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Transforming Healthcare Delivery

Posted Nov 14 2010 7:57pm

So…life’s been really busy – which has meant a hiatus from the blog. Moving forward, I’m committed to making this more of a priority and looking forward to writing about a range of health-related topics – not just US healthcare reform.

A couple weeks ago, I had the opportunity to spend some time in the UK meeting with folks from several hospitals, including University Hospital of South Manchester , Milton Keynes Hospital and Great Ormond Street Hospital Charity . Fun story about Great Ormond Street Hospital – JM Barrie gave them the rights to Peter Pan, so they get royalties every time the play is performed .

The UK is focused on some exciting ideas around transforming healthcare delivery. They think about health from end-to-end – including everything from subsidized child care for poor families to social services to elder care to General Practitioners (GPs) to specialists to hospitals – and are working to align incentives and reimbursements with integrated care models. As they look to reform the system, the government is focused on two core principles: creating a marketplace for healthcare services – so market signals determine who gets paid what for healthcare and how capital is invested – and a patient-centric approach that includes a personally controlled health record.

The changes will be dramatic. The government has already announced a plan to give GPs responsibility – and funds – for commissioning care for patients in their area by buying treatment from hospitals, charities and other doctors. Folks are taking a collaborative approach to building out these integrated systems – at South Manchester, they’re pulling together officials from public health, the hospital and community GPs to figure out how to get started.

It’s going to be really interesting to watch this over the next two to three years. There’s every chance the UK will move much faster than the US to a health system that’s more focused on value.

Last week, I was in Washington, DC. It’s a trip I haven’t made in a while, and it was fun to be back. A highlight of the week was a meeting at the Pentagon – my first time there. It was great to see and honor those that serve – especially a couple days before Veterans Day.

I was in DC – along with about 2400 others – for the mHealth Summit . The event was filled with lots of buzz and excitement around the transformative possibilities of cheap mobile devices and connected services for healthcare around the world. Health is inherently mobile – it’s about decisions you make and actions you take as you live your life, so I’m optimistic that ‘mobile health’ will become an integrated part of our healthcare system. What I don’t know is whether it’s going to take three years or thirty years for us to get there. In the US, we need to transform the incentive system – so doctors don’t just get paid when patients come to their office – before broad adoption of mHealth will happen.

In DC, there was of course lots of conversation about the election and its impact on healthcare reform. It’s unclear how the politics will play out, but payment reform to create value and drive out waste is a bipartisan issue – Democrats and Republicans both see the need, though they disagree on the means.

I applaud the attention on new delivery and payment models for healthcare – in the US, through the creation of accountable care organizations (ACOs) and in the UK through GP-based commissioning.  Both models support a holistic, integrated, patient-centric view of health and recognize the need to get the incentives right. It seems like healthcare reform will enable and may potentially accelerate experimentation.

As we talk to customers around the world, it’s clear that they aren’t waiting for results from all these reform experiments. There’s a distinct focus on finding information technology tools now that help them understand how to manage the care of populations in a very different way – not just when patients visit their facilities.

  

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