Putting Purpose into Action: Global Healthcare Access

ADDING BUSINESS VALUE

Our business success depends on our ability to make our products and therapies accessible to the patients who need them. We are working to improve the availability and affordability of our products by forming partnerships around new healthcare models and investing in critical skills and infrastructure. Our approach benefits society by increasing access to essential healthcare for underserved communities.

EXPANDING ACCESS TO QUALITY HEALTHCARE

Fulfilling our Mission requires that our products be accessible to as many people as possible. In FY20, we contributed to positive health outcomes for more than 72 million patients, but millions more still lack access to essential treatment.

We improve access to our products by developing innovative treatments for unmet healthcare needs, partnering with others to deliver new healthcare models and solutions, and investing in education and skills.

TECHNOLOGY  INNOVATION

We invest in meaningful innovation that will make a difference to patients and healthcare systems globally. We maintain a strong product pipeline by developing novel applications of existing technologies, investing in emerging innovations, and exploring new materials. The potential for medical technology to improve health outcomes is nearly boundless. We harness that potential to develop and deliver effective products and therapies to market.

Our current focus areas include:

• Robotics — for improving clinical outcomes, standardizing therapy delivery, and assisting with  clinical decision workflow
• Artificial intelligence (AI) and machine learning —  for a range of applications, including visual computing  to aid clinical decisions and deep learning algorithms  that adapt to patient needs
• Simulation and modeling — to develop validated methods in partnership with regulators and clinicians,  enabling innovations to get to market faster
• Remote innovation — in response to the COVID-19 pandemic, we increased our focus on virtual and remote innovation, helping to maintain access to vital care while reducing exposure for patients and healthcare professionals

Research and clinical trials

We develop and test potential new solutions through a rigorous process of design, development, preclinical,  and clinical studies.

Our development processes include predictive technology to enhance our understanding of how a product will work in the field. We generate cost-effective evidence using advanced statistical methodology and modeling simulations, while also bringing promising innovations to clinical trials. Our focus, however, remains on safety and effectiveness, always with the patient experience and outcomes at the center.

FY20 highlights include:

• Initiating a worldwide pivotal study to evaluate our Extravascular ICD, a novel implantable defibrillator system with a lead placed outside the heart and veins.
• Advancing work to help tackle the opioid crisis by developing innovative pain management therapies, including targeted drug delivery and a novel approach to spinal cord stimulation, both for the treatment of chronic pain.

New products

Selected new product launches in FY20 include:

• The CareLink SmartSyncTM Device Manager allows physicians to program and download data from compatible cardiac implants using an iPad
• GI Genius Intelligent Endoscopy Module, offered through a strategic partnership with Cosmo Pharmaceuticals, is an AI-enhanced endoscopy system designed to detect colorectal polyps. This device is CE-marked and was launched in selected European markets. GI Genius does not have U.S. Food and Drug Administration approval or clearance and therefore is not available for sale in the United States.
• Micra™ AV is the world’s smallest pacemaker with atrioventricular (AV) synchrony providing a leadless and minimally invasive implant procedure option for patients with AV block.

Read more about our new FY20 products at the Medtronic Newsroom.                   

Partnerships for innovation

Partnership and collaboration play an essential role in enabling us to find and extend innovative solutions to local and global health challenges. FY20 highlights include:

• Continued contributions as a core partner in the European Institute of Innovation and Technology (EIT) health consortium, with a focus on innovation and business creation
• A strategic distribution partnership with Viz.ai for its applied AI software to help synchronize stroke care — potentially saving time and increasing access to lifesaving stroke treatments

DEVELOPING AFFORDABLE, SUSTAINABLE HEALTHCARE MODELS

Affordability is just as important to improving access as the physical availability of a product or service, because the best treatment options are sometimes financially inaccessible for patients and healthcare providers. Driven by our Mission, our goal is to make medical technology available to any patient in the world, and we develop specific pricing programs and policies to enable this. We are creating new healthcare models — based on value, efficiency, and outcomes — that narrow the gap between what is available and what is affordable. Our pricing takes into account local structures and healthcare systems including the economic value that our products generate for the healthcare system, as well as market dynamics. We aim to price our products fairly and reasonably, and we offer a variety of pricing models, including:

• Volume pricing or rebate options for hospitals
• Adaptive pricing for treating long-term conditions
• Programs to assist new and existing patients

We provide a range of price points across a given technology portfolio to match different affordability levels and willingness to pay for the same technology.

Value-based healthcare

Healthcare providers, governments, and payers are under pressure to improve patient outcomes and reduce costs. Traditional models of payment by volume of product or therapy do not incentivize value. We believe the solution lies in a transition to value-based healthcare (VBHC) models. VBHC is an integrated approach to combining products, services, and solutions that improve patient outcomes per dollar spent in the healthcare system. Value is measured by long-term patient outcomes rather than short-term transactions.

The value-based approach is gaining traction globally, and to accelerate this transformation we continue to collaborate with others and advocate the advantages of this model.

In FY20, we organized the first public-private sector roundtable on VBHC at the June G20 meeting in Japan, followed by a larger session at the January G20 meeting in Saudi Arabia. This led to decisions by the G20 governments to have a continual focus and dialogue on VBHC matters. We also focused on VBHC during a meeting we hosted at the United Nations High-Level Meeting on Universal Health Coverage.

As COVID-19 has profoundly changed the future for payers, health systems, and Medtronic, VBHC presents the opportunity to positively rethink how we define value and design programs to meet the challenges created by the pandemic.                                                                                                        

EXPANDING GLOBAL HEALTHCARE ACCESS

Healthcare is advancing every day, but the benefits of these developments are not shared equally. Too many people still do not have access to the products, treatments, and services that are standard care for others. This is particularly true for preventing, detecting, and treating noncommunicable diseases.

We work across healthcare pathways to develop and scale programs that expand access to our products and services in underserved communities.

Medtronic Care Management Services

Remote health monitoring through digital platforms and telehealth offers a cost-effective7 way to improve outcomes8 and engage patients in monitoring their own symptoms and health data.

Medtronic Care Management Services (MCMS) offers remote patient monitoring that combines care management services with patient engagement solutions, data analytics, and reporting. MCMS works with health systems, post-acute care providers, and health plans to integrate and scale monitoring programs for patients with complex, chronic, comorbid conditions.

In FY20, MCMS responded to the COVID-19 pandemic by developing and launching two new remote monitoring solutions:

• The Respiratory Infectious Disease Health Check is designed for patients with chronic, comorbid health conditions at the highest risk of complications associated with COVID-19. It is included as an add-on to all MCMS remote monitoring programs. Patients can track their respiratory infectious disease symptoms and body temperature through daily health checks.
• The Medtronic COVID-19 Virtual Care Evaluation and Monitoring solution combines a virtual assistant symptom survey with a registered nurse command center. It provides assessment, remote monitoring, and recommendations for patients with potential COVID-19 symptoms, based on U.S. Centers for Disease Control and Prevention  (CDC) Guidelines. This stand-alone offering was designed for health systems, health plans, and large employers. It is also available to all U.S.- and Puerto Rico-based Medtronic employees and their eligible dependents.

MCMS will continue to invest in technologies to transform healthcare systems and the virtualization of care — focusing on home-based connectivity and high-quality, impactful clinical decision-making.

Patient access acceleration and insights

We quantify treatment needs and uncover key barriers to access in developed and emerging markets using our data-driven Patient Access Acceleration (PAA) methodology.

PAA insights help remove barriers by guiding our market development strategy and driving investment in key areas to remove those barriers — including evidence generation, economic coverage expansion, capacity building, training and education, and disease and therapy awareness.

We combine data each year from thousands of PAA assessments across countries and therapies, applying what we learn to improve planning and reduce risks associated with future market development investments.

Our Patient Access Insights (PAI) consulting service identifies local needs and barriers to access and informs the development of appropriate solutions.

We partner with hospitals around the world to apply PAI  to specific services and pathways of care. Going forward, we aim to leverage our PAI service to better inform focus areas for our partnerships with hospitals.

Capacity building

With medical knowledge currently estimated to double every 73 days,9 it can be challenging for professionals and patients to stay on top of the latest developments.

We contribute to the collective knowledge of the healthcare ecosystem by supporting and delivering capacity-building and training programs. Continuous learning and upskilling contribute to better patient outcomes, more efficient health systems, and improved access to healthcare.

Examples of our capacity-building work in FY20 include:

• Partnering with the Endoscopic and Laparoscopic Surgeons of Asia (ELSA), we launched a webinar series to update their 2,550 members on the latest surgical knowledge and interventions.
• Launching a patient-focused obesity education platform in Australia and New Zealand designed to combat myths about obesity and empower people to start conversations with their physicians.
• Spearheading the Ventilator Training Alliance app in response to the COVID-19 pandemic. The app is free to download and contains training videos and manuals for all ventilator types by all major manufacturers, including Medtronic.

In FY20 and into FY21 we will continue exploring new options for remote and virtual learning capabilities  so we can continue to offer capacity building and knowledge sharing for healthcare professionals during COVID-19.

Medtronic LABS

Medtronic LABS is a social impact business, funded by the Medtronic Foundation. Medtronic LABS works to expand access to healthcare for underserved patients, families, and communities across the world, with a focus on financially sustainable solutions that maximize social impact. It designs healthcare delivery models that integrate digital and product technologies across the care continuum.

• Medtronic LABS solutions are built upon five principles:
• Design with and for communities to address local barriers across the care continuum
• Employ evidence-based practices and protocols for uncompromised clinical excellence
• Address the social determinants at the root of  poor health
• Integrate digital and product technologies for high-tech, high-touch models of care
• Innovate operational models that enable efficiency at scale

Building on progress in FY20, Medtronic LABS will continue to expand its three current programs through partnerships — with local technology entrepreneurs, healthcare providers, NGOs, governments, and other stakeholders — to amplify impact and scale.

Medtronic LABS is currently assessing modifications to its programs as a result of COVID-19. Its focus on innovative technology, including telemedicine and remote monitoring, means the business is well-positioned to adapt in the wake of the pandemic.                                                                                                                                                                                                                            

Public-private partnerships

Public-private partnerships play an important role in increasing patient access to our products and services in new markets around the world. We pursue partnerships that address gaps in healthcare, guided by the Medtronic Public-Private Partnership Council. Our aim is to develop longer-term contracts that enable sustainable, scalable projects and programs in four areas:

• R&D
• Manufacturing for market access
• Clinical training and education
• Health system strengthening

In FY20, for example, we initiated a partnership to enhance clinical training and education in a sub-Saharan country. The partnership enables surgeons to develop existing laparoscopic skills, with a focus on general surgery and gynecology. Participants access an e-curriculum for training on basic laparoscopy before moving to hands-on learning. The program also provides surgical equipment and simulators, with ongoing maintenance services. This ensures that the trained surgeons have working equipment available to use with their newly acquired skills.

ADVOCATING FOR INCREASED ACCESS AND AWARENESS

Healthcare systems are complex and evolving. Sustained, collaborative effort is often necessary to remove systemic barriers to change and to develop new opportunities.

We engage with governments and other organizations to advocate for improved access to essential treatment and add our voice to the debate on key healthcare issues.

In FY20, Medtronic participated in the first United Nations High-Level Meeting on universal healthcare coverage, the most significant political meeting on the issue to date. World leaders made a shared political declaration recognizing that all people should have access to high-quality, affordable healthcare — a vision Medtronic shares. Omar Ishrak, our CEO at the time, was the only private-sector representative to serve as a panelist at the meeting. Medtronic sponsored a side event on VBHC and universal healthcare coverage, attended by representatives from governments, businesses, and key international nongovernmental organizations. We also held one-to-one meetings with government officials to advance public-private partnerships aimed at expanding healthcare access.

Read the full report.