Partners Center for Connected Health Symposium 2009

On October 21st and 22nd I attended the Partners Center for Connected Health’s 2009 Symposium, “Up from Crisis: Overhauling Healthcare Information, Payment and Delivery in Extraordinary Times,” in Boston, MA. The event brought together a diverse group of healthcare leaders and innovators from across the country and featured discussions ranging from the future role of technology and social networking in healthcare, to in-depth analysis of behavioral science and why people make decisions that common sense would tell them will lead to adverse health outcomes.
The attendees ran the gamut, which greatly enhanced the value of the interactions and discussions. There were C-level executives from the insurance community, hospitals, home health agencies; numerous physicians, practicing both primary care, as well as specialists; there were a number of entrepreneurs in attendance, most of whom were in some capacity connected to the tele-health or mobile-monitoring space; and there were also a number of academic folks and authors in attendance, many of whom were MD’s, Phd or MBA’s by training.
The overall focus of the program, to my mind, was looking for ways to enhance high quality care, while concurrently utilizing lower cost models to do so. This strikes an acute chord with me, as I believe the next revolution in healthcare has to be enhanced utilization of homecare and other services which reduce the utilization of higher cost care settings; hospitals and nursing homes. Not only is homecare the patient preferred model, but it is also drastically more cost efficient, in the long and short term, than any other care model currently in use. As a nation we simply have to find a way to decrease healthcare costs without marginalizing our system and jeopardizing positive health outcomes and quality of life; when homecare is delivered effectively it does all of those things and so much more.
One of the most eye opening presentations I saw (this is hard to get to, as so many of them were fantastic) was presented by Intel Health and centered on the deployment of interactive, data rich, tele-health systems in the home. Obviously Intel Health has one such product so the novelty was not in the pitch, but rather in some data that was presented around a study done by the Veteran’s Administration (VA). MORE DETAILS OF THE STUDY AS WELL AS LINKS TO IT CAN BE FOUND BY CLICKING HERE.
The VA used an aggressive home healthcare and tele-health pilot program to study cost reductions, particularly in patients with multiple co-morbidities, those who traditionally use the most healthcare dollars in their care. The programs results showed 80-98% savings – primarily by decreasing hospitalizations (reducing by over 50%) and better managing things like diet and care at home. Utilizing the technology created a constant feedback loop between patients and providers, and allowed for higher quality, lower cost care…this is the future folks, THIS is how you “bend the cost curve” in healthcare. Get people out of hospitals and nursing homes and treat them in their own homes, using technologies that are commonly available to reach them and communicate with them, thus empowering them with information they can take immediate action on – by say lowering salt intake, or decreasing sugar for a period of time.
There were provocative comments as well, like when one speaker pointed to a well defined study which showed over 50% of healthcare costs are caused by high risk or bad behavior (personal decisions like smoking), then continued that until we penalize this behavior monetarily the results of it will continue to weigh the system down. There was also discussion around taxes and subsidies; would taxing foods proven to be unhealthy and subsidizing those deemed healthy change behavior? No definitive answer there as it’s a very thorny issue; but the point of the symposium wasn’t to send you packing with an ideological framework for change, it was to force you to question the way our system is currently organized and empower you to look for ways to improve and enhance the system, to deliver better outcomes for patients and improve the financial condition of the overall healthcare delivery system.
What is clear is that we are at an inflection point in the healthcare debate and the decisions made today will have vast repercussions for a generation to come. The symposium demonstrated that we have the educational and experiential capacity to get the job done – what we may not have is the political will to do it. Empowering patients with information and access to their professional partners is key to incentivizing good behaviors, and keeping them away from where they actually work – hospitals mainly – is key to driving down cost. So, with all this care transitioning away from the hospitals and out into the community, where will they go? Can so many hospitals survive simply treating trauma cases and real emergencies? How will they align their systems to survive as care transitions elsewhere? Time will tell if any of it happens, but money will likely eventually dictate that it does and I remain hopeful that homecare is not so gutted by the current reform process that it is rendered helpless and incapable of responding in the future. We must begin the process of aggressively incentivizing numerous forms and methods of homecare, without them the system will be lost and will continue to flounder in the face of high cost, marginal quality, and mediocre satisfaction…