TED Conversations

Closing Statement from Michael J. Barber, VP, GE Healthymagination

Well, TED community, now that our conversation has come to a close, I’d like to thank you all for sharing your thought-provoking questions and insightful ideas on patient behavior. I also want to thank Dr. Nancy Snyderman for participating and for bringing her valuable medical perspective to our discussion.

Over the course of the conversation, some key takeaways for me included:

+ It takes time to drive real change in community healthcare systems but it is worth the effort to increase access, decrease costs and improve the quality of healthcare.

+ Being smart and honest with our healthcare providers goes a long way no matter which country we live in.

+ We can save 100,000 lives a year by preventing hospital errors.

+ Learning about health early in life and developing good habits can have a big impact on our healthcare system in the future.

+ As patients become better armed with information through technology, we will see the patient/doctor relationship evolve into something more meaningful and efficient.

+ If good health is a priority in the workspace, these habits will translate into the home.

This has been a great first experience with TED Conversations for me and I hope to meet you all in the digital healthcare space again soon.

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    Jul 21 2011: I don't believe the solution is as simple as figuring out how to make people make tough decisions. This is a complex issue/problem. Technology, simple solutions (like checklists) and mandates all have been implemented in an attempt to improve our health care system. Billions of dollars have been spent on research for and implementation of these various initiatives. Complexity science and systems science explains why we have not seen sustainable improvement- we have not changed our health care system structures. As long as we continue to have individual physicians acting independently and hospitals designed in hierarchies with vertical departments, we will not see improved health care no matter how much technology, information and money we allocate to these systems. We need to re-allocate resources to the horizontal processes that are the important processes to be defined, measured and improved- the cycle of care for each patient problem and disease from the patient's perspective. The solution is relatively simple- develop care teams (with physicians acting as a part of a team) and communities around definable patient problems and use continuous clinical quality improvement principles to create value. The implementation is challenging because of the strong attractors in place for the people in control of the resources in our current health care system structures to maintain the status quo, especially at our traditional academic medical centers. I would change your question to: How do we change our health care system structures to enable sustainable improvement for the health of our society?- each problem will require a variety of emergent solutions driven by engaged, accountable communities.
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      Jul 21 2011: Hi Bruce – Really interesting thoughts here. We’re working on one project that might interest you – an experiment along the lines of developing a community-wide consortium of employers, payers, providers and patients who are focused on reducing costs, raising quality and increasing access to healthcare. In Cincinnati, where GE has a major presence, more than 12 percent of its population lacks health insurance, the mortality rate is higher than average and annual health spending increases have been averaging eight percent. In early 2010, GE coordinated with community leaders and other local corporations to catalyze citywide approaches to reducing costs and improving quality of and access to care. The community’s goal is to drive $1 billion of cost out of the system – while improving outcomes – by 2014. It’s been a marathon – not a sprint. Even though we like to see progress quarter-by-quarter at GE, we realize that it takes time to drive real change. In Cincinnati, it took creating an executive stakeholder board, agreeing on a set of metrics, developing incentive plans for Patient Centered Medical Homes (PCMH), creating patient engagement portals and there is more to come, but the needle is moving. The question we’re asking ourselves now is how to repeat this model in other communities.
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        Jul 21 2011: Thanks Michael- that sounds like a marathon. Congratulations on the effort so far. It is very challenging to get all of those stakeholders to work together. We are working on more of a bottom-up approach, starting a new academic medical center with just five divisions, to start with- hernia disease, obesity, breast disease, GI disease and trauma. We are building teams around these patient groups and defining dynamic care processes and outcomes measures. We have a group of engineers on our teams to apply clinical quality improvement processes to learn and improve value within these processes. We are working with industry partners to learn where their products have value (and where the don't have value or cause complications) within these care processes. After a year of planning, we are starting the implementation now. Thanks again for the interest.
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        Jul 22 2011: This project sounds fantastic - as long as people from ALL INCOME LEVELS are included WITH EQUAL SAY, and as long as there is equal/fair representation from genders, cultural groups, and age groups. Please post where to find the findings once they are published!

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