A View on the Future of Health Systems Governance: A Q&A with Nino Kharaishvili

Health systems today face complex challenges. 

Emerging and evolving science and technology drive constant change in models of care and health services delivery. Burgeoning data sets make the task of interrogating, interpreting, and using that data to optimize operations ever more complex. Growing populations, changing demographics and communicable and non-communicable diseases that continue to flourish in our communities are pressuring service capacity and budgets. 

Current and upcoming global health crises have triggered vital discussions about the complexity of supply chain networks and the health defense of countries. These situations emphasize the critical need for advanced biomedical education and research infrastructures, as well as domestic production capacities in the pharmaceutical sector within an integrated healthcare framework. Moreover, they underscore the significance of essential service providers, including water utilities and public transportation systems, in maintaining the health and prosperity of communities. 

Around the globe, we’re helping clients face these challenges head-on, reimagining approaches to create and sustain, well-functioning, thriving and resilient health systems and contributing to personal, societal and economic wellbeing with help of our teammates like Dr. Nino Kharaishvili, our global solutions director of health systems governance. In this Q&A, we connect with Nino to discuss the trends and opportunities ahead for health systems in the future.  

Tell us a bit about what a day in the life is like as Jacobs Global Solutions Director for Health Systems Governance, and what we offer to our clients in this area. 

My role focuses on improving health outcomes globally and enhancing the systems that countries use to implement better policies, programs, activities for health systems. I partner with government  entities, healthcare agencies, hospital leadership and public health authorities to identify the most effective and efficient ways to deliver health services in a particular geography. Lucky for me, I’m very passionate about this work and the impact it can have on the world around us. 

Right now, we’re working with clients on the vital issue of global health security, which is an interesting intersection of national security and health events. As we witnessed with COVID-19, pandemics and other major health events have the potential to cause havoc within a country. So, we’re working on ways to predict and prevent those events, getting the right data to decision makers and policy makers, and putting solutions into place before an event occurs. 

We’re also working to incorporate health topics into the climate dialogue. Climate is a critical conversation, of course, but health issues are just now gaining more traction in this area. For example, the United Nations COP28 forum included Global Health Day for the first time. Now, we’re seeing more discussions around the health effects of climate events and work with our clients to anticipate, prepare and recover from those effects. 

What are the biggest challenges for health system governance?  

Countries face different challenges in their health systems governance and require tailored approaches to solve them. Sometimes the solution is a policy framework, or a risk or vulnerability assessment to understand the potential occurrence of adverse events, or workforce development and training assistance – no one size fits all.  

Policy makers around the world need more information about the impacts of certain health events so they can make the best decisions for their countries. They need to decide how to allocate funds, how to arrange their response teams to prepare for events, and which best practices to implement to protect their citizens. There’s a lot of confusion around the best ways to deploy systems, what resources you need to allocate and where, and how to go about making effective policy.  

Speaking of these policy needs, how are you helping our clients think differently to respond to future challenges? 

We’re living in an interesting era  with the major health, climate events and social-economic disruptions all testing the capacity of our health systems and giving the resilience concept another level of importance. 

To address the complex operational environment for health systems, we offer a health system resilience framework organized into eight solutions-based core competencies. We use this framework to offer comprehensive services and address challenges ranging from facilities to operational continuity, to policy frameworks, to technology services, among others. We believe that by improving our clients’ resilience we will minimize economic loss and impact on affected communities. 

There’s tremendous potential to help our clients and make a difference, particularly when it comes to understanding the intersection of health and other focus areas like climate response or infrastructure modernization.  

What are the biggest opportunities ahead in health systems governance?  

We can learn a lot from more mature markets or even other locations in the world about what’s working and how we can adapt those solutions to deliver what our clients need for the future. There’s no better example of this than the COVID-19 response.  

For example, we worked with FasterCures, a center of the Milken Institute to collect insights from more than 20 countries and identify success factors in their response to the global health event. Our research identified overlooked factors that helped lead to positive outcomes in countries across Asia, Africa and Central & South America and also provided recommendations that policymakers can explore to improve pandemic preparedness and global health security. Elsewhere, we turned to data solutions to monitor and track the true spread of COVID-19 in community wastewater systems. 

Learning from and adapting successes from other markets and regions, especially with innovative and data-driven solutions, helps keep our clients resilient to the health security challenges of the future.  

You mentioned data-driven solutions and helping clients stay ahead. Where do you see the industry heading?  

We’re seeing more clients take interest in improving health data science using massive data lakes of structured and unstructured data to predict certain events. Discovering insights through data analytics and applying that knowledge with business intelligence provides decision-makers with competent and reliable information needed to move faster and make good decisions for their infrastructure, patients and communities. Of course, the widespread adoption of artificial intelligence is allowing organizations to analyze novel and complex datasets with unprecedented scalability.  

In addition to predicting future events, data can also provide holistic simulations of buildings, like hospitals or care clinics, before they’re built. Data-driven models and design give infrastructure owners an opportunity to test their future operations before implementation, ensuring they deliver the best care and results for the future.  

Health systems are a core part of societal wellbeing. Is there a project you’re particularly proud of?  

We recently secured a contract to develop a National Biosurveillance Network strategic case with the Health Security Agency of the U.K. Central Government. We'll be developing a strategic outline for how to react to biological events, either naturally occurring or humanmade. that occur in U.K. territory. This project will also contribute to global standards for the future by providing new information, more data, and advances in learning and strategic planning.  

We’re also working globally to make healthcare and opportunities for good health and wellbeing more accessible to all, eliminating disparities and improving social determinants. In this field, every step we take, every policy we shape, and every patient we serve contributes to a fairer, healthier world – and that’s an opportunity that makes me very proud.