Healthcare Innovations

How Health Care Ought to Change

Rather than parse the candidates boring, calculated to get funding and votes policies, the Institute for Alternative Futures is drafting its own idealistic policy. Four of the nine papers have already been published. Enjoy!

Institute for Alternative Futures.

IAF is looking forward to the 2008 U.S. Presidential Election with a forecasting project to guide those who will transform healthcare with clear and compelling descriptions of a system that works for all. Over the course of 2008, IAF will publish a series of papers addressing nine key transformations. Click on the papers outlined below to learn about key changes needed in our healthcare system to create a better healthcare system in 2019.

Innovation Starts at Home

One of the best ways to make innovation happen is to just start experimenting and trying out ideas. Nice to see it happening with Allina.

Allina Hospitals & Clinics establishes new Center for Healthcare Innovation. 2008-Jun-11 (press release)

Allina Hospitals & Clinics today announced it is creating a new, $100 million Center for Healthcare Innovation to support innovations in both clinical and population health research that can be translated to improved health for patients and the wider community.

The Allina Board of Directors has authorized a $50 million investment over the next five years, with $10 million to be invested annually. The organization intends to raise an additional $50 million over five years in partnership with private corporations, foundations and through sponsored research and grant-making organizations.

The Center will launch with three inaugural projects:

• The Heart of New Ulm is an innovative and visionary effort to eliminate heart attacks in the community of New Ulm, Minn. Today, nearly 90 percent of New Ulm residents are New Ulm Medical Center patients and therefore have a record in Allina's electronic medical record system. This level of participation by one community in the electronic record system provides an unparalleled and robust database for understanding population health and gives Allina the ability to identify patients at risk for cardiovascular disease, ensure they receive early and appropriate interventions, and track their care over time. Combined with public education and awareness, this project promises to go beyond identifying the causes of heart disease to focusing on early intervention and prevention. The
  
• The Backyard Project  Allina will extend its historic and long-time commitment to the Phillips and Powderhorn neighborhoods of Minneapolis to improve population health. Allina's system office, largest hospital, Abbott Northwestern, and only specialty eye hospital, Phillips Eye Institute, are all located in this diverse, but health-challenged neighborhood. Bringing together residents, researchers, policy makers, community leaders and others, Allina will forge new models for improving residents' health status and understanding how medical, social, educational and economic factors are interdependent and impact health in its own "backyard" neighborhoods.
  
  
• The Allina Center for Patient Safety Allina will create the "next level" of patient safety efforts by a health system, improving the quality of care and reducing the cost of error. The Center for Patient Safety will be a source of knowledge and information to strengthen cultures of safety across Allina. Through the Center, Allina will develop the leadership skills that build a stronger focus on quality and safety.

Innovation Floods out of the Cleveland Clinic

Time magazine did a big article about how much the Cleveland Clinic is doing to push medicine into an new level of effectiveness.

TIME: Medical Mouse Practice, 2008-Jun-5, by Kathleen Kingsbury

Placing exam-room computers on moving carts was an important early step, so that physicians didn't have to turn away from the patient to enter data into the terminal. This helped resolve a common patient complaint, that electronic records seem impersonal. Harris, a practicing general internist and a Wharton M.B.A., has used his clinical experience to foster innovation that directly benefits patients. The hospital's 3 million--plus patients can schedule appointments online, for example, and fill out paperwork on the Web before they get to the waiting room. Cleveland Clinic's specialists supply second opinions to patients worldwide who enter symptoms into an Internet form and then send test results to doctors via FedEx. Cardiologists silently, invisibly monitor patients' pacemakers and other implanted devices remotely to make sure they're functioning correctly.

Businessweek's Picks

BusinessWeek recently conferred with Larry Keeley, co-founder of innovation consulting firm Doblin, to figure out the most promising areas for innovation in healthcare:

• digital health records
• medical tourism
• concierge medicine
• predictive care
• genomics
• technology used to limit contagion
• culturally adapted treatments
• intervention to reduce unhealthy behaviors.

These are certainly areas which are receiving a lot of pressure to revolutionize healthcare. I suspect that some of them will turn out to be dead ends.

Fresh Eyes

At first, it sounds like a bad thing, get a temporary doctor as opposed to someone who knows you, but it many situations the doctor knows your chart more than he or her knows you anyway. I'm a big believer in bringing in "fresh eyes" to many jobs, and a temp may observe something that developed slowly and unnoticed.

Chicago Tribune: Rising number of temporary doctors. 2008-Jun-3, by Sarah Morgan (via HealthLeaders)

For doctors, working as a temp can be a way to escape some of the more tedious aspects of medical practice. A doctor can simply tell the agency in what state or what type of practice he or she wants to work, and the agency takes care of the rest: finding a placement; making sure the doctor is properly licensed in that state; arranging and paying for travel; finding accommodations in a hotel, apartment or house; and orienting the doctor to the hospital or medical group where they'll be practicing. The agency also covers the doctor's malpractice insurance. A placement can be anywhere from a few days to a few months.

"It sort of gets you off the treadmill of medical practice," said Phil Miller, spokesman for Staff Care. "You're basically focusing on the patients."

New Funding for Risky Ideas

The focus on "world-changing" ideas is less important than the acceptance of a high level of risk.

Houston Chronicle: Howard Hughes charity giving $600 million to 56 scientists. 2008-May-27, by Philip Rucker

The Howard Hughes Medical Institute is expanding its flagship investigators program to nurture a new class of scientists. By endowing their research over many years, the institute hopes they will make major discoveries in a variety of fields, including genetics and biology.

The scientists, chosen from more than 1,000 applicants, said they want to answer such ambitious questions as how global climate change affects the spread of cholera, malaria and other infectious diseases and whether doctors can apply the engineering behind the building of airplanes and computers to the human immune system.

Innovating the Medical Practice

I was going to post about Dr. Jay Parkinson six months ago, but I'm glad I waited because his story is much bigger now. Despite the snarky headline, the story below is very positive. Instead of joining the health care system, Parkinson tried to start a bare-bones practice in Brooklyn that took cash only, employed no staff, and relied heavily on internet technology. What he discovered was that he couldn't continue without some kind of record-keeping infrastructure. Now he has a new partner, Myca. I think the marketing plans are sort of scary. If I were them, I wouldn't spend anything on marketing until they have more of a track record. Guess they're scared of not covering fixed costs fast enough.

MDNG: Jay Parkinson Sells Out?, 2008-May-12, by Bill Schu

What he’s building now is a practice called Hello Health that looks and feels like his (no office staff , no waiting rooms, open communication lines directly with physicians and patients), but with several improvements that only a huge investment can provide. Parkinson says the patient and physician interfaces on the operating system are leagues beyond a traditional EMR. Hello Health will offer free generics to patients and by-the-minute appointments that physicians will travel to via Vespa scooter should a face-to-face be necessary.  Parkinson is nothing if not a master at marketing, and now with Myca’s resources at his disposal, the sky is the limit. Hello Health has enlisted the talents of the Barbarian Group, the marketing geniuses behind Burger King’s subservient chicken Web ads. But, according to Parkinson, the best feature of Hello Health may be the group’s unique takes on franchising, marketing, and quality, borrowed in part from other successful consumer brands, such as the car-rental service Zipcar and fast food chain Chick-fil-A.

Medicine for Communication

Although I forgot to post it when I found it, the slide show linked below is still an amazing compilation of efforts to improve communication both doctor-to-doctor and doctor-to-patient using the internet. It contains lots of individual juicy bits to follow up later. Hungarian Mesko is a big fan of the virtual reality site Second Life, but he keeps up with almost all web-related medical endeavors.

ScienceRoll: Web 2.0 and Medicine: The Slideshow. 2008-Feb-16, by Bertalan Meskó

"Medical professionals should take control of publishing medical information on the internet."

Required: New Ways to Organize Research

At some point (soon), medical research will have to invent new types of organizations because the existing ones are just overwhelmed. Read the whole article for lots of detail about what will be required.

Bio-IT World: Accelerating Intuition, 2008-May-7, by Catherine Varmazis

John Reynders, VP and CIO at Johnson & Johnson (J&J), said the “absolutely insane” amount of data being generated in the life sciences, and the heterogeneity of that data, require new ways of working and connecting with people. Specialists in all fields need to work in the “white space” between fields, and to collaborate more with colleagues within, and partners beyond, their organizations. “The company that thinks it’s sufficient to connect great minds behind its walls – well, it won’t be a great company for very long,” Reynders said.

Innovation Constrained by Status Quo

I hate to be a wet blanket but there's something creepy about this site, which is sponsored by Humana. So far the issues are being discussed are not disruptive and probably not significant. Well, they are still worth watching...

Innovation xChange

Do you want to improve the U.S. health care system? Or at least be part of the much-needed dialogue?

 

If you have ideas or solutions to improve the system, submit your ideas through ChangeNow4Health’s Innovation xChange and you can win up to $10,000 or have your ideas published in the e-book, Tomorrow’s Health Care.

 

The Innovation xChange is looking for practical ideas and suggestions for improving the health care system. All participants in the system, from providers and health plans to consumers and government, are encouraged to join in the discussion.