Fresh perspectives in health care

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The topic of the 8th annual Connected Health Symposium was timely: Driving Quality Up and Costs Down:  New Technologies for an Era of Accountability.  Nevertheless, what made it a great conference were the fresh perspectives it brought to the fore.

Measurement, analysis, and communication are imperative

Brent James, the Chief Quality Officer at Intermountain Health Care, set the stage by describing how he and his employer, Intermountain, have succeeded in simultaneously improving health care quality and decreasing costs.  He credits this achievement to the incorporation of baseline protocols into the clinical workflow, followed by continuous improvement.

According to James, despite the explosion of knowledge and technology over the last 200 years, modern medicine has continued to rely on individual's judgment rather than measurement.  James observes that this ongoing dependence on subjective recall has led to tremendous variation in the practice of medicine, a paucity of valid clinical knowledge about best treatments, long lags between identification of best practice and its dissemination (more than 15 years), and a "striking inability to do what works".

The solution, James argued, is building standard baseline protocols into clinical workflows, which individual physicians are then free to override.  James says that this methodology is effective because standardization allows clinicians to spot what works-something they can't do when everyone practices medicine a different way.

Then, it's a matter of iteration.  Over time, employment of this process has helped Intermountain achieve better quality and lower costs than many of its larger, better-funded peers.

Better health depends on reducing income disparities

Next up was Kate Pickett, co-author of The Spirit Level: Why Greater Equality Makes Societies Stronger.  Her perspective is a macroeconomic one.

Drawing on a number of statistics, Pickett argued that income disparity is the most powerful predictor of health at a societal level.  Displaying chart after chart, she demonstrated that citizens of countries such as Denmark and Japan have better health, and life expectancies, than citizens of wealthier countries such as the US and the UK where the income gap, from richest to poorest, is greater.

In a follow up interview, she offered possible explanations.  Among these are that inequality erodes trust-and that people in lower strata of society experience anxiety and stress when they believe there is no hope of upward mobility.

Many more perspectives covered

This post summarizes some of the insights from the first two keynotes.  Over the course of two days, each presentation added a different way of looking at the issues related to improving health care quality and cost.

The business of health care

There were sessions about reimbursement, medication adherence, accountable care, and financing health care.  And, there were lots of demos on innovative technology.

The psychology of motivating change

In addition, however, there were a number of talks about motivating desirable behavior.  Examples included sessions on using games to promote better health, biofeedback, self-quantification, and even tips for effectively communicating health information to the distractible multi-tasking consumers of health information that make up the next generation.

Connecting the dots

I found that I spent much of the conference thinking about not just the topic at hand, but about the implications of each talk for other topics discussed at the conference.  Luckily, the event producers recorded many of the panels, and presentations, as there was a lot to absorb in just two short days.

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