'Tech'-ing Better Care of Patients
Joseph Kvedar, MD
After nearly two decades of pioneering research into connected health as a reliable model for healthcare delivery, Joseph Kvedar, MD, has won fans and won over skeptics.
Kvedar is founder and director for the Center for Connected Health, part of Boston-based Partners HealthCare System. He started the Center in 1995 on the premise that healthcare doesn't always have to be delivered in a doctor's office or a hospital. His use of home monitoring, text messaging, and the now ubiquitous smartphone shows improvements to patient health, provider efficiency, and a hospital's bottom line. His findings are just in time for the changing reimbursement reality, and for consumer demand of quicker access to personal medical data.
Kvedar's research predates the terms ACO and mHealth, but his findings solve contemporary problems, particularly in chronic disease management. For example, what began 10 years ago as a telemonitoring pilot program of congestive heart failure patients continues to show a 50% drop in the readmission rates.
Kvedar's use of technology and analysis of patient data has benefits beyond the balance sheet. His patient groups embrace things like uploading their blood glucose levels to an online program that is shared by doctors and nurses for diabetes management. Instead of feeling cheated that they didn't get any face time with a doctor, the patients feel like they have a hotline.
"Let's face it: We, in healthcare, have set up a system where we're hard to get to; we're hard to interact with; we're not really customer friendly. I can't call any doctor's office customer friendly, and these technologies give consumers and patients a way to directly connect and they tend to love it," he says.
Competing to Convert Care Dollars Into Cure Dollars
Richard Merkin, MD
If you're trying to solve complex problems in medicine today, it doesn't seem like the thing to do would be to assemble a community of math whizzes who've never met each other and ask them to team up, compete with each other, and outguess the medical community. But that's just what Richard Merkin, MD, CEO of the Heritage Health Prize is doing.
Start with cash: The $3 million Heritage Health Prize, a data-mining, predictive-modeling competition to reduce avoidable hospital visits, launched in April of last year. Add a tech-powered online community that, this past September, included more than 1,500 participants assembled into 1,300 teams that had submitted more than 22,000 entries.
"We noticed that when we identify high-risk patients, we could intercede and prevent a lot of unnecessary care," Merkin says. "It became obvious that if we could identify with greater specificity and sensitivity, then we could really transform healthcare in the world, particularly starting in the United States, and hopefully reallocate some of those healthcare care dollars into cure dollars."
Using historical claims data, competitors predict which patients will be admitted to a hospital within the next year. They can tweak their algorithms once a day, and accuracy rankings are displayed on the leaderboard at www.heritagehealthprize.com.
The history of prize-based scientific breakthroughs stretches long back in time, before the prize Charles Lindbergh won by flying nonstop between New York and Paris in 1927. In many cases, the winners of such prizes are building new industries, Merkin says.
On the Path of Mutual Alignment
Patrick McGuire, CPA
Patrick McGuire, CPA, the senior vice president and CFO at St. John Providence Health System in Warren, Mich., has played a pivotal role in his system's financial transformation, but it's his innovative approach to physician partnership that sets him and his organization apart.
Since joining St. John Providence Health System in 1986, McGuire has helped his system through numerous ups and downs. But in 2010, he found himself in unfamiliar territory as the system planned to move into delivering coordinated care to patient populations, and to do that it would need to forge stronger physician relationships.
"We had long-standing relationships with our physicians going back to an early 1990s PHO … but we got to 2010 and looked at our alignment with physicians and we realized our physicians didn't view the partnership as much of a partnership, at least not as much as we did," he says.
To create an equal partnership, the six St. John Providence–affiliated physicians' organizations became one—the Physician Alliance. And in May 2011, the Physician Alliance created an equal partnership with St. John Providence Health System to become SJP Partners in Care.
"I want the physicians to be the most successful in our market, and they want us to be successful. And if I'm not building something to make them successful from a clinical and patient satisfaction standpoint, then I'm not building anything with staying power. If you start with the premise that you're really equal partners, you'll have a successful recipe for the future," McGuire concludes.
Leading the Dialogue on Cultural Change
Risa Lavizzo-Mourey, MD
Risa Lavizzo-Mourey, MD, probably began her preparation to lead the Robert Wood Johnson Foundation when she was a child growing up in Seattle.
Her parents were both physicians. The Harvard Medical School graduate says she grew up understanding "the incredible privilege and honor it is to be a physician and to have that intimate relationship with a patient."
At the same time, conversations with her parents helped her understand the larger forces in society—such as poverty and policy—that can affect whether people have access to physicians and the healthcare they need.
In her 10 years as president and CEO of RWJF, Lavizzo-Mourey has deftly guided the multibillion-dollar philanthropic organization to take on and speak out about what she terms "the important cultural changes that are necessary for us as a nation if we are going to become healthier."
In 2011 the RWJF, which is funded through an endowment, awarded 739 grants worth $397.4 million, but Lavizzo-Mourey says the foundation is increasing its use of tools other than grant making, such as strategic communications and collaborations, to try to achieve its goals. She explains that the move is grounded in the realization that RWJF "needs to deliver a very consistent message and develop strong relationships with other foundations, nonprofits, and business leaders to raise awareness and produce the social change necessary to achieve its goals."
Lavizzo-Mourey says the best part of her job is spending each day figuring out what the foundation can do make meaningful change happen. "Not a day goes by that I don't talk to someone or interact with someone who has been able to achieve something important for the country or community or people who need help."
—Margaret Dick Tocknell