are overcome we can also include the way we evaluate technologies that can on one side help us make these connections. Think about digital health solutions that can track links between human, animal and planet health.
Share
06:48
But on the other side when we evaluate technologies before because policy makers have a great responsibility of setting the criteria how to value technologies that come to the market, even
healthcare
, we have systems of course evaluation even more than in other sectors because patients and populations have to have access to safe technologies.Share
Virginia Stagni
07:10
I would love to ask you something about the career approach into the health world. Basically when we are looking as well at the technology and definitely the use of data, big data when it comes to
healthcare
policy, it's an integral part of the policy making process.Share
07:28
If you had to recommend the kind of skills that someone should, you know, learn and nurture to really enter in this complex industry, what would you say in terms of data and tech?
Share
Aleksandra Torbica
07:40
It has become evident again also through the experience of this global challenge brought by
Coronavirus
, how much, you know, the data are important and I think that somebody said that this pandemic is the most measured event ever in human history and we have collected so many data in order to inform policy.Share
07:60
So the capacities and competencies to analyze data, to interpret them, to make them useful and then to inform decisions whether they're business decisions or policy decisions, I think that's a key competence that in the future will be increasingly, it has been always requested, but now with all these opportunities with the technological innovation to collect data, big data, artificial intelligence, data scientists the way that we call them in order to analyse this data and again provide.
Share
08:29
But a word of caution I would like to share because the risk is that once we are so concerned about technical expertise, so you know algorithms and you know all the things we need to know in order to analyse correctly the data, construct the databases and use these tools, there is a risk of losing the big picture.
Share
08:49
And the big picture in
healthcare
is really this 360° understanding of the context in which these data are being analysed and what are they for.Share
08:59
So the interpretation of the data, how to read the information that we have available and how to use this evaluation in order to inform policy making, this is something that I have always be striving for also in my research.
Share
09:12
To do research that at the end could actually make the difference, inform the real life decisions. Technical competences, which also my university has been invested a lot in the last years in order to train the new generations of professionals with these technical skills.
Share
09:28
I welcome that a lot but I also welcome that these competencies are somehow complemented with a more specific knowledge about the context in which they will be applied to.
Share
09:39
And health and
healthcare
provides a lot of opportunities but a lot of challenges as well if they're not properly studied and understood because health and healthcare
are different from other market or economic sectors in which we can apply these competencies.Share
Virginia Stagni
09:54
When you add to work with very different people from so many diverse backgrounds, how did you go working with these different mindsets and different people and would you have any suggestions for someone that is approaching the
healthcare
system as much as any other complex systems and needs to have these open mindfulness approach to work with diverse backgrounds?Share
Aleksandra Torbica
10:17
I'll be completely honest with you Virginia when I was invited by the President,
Mario Monti
, Who
you may know is the ex prime minister of Italy and has been a European Commissioner, to be his advisor on this Pan-European Commission for Health and Sustainable Development endorsed by the WHO
Europe.Share
10:35
And when I started that fascinating journey, it seemed to me like closing the circle in my professional career in a rich way. I have spent 20 years or so of my academic life teaching health economics, health are management, health policy mainly to the medical profession. Telling to medical doctors, pharmacists, people working in the system, working for the
healthcare
system and also people working for the healthcare
industry but indeed focused on market access issues and so on of the technologies about the importance of economics and management and policies, social science component to improve the functioning of the health care system.Share
11:15
So somehow economies, teaching medical doctors about important of numbers on the other side, you know, I found myself in this commission to the economist, finance people with the top level. somehow I was the only one or one of the few, there were some representatives again in the scientific board that also some commissions that had medical background, about the importance of health for the economy.
Share
11:39
So it was the loop that I found really fascinating.
Share
11:42
So as soon as I felt that there is space for my ideas and my thought, I took that space and you know, I got the courage to make proposals and I was fortunate enough to have the support also of this prestigious group.
Share
11:57
At the end of the day, I really figured that it's true, it may be scary sometimes that you feel you will not be able to contribute, but then it's all about, you know, starting. It may not be successful every time, but at least you start the discussion not fearing it's going to be a failure and in that sense, you know, you gain confidence because you find on the other side really the openness and this open minded approach from both sides and building the bridges between disciplines in order to tackle the complex issues because that's the only way.
Share
12:29
There is no one single discipline that can really face what we are facing in health. That was somehow for me again an eye-opener that allowed me to make this translation and conversation in different languages
Share
Virginia Stagni
12:43
And I think this is such an important skill that sometimes is very hard to acquire and nurture, but I think once you get how to communicate with different people from different backgrounds and being able to walk in their shoes, it's not just a matter of professional relations, but it's also a matter of human relations. And I think this is really important when we're talking about empathic leadership and how to be able to influence people.
Share
13:08
I would love to ask you how would you recommend for those beginning their career, how they can be open to unexpected opportunities and also be flexible with the changing their minds?
Share
Aleksandra Torbica
13:20
It's true that, you know, and this is the advice for our young listeners that you need to find your trigger, your niche, your passion, something that really fascinates you, drives you motivates you.
Share
13:32
So, you know, the topic, the field for me it was, as I said, health. However, within this drive, within this motivation, be prepared to open your eyes, open your hearts to the new opportunities because things will change in life.
Share
13:47
There are so many things that we cannot predict and we have learned that even very well over the past few years. What is important and once again this is something I learned may be exposed, is really to understand what are your values.
Share
13:60
So whether it's, for example, like in my case, it was really about contribution to the society, making the difference, trying to be, you know, as rigorous as excellent in my sector as possible, using scientific knowledge to make the difference in real life.
Share
14:18
So finding the values that drive your choices, your career choice may change, but if you stick to your values you will not have the fear to make these changes and make, you know, take the new road, because you will have this guiding principles that will put you in a safe place.
Share
Virginia Stagni
14:35
What is something that new job seekers most of the time think it's true about the health industry, but isn't?
Share
Aleksandra Torbica
14:41
Once again, I may be biased, but I really think that those aspiring to work for the
healthcare
industry, not only should be concerned about the technical competencies of a specific function they want to cover, but even more importantly about, again, the sector in which that company operates.Share
14:60
So it is not true that you can, just you know, a one size fits all type of approach apply some of these competences, because understanding the context, for example, knowing much more about the public sector, which is one of the main stakeholders of the
healthcare
industry, being the healthcare
industry the most regulated industry of all economic sectors, because of the different reasons that I'm not going to into today.Share
15:24
Understanding the reasons underlying this regulation and the limits that the health care industry has in order to operate in the market, because of some public goals that it has to pursue, is the key.
Share
15:37
So again, we are coming back to the very first point about a really, really important awareness about combining the technical competencies or something specific to a more general knowledge about the context in which this competence will be applied.
Share
15:53
For the
healthcare
industry it may also required again, knowing about, for example, about how government functions, which is not necessarily in the minds of young professionals who would like to conspire a more business-oriented career in this field.Share
Virginia Stagni
16:07
Now it's time for questions. If there is something a bit unique about this Talent Show podcast is that we are welcoming our early career professional students directly in the podcast show to ask our experts their questions and we have two challengers, Samuel and Francesca that do have some questions.
Share
16:25
So Samuel does have a question for you.
Share
Samuel
16:29
My question to Professor Aleksandra is: what are the most exciting
healthcare
technology innovations that you've been keeping your eye on?Share
Aleksandra Torbica
16:36
Thank you Samuel for this question. Indeed, the recent years have seen really the boost in technological innovations in health care and there is a range of them. Some of them I've had the opportunity already to work on also in my research.
Share
16:52
I would say that what fascinates me the most in the recent here's was the application of artificial intelligence to
healthcare
. So the support to medical doctors, professionals to make decisions based on these tools is something that will definitely revolutionise the way we operate within the hospitals or healthcare
providers in general.Share
17:17
Recent years have seen this rapid development in artificial intelligence technologies and I think this trend will continue with more diffused applications in health and
healthcare
.Share
17:27
This technology gives enormous opportunities but again also has a lot of challenges because again, in terms of implementation, in terms of you know, where you draw the boundaries in the use of these type of tools in order to treat patients and make decisions about the patients and so on.
Share
17:43
So far we have seen it applied mainly to diagnostics and detection of diseases. So to assist discovering a disease using the data available, the big data, but I think this will have much broader applications in the future and needs to be assessed and managed appropriately in order to have its full potential.
Share
18:03
So if I had to name one, I would really talk about artificial intelligence and although, you know, also machine learning tools that are used in order to apply it to the
healthcare
sector.Share
18:14
Thank you Aleksandra, and our second question is coming from Francesca Giovanni.
Share
Francesca
18:19
How can digital health make a difference to tackle the issues of our century, from social inequality to climate change through the one health approach? How can we make the most of it to invest in prevention and early intervention? Thanks and looking forward to hearing from you.
Share
Aleksandra Torbica
18:36
Thank you Francesca. Again, it's a very, very important question. It has many sub questions in it because we talk about equity and the qualities. We talk about the connection between the human, animal and environmental health. So let me just address one of those.
Share
18:51
I think that the digital innovation and digital health can really be the most powerful tool we had so far also to address inequity of access, for example, to health care services in the population.
Share
19:03
While 10 years ago we would talk about digital divide and we will talk about the fact that not all the population had access to digital technologies, there still may be some generation issues, but if you think about today, even in the lowest middle-income countries access to cell phones, so to potentially some apps that can be downloaded on a smartphone, is much, much, much higher.
Share
19:25
So having you know, the opportunity to reach and to get to the patients, to the people, to the community through the digital technologies can really be the booster of increasing equity of access.
Share
19:39
So addressing inequities within society that we observe and we have observed a lot with pandemic. On the other side, these tools can be used again to connect the flows of information about human, animal, environmental health as we have also seen in our
FT
Challenge when we had some brilliant ideas about the startups in low and middle income countries on how these technologies can serve for this purpose.Share
20:04
Where you can use the platform, just thinking of the winner's solution, in order to connect information about, you know, some specific viruses that can, you know, jump from animals to humans. About environmental related health risks in the community.
Share
20:18
Digital technologies can really be a tool, first of all to increase awareness about this, which is already a very first but very important step and then actually as an instrument really to operationalize the concept of one health by bringing this data together.
Share
Virginia Stagni
20:35
Aleksandra, thanks for being part of the talent show and of course about your insights and anything that our listeners wants to know more about your research, your career as well as your expertise, don't hesitate of course to tap into our podcast links to give you all the full understanding of what we just discussed. And of course of Aleksandra; s interests and the researchers.
Share
20:58
Thank you so much Aleksandra for being with us, it's been a pleasure and up to the next episodes.
Share
Aleksandra Torbica
21:03
Thank you so much Virginia for hosting me. It was an absolute pleasure and up to the next location, Thank you.
Share
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Virginia Stagni
Aleksandra Torbica
Samuel
Francesca