Posted on | September 10, 2009 | No Comments
Mike Magee MD
In the wake of last evening’s remarkable speech by President Obama before both branches of Congress, the Administration and Congress must now skillfully move forward in their effort to secure Health Reform. Their focus must remain squarely on locking in the major Health Care sectors and their induced cost containment concessions, and on expansion of insurance coverage to the uninsured.
Clearly, we will have reform, but whether the reform will transform is another question entirely. For Health Reform to transform, a strategic plan is required that will structurally reorganize the way we deliver health care, will provide the capacity to harness technology to plan forward, and will create the ability to simultaneously advance both quality and efficiency through virtual, information-rich linkages that motivate and deliver healthy behaviors.1,2
What would transformative health reform look like from a national, system-wide vantage point? Here are ten “transformers” that would indicate true change and significant progress.
1. Hospitals and specialty services would be right-sized based on volume and outcomes to eliminate excess capacity. Low volume, poor quality hospitals and specialty services would be eliminated . New rational and innovative community services would be provided based on defined need . Regionalization of in-patient services would require some patient travel but access to excellence would be facilitated, not impeded.
2. Healthcare would be redefined on both an individual and system wide basis as a strategic planning exercise.
3. Health consumers would be rewarded financially (through tax incentives or lower health premiums) for achieving health.
4. Our nation would move radically toward integrated health care team models and away from solo practitioning with team leadership assumed by those with interest and training. Virtual information linkages would help bridge geographic barriers, giving all the capacity to join a team approach.
5. All current health care workers job descriptions, including physicians – both primary and specialty care would be redefined. Health professional workforce plans and training curricula would then be critically reexamined and adjusted as required. Standardized compensation, with team and individual rewards for keeping people well would become the norm. Debates about physician versus nurse, primary versus specialty would no longer be relevant. Skill set, interest, and capabilities would define one’s role on the team. All team members would be equally valued.
6. National health information standards would be mandated immediately to assure information compatibility, portability and privacy.
7. Health professional credentialing and licensing would be nationalized. Medical liability would be reformed and conform to national standards.
8. Universal coverage would be provided. In return, the roles and responsibilities of individuals, family, community and society would be clearly defined and financial incentives would be aligned to reward success.
9. The concept of the Electronic Medical Record (EMR) would immediately be supplanted by the Lifespan Planning Record (LPR), a 100 year, forward facing, consumer controlled online application designed to support personal, prospective, predictive and preventive health planning.3,4 Google, Microsoft, Apple, Intel, and other information innovators would be empowered and incentivized by the Federal Government to develop within one year this “killer application” and launch Version 1.0 as an open source free of charge offering downloadable online and embedded in all new computers. A specific accelerated timeline for national adoption would be put in place.
10. Recognizing that health is the ability to reach ones full human potential, the national goals and objectives of the Health, Energy, Environmental, Housing, Transportation, Education and Military sectors would be full integrated in the pursuit of a healthy America.
True reform should be judged by the nation’s capacity to support the development of our future human potential, productivity and creativity by adopting a sufficiently powered vision that fully applies our vast scientific and humanistic resources as they continue to evolve.
1. Institute of Medicine. Summit on Integrative Medicine and the Health of the Public Agenda. Magee M. Models To Promote Primary Care. Feb. 25, 2009. http://www.iom.edu/?ID=52555
2. Magee M. Connecting Healthy Homes To A Preventive Healthcare System: Leveraging Technology For All Its Worth. Harvard Health Policy Review. Fall 2007. Vol. 8:2, 44-52. http://www.hcs.harvard.edu/~hhpr/currentissue/Fall2007.pdf
3. Magee M. Health Records of The Future. Health Politics. Nov.16, 2006. http://bit.ly/GGnn9
4. Yoediono Z, Snyderman R. Proposal for a new health record to support personalized, predictive, preventativeand participatory medicine. Personalized Medicine. 2008. 5(1), 47-54
5. Magee M. Powering Health Care Visions: Advantaging Complexity, Connectivity and Consumerism. Intel Technology Journal. Fall, 2009. (in print)