Today I’m at the Institute for Health care Improvement Annual Forum in Orlando.
Every year, the keynote frames the state of health care in the US and the work ahead to make it better.
Maureen Bisognano delivered an energetic keynote that I would summarize as "join a community of motivated people and change the world"
She started with a refection on the book Connections by James Burke. Innovation happens when people come together as teams and seize the right opportunities at the right time, often by accident. Change can be surprising when different ideas combine, leading to a sum greater than the parts. 1+1 will equal 3.
Every year at the Annual Forum, IHI brings together the health care community to share stories of improvement efforts with the hope that these lessons learned will spark innovation around the globe. By listening to others stories, health care leaders will be inspired to envision a different, better future.
Maureen described IHI’s goals as
*Realize Patient Centered Care and Outcomes
*Strengthen Health care Delivery Systems
*Drive the Triple Aim – improving the experience of care, improving the health of populations, and reducing per capita costs of health care
*Build Improvement Capability
She shared examples of people and organizations that have embraced these goals.
Christian Farman, an engineer and athlete from Jonkoping, Sweden developed glomerunephrtitis and the dialysis treatments were making him sick. He worked with his nurse to design a program of self dialysis, putting him in control of his own health. Today at the same Jonkoping dialysis center, 60% of patients self dialyze. Christian returned to health, quit his engineering job, and became an RN.
Derek Feeley leads the National Health Service efforts in Scotland, where he has worked tirelessly to reduce central line infections and ventilator associated pneumonia. Today, the central line infection rate in Scotland is zero – that’s quality improvement for an entire country, not just a single health care system.
Intermountain Health care has reduced recovery times for ventilator dependent patients by encouraging early mobility – walking and exercising even before the ventilator is removed.
Kaiser has supported 6 million e-visits, using the web in creative ways for diagnosis, treatment, and follow up.
At the Centers for Disease Control, Tom Frieden has championed the health impact pyramid – categorizing the interventions that have the greatest impact. The base of the pyramid is socioeconomic factors followed by changing the context of decision making, long lasting protective interventions, clinical interventions, education and counseling. The most effective way to treat chronic disease may not be a mediation or education, but eliminating homelessness and improving diet.
Maureen described the remarkable effort of a community group working to eliminate homelessness and improve health –www.100khomes.org
Socioeconomic factors are critically important when the economy is fragile. Current 20% of the US has less than $1000 in savings. 50% has less than $5000. At the same time
5% of population accounts for 50% of the cost of health care
We live in an era of information and have an ability to share experiences ad collaborate on innovation more than ever before.
It’s up to us to spread our stories and make a difference, working together as a community.
In addition to his CIO role at BIDMC, Dr. Halamka blogs at GeekDoctor.blogspot.com.