‘Who will fix the future of healthcare?’ A reflection on the need for cross-disciplinary collaboration

Asli Kalin, GP and Academic Clinical Fellow, reports from a Pilot Foresight workshop, held on Monday 25 March 2019 at Green Templeton College:

In an era where specialising is becoming the norm and starting as early as high school, where most career moves involve narrowing down one’s expertise even further, and where the wealth of knowledge is only ever-increasing, professionals are paradoxically becoming more disconnected in a supposedly ultra-connected world.

How do we overcome this problem? How do we ensure that we are helping to build a community of people, policy makers and professionals who have enough breadth of knowledge and experience to tackle issues that cross traditional boundaries? These were some of the questions that were discussed at the pilot Foresight Event held at Green Templeton. It soon became apparent that the issue of the future of healthcare is so complex and broad that no one discipline, or group of individuals, is able to solve it alone. Instead it requires collaboration, communication and cross-disciplinary understanding. And the Foresight event was just that – the beginning of a conversation between people of different and diverse backgrounds.

I am a part-time clinician, clinical lead for a medical start-up that uses artificial intelligence to tackle antimicrobial resistance, and clinical academic with an interest in health technologies, health policy and global health. Unsurprisingly I spend a lot of my time in completely different settings and with people of different backgrounds. Whilst this comes with its challenges, the benefits are huge. After all, trying to understand the principles of Python whilst talking to a machine learning expert and those of health financing speaking to a health economist aren’t that different. The idea is to know enough about the subject to be able to communicate with these experts and make connections with the ‘bigger picture’. There is something hugely satisfying about being able to talk to such a diverse group of individuals who all bring to the table their very different ways of thinking and their wealth of experience and expertise.

This is also not too dissimilar to being a general practitioner coordinating the care of patients between specialties. Whilst specialty services are increasingly becoming more and more specialised (nowadays, you aren’t just a respiratory physician, you are a respiratory physician specialising in inflammatory causes of interstitial lung disease), patients are becoming increasingly more complex. Indeed, their syndromes and presenting complaints span systems and specialties. Adding onto this their co-morbidities, polypharmacy, and psycho-social problems, having a care giver who understands them as individuals not limited to one bodily system is hugely important and valuable.

So, how can Green Templeton College and the Foresight initiative help support individuals to appreciate and speak cross-disciplinary languages and understand the realities beyond their areas of expertise? Many ideas came about as a result of our day-long discussion. At their heart was a need for a space for people to share experiences (across systems, disciplines and perspectives), to learn from each other and to nurture and support future leaders.

Grounded in discussion from the day, my vision is of an ‘Oxford Health & Care Institute’ that could act as a global ‘hub’, bringing together world leaders in healthcare, policy-makers, government officials, health activists and patient groups. This wealth of global knowledge and experience would be combined with Oxford’s own expertise in the multitude of disciplines which span health and care. It would be a place where both success stories and failures are shared and where insight can be gained and transferred. This shared expertise would then be used to inform health and care across the globe. I have no doubt that this vision would be enthusiastically embraced by many policymakers and health and care professionals.

Having regular talks and events by experts from other industries and organisations at our local hospitals would expose our medical students and local healthcare professionals to what exists beyond their daily routine. This would trigger ideas and questions which can only arise when one is exposed to completely different perspectives. This goes the other way too. Could healthcare institutions such as hospitals and GP practices host people from other disciplines? This is paramount if we are ever hoping to tackle the wider determinants of health. Wouldn’t it be powerful if someone working in the housing sector of the government had witnessed the journey of a homeless patient?

The future of healthcare holds many challenges and initiatives such as Foresight which set a platform for dialogue and cross-collaboration will be the key to address these. They will also be central in developing those ‘generalists’ who can build a good understanding of the overall puzzle which is healthcare whilst being able to focus on each piece as and when required.

As I left the grounds of Green Templeton College with the fresh evening breeze of spring gently on my face, I remembered my colleague’s message from the morning: ‘You didn’t make it in today.’ I had replied to her that I was at a healthcare conference and would be away from the practice for the day. Foresight had been much more than that. And whilst my answer didn’t do justice to what I had been up to, I left feeling blessed to have interacted with and learnt from such a diverse and inspiring group of people.

Asli Kalin, GP and Academic Clinical Fellow
29 March 2019