A new ecosystem for health Creating a shared vision
ealth does not mean the absence of disease. It means enabling people to live their lives fully so that they can meet the needs of all those who rely upon them. Health care innovations can promote these aims, by discovering and implementing solutions to improve both health and care processes.
The problem with such innovation is not a lack of advances in genetics, drugs, and devices, but rather a lack of innovation in the delivery system itself. Successful innovation is signiﬁcantly impeded by payment systems that focus on the number of visits, tests, and procedures, rather than on the need to improve health.
Douglas L. Wood, MD, FACP, FACC Center for Innovation at Mayo Clinic Dr. Wood is the medical director of the Center for Innovation and a practicing cardiologist at Mayo Clinic. He previously served as vicechair of the Department of Medicine, and chair of the Division of Health Care Policy and Research at Mayo. He served on the Governor’s Health Care Reform Task Force and has been a leader in health reform in Minnesota. Dr. Wood has held important posts in the American College of Cardiology and the American Medical Association and has been an adviser to the Secretary of Health and Human Services in both Republican and Democratic administrations.
A new vision of what health should be
This new ecosystem starts with a vision of what health should be, including all the determinants of health, in which innovation is needed to make our new vision function. It should start with a deep understanding of what people need, followed by a way to bring about accessible and affordable services within a system that is capable of rapid, adaptive change. In my view, this new ecosystem for health will be initiated and implemented by individuals and organizations outside of established medical institutions, in response to real and personal challenges. The resulting products and services could create a new network of resources, or could alter existing networks. Of course, success will depend on access, affordability, outcomes, and trust. Established medical institutions—such as Mayo Clinic—will need to remain relevant and identify their place and role within the new ecosystem. With these forces at play, the new ecosystem for health will thrive because it will be based on people’s actual needs. Every year, I see more individuals, entrepreneurs, and health care providers challenge assumptions, take risks, and make signiﬁcant changes for the future of health. These brave souls recognize that the existing structure is too entrenched, and we ﬁnd our country, for the most part, still burdened with skyrocketing pharmaceutical prices, shackled to reimbursement systems based on sickness care,
MINNESOTA HEALTH CARE NEWS MARCH 2016
There is no question that we need a new model to achieve changes in health. Some of the most promising momentum I’ve seen comes from a relatively small annual gathering of innovators and disruptors called the Transform conference, hosted by the Mayo Clinic Center for Innovation. Transform engages people to boldly create a sustainable future for health. In 2015, more than 700 attendees from 34 states and 15 countries participated in the three-day event, where they learned of innovations such as: • A remote blood glucose monitoring system that allows parents to view blood sugar levels of children when they are away from home. Software developer John Costik created the device for his son, who was born with type 1 diabetes.
Consumers need to insist on having health.
Health care is just a small part of the larger ecosystem of health. We have to think about health at home, at work, or at school, and then integrate in aspects of public health, mental health, access to care, integration of care, affordability, insurance, technology, and infrastructure.
Signs of change
and wrestling with rising insurance costs, despite the Affordable Care Act (ACA).
• “Oscar,” an alternative insurance company developed by entrepreneur Mario Schlosser. Paying its ﬁrst beneﬁts in 2014, Oscar now claims 40,000 members, more than doubling the number of members in the last open enrollment period in New York, one of the most competitive insurance markets in the country. • Latino Health Access in Santa Ana, California, created by America Bracho, MD, to improve the health of those living at or near the poverty line. Latino Health Access trains local community health workers or “promotores,” who go door-to-door to promote healthful eating, exercise, and preventive medical tests.
Taking the ﬁrst steps Physicians need to think about health ﬁrst, and then what it means to truly understand people’s health needs. Physicians then have to create care plans that focus on their patient’s health goals rather than on narrowly deﬁned treatments or guidelines based solely on clinical measures or processes. Consumers need to insist on having health, meaning the ability to live a meaningful, productive life without the burden of illness. This includes burdens imposed by physicians with prescriptions and proscriptions that are not relevant to a person’s goals for health. This new ecosystem is already starting to form, as people and organizations gravitate toward resources and connections that work for them and as entrepreneurs create innovations in response to what truly beneﬁts people. I hope that we continue to see more changes like these within our health care system.