40-year career journey from pharmacy student to Chairman of the Board of OptiMedis AG

I began my career in the healthcare arena 40 years ago. I hold a pharmacy diploma from Philipps-University, Marburg, Germany, but instead of working in pharmacies I decided to concentrate on community work and prevention. I used my civil service after the diploma to build up an adventure playground for children in a poor area of Frankfurt and through that I came into contact with similar ideas within the World Health Organisation (Copenhagen) under the developing concept of health promotion.

In 1984 I used the chance of an extended study tour to the US to do research across a range of community health and self-help initiatives to study the early forms of managed care. Afterwards I worked in health sciences with the University of Hamburg and supported WHO in developing the so-called ‘settings concepts of health promotion’ (Health Cities, Health Promoting Hospitals, Health Promoting Working Places and so on). To actively engage in these activities, I decided go into politics – I became elected as representative for the city council of Hamburg for two years- and also took a risk with private entrepreneurship and built up my own consultancy company Hildebrandt GesundheitsConsult GmbH. The latter worked with hospitals, sickness funds, health insurances, physician networks, pharmaceutical and biomedical companies, ministries and many others, but exclusively in the health care arena.

During this time, (1994 to 1997) I formed an international joint venture with a Californian based consultancy to strengthen international knowledge exchange. More and more I realised the problems of the sectoral segregation of health care and prevention. I tried to develop better integrated regional settings but failed through the wrong incentives that were in place in the sectoral organisation of health care in Germany.

In 1999, I was lucky to be able to be offered the chance to consult the then new German Health Minister Andrea Fischer to help introduce the possibility of specific managed care contracting into the German healthcare law.

In my current role is Chairman of the Board of OptiMedis AG, an integrated care management company, located in Hamburg, in Germany, I concentrate exclusively on the development and the management of integrated care (delivery) systems and the research and development that is needed to fulfil its potential to improve the quality, the people-centredness and the sustainability of health care. OptiMedis AG is partly owned by staff and a social investment company, but I am the majority shareholder. We co-operate with doctors, hospitals, health insurance funds, and the social associations and community initiatives to provide entire regions with integrated (full-service) healthcare solutions. Its remit includes analysis of healthcare data and independent, data-based real-life care research. Results are made available for the integrated provision of healthcare services.

Our oldest project is ‘Gesundes Kinzigtal’. It got quite a huge interest internationally because we have operated it for 13 years and have been successful in developing better health at a lower-costs and with high patient satisfaction (the triple aim) and provider satisfaction (quadruple aim). Gesundes Kinzigtal GmbH is a health care management company based in the small German town of Hausach, which operates a regional integrated care system (Integrierte Versorgung Gesundes Kinzigtal – IVGK), and is accountable for all health care outcomes of the around 33,000 people in that region who are insured by the public health insurance companies AOK and LKK Baden-Württemberg.

How do you continue to advance policy and research on integrated care in your current role?

We lecture and publish a lot on our work – nationally and internationally – and work together with more than twenty universities to advance policy and research on integrated care. Currently we are involved in four EC-funded research projects and several others funded by German foundations and ministries. In OptiMedis my friend and colleague Dr. Oliver Groene is head of research, but I am strongly involved in several projects as well. One of my favourite activities is connecting with students and young professionals to ensure I stay alert for their ideas and initiatives.

How do you stay relevant in integrated care research and practice?

Aside from these roles, I am also co-chair of the Heinrich Boell Foundation, a policy thinktank aligned with the Green Party in Germany; a board member of the German Managed Care Association (BMC) and the International Foundation for Integrated Care. I have also published more than 100 papers on health and disease management; managed care; health care policy and integrated delivery systems.

What do you think helped you get here?

Curiosity in new ideas and a strong feeling towards the negative side effects of our current health systems and the negative consequences for the individuals resulting out of the false economic incentives in our systems and the commercial interests damaging the health of our populations.

In your scope of work, what do jobs in integrated care research/policy look like? Where should a young professional or junior researcher interested in integrated care look for such jobs? E.g. Industry, hospitals, government, research institutes?

Health care and public health is such a complicated and regulated sphere, that young professionals or junior researchers should try to connect with institutions linked to health care as much as possible. Only from inside these institutions can the real (and mostly wrong) incentives be realised. Besides industry, hospitals, government, insurances and provider associations, some time in consulting companies would be helpful as well. Research institutes are useful to get real-world training in methodology but often lack a certain insight into the incentives in the different sectors.

Is there something you know now that you wish you knew when you were starting out in the field of integrated care?

Stay curious and ‘hungry’ for the real change, and don´t give up your passion for the improvement of public health and our health systems. Hopefully we all will earn the profits from it when we ourselves get old and maybe dependent on the health system ….

Dr Helmut Hildebrandt is the treasurer for IFIC and Chairman of the Board of OptiMedis AG and leading expert on Integrated Care.