My friend Paul Grundy has begun a blog on the IBM website, found here. In his first installment, he details the events of why, in part, I am more optimistic about the future of American healthcare for having worked with him. In the first part of his entry, he identifies why IBM has more than an intellectual interest in health care:
With this information, [Watson, the IBM supercomputer] can suggest options targeted to a patient’s circumstances. This is an example of technology that can help physicians and nurses identify the most effective courses of treatment for their patients. And fast: in less than 3 seconds Watson can sift through the equivalent of about 200 million pages, evaluate the information, and provide precise responses. With medical information doubling every 5 years, advanced health analytic systems technologies can help improve patient care through the delivery of up- to-date, evidence-based health care.
The point he makes following this, though, is not that the computer will lead to a reduction in health costs by decreasing the need for human interaction. This data needs to be converted to actionable information. That is where IBM, the company that purchases health care, has taken the lead:
So, how to make sure this actionable information flows and is held accountable at the level of a healing relationship?With this question in mind, in 2006, IBM – as a buyer of care- hosted a meeting for 47 of the Fortune 100 buyers, TRICARE, the federal Office of Personnel Management (OPM), buyers and the whole house of primary care. They agreed to guidelines now known as the Joint Principles of the Patient Centered Medical Home (PCMH).
This is how the Patient Centered Primary Care Collaborative got its start.From this group came many of the elements of care transformation included in the Affordable Care Act.
As you can see, Paul and IBM have influenced healthcare for the better and will continue to do so. If you have an interest in policy, specifically where its going as opposed to where it has been, I would advise you to pay attention to his thoughts.
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January 19, 2012 at 2:53 am
Robert C. Bowman, M.D.
Until Paul and IBM and others figure out how to increase health spending on primary care and in 30,000 zip codes with 200 million Americans, no electronic wonders will help most of the population left behind.
Primary care is mostly people delivering care to people. Until people understand that health care services are about people delivering care to people, claims of innovation and reorganization benefits will actually result in declines in health access and health quality with increasing costs. Without the workforce, there is not the health care.
It does not take a supercomputer to figure out solutions such as increased spending specific to populations in need of basic health care and a focus on permanent family practice as the workforce solution. Family medicine at over 90% family practice is the solution specific to most Americans across all ages and in all locations in need of workforce. Non-family practice sources are greatly limited as are NP and PA graduates with 25% or less remaining in family practice.
None of the three or four letter abbreviations work without redirections of spending and permanent family practice. The more people link people to primary care, the better chance there is to solve health access woes. The more people link technology to primary care, you can be that primary care is going downhill. Witness the same problems for nurses, teachers, and public servants. Front line human infrastructure is first and foremost about those who serve where needed when needed and even when neglected and ignored and blamed. On such people the entire nations depends.