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3 Ways to Reimagine Healthcare Delivery

Analysis  |  By Tinker Ready  
   October 27, 2016

Speakers at an NCQA event suggest that some services could be delivered differently, by non-physicians working outside of hospitals.

Up until a few decades ago, drivers needing service or repairs had to take their cars to the repair shop. Then came companies (Midas in 1956 and Jiffy Lube in 1971) that offered inexpensive, routine services such as oil changes and replacement mufflers.

Now drivers had options.

Speakers at an NCQA Quality Talks event Monday suggested that a similar service delivery model could apply to medicine and lead to better, more efficient, less-expensive care.

Others said we are already headed in that direction through telemedicine, urgent care clinics, and programs designed to keep patients out of that human repair shop known as the hospital.

"The health plan of the future" was one of three themes explored at the event.

Speaker Barbara McAneny, MD, the CEO of the New Mexico Cancer Center, said she does everything she can to keep her patients out of the hospital. Her group has succeeded in preventing unneeded admissions through the creation of an oncology medical home.

Every time she admits patients to the hospital, their quality of life declines a little bit, even if they don't suffer complications or infections, McAneny said.

1. A Medical Home for Cancer Patients

Her team created the "COME HOME" medical home model which aims to "improve health outcomes, enhance patient care experiences and significantly reduce costs of care by keeping patients out of the emergency department and hospital as much as possible."


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The program credits a system that includes triage, extended hours, and evidence-based medicine for reducing the costs of caring for Medicare patients by about 6%.

She noted that the country cannot afford the rising cost of healthcare, which leave less for education and other services.

"We are looking for a solution," McAneny said. "If you give doctors the tools that they need and the ability to hire the personnel to create a team… you can come up with a system that not only gives better healthcare at a lower price, but makes doctors a lot happier and willing to work a lot harder."

The program is aimed at those newly diagnosed or suffering a relapse of cancer, but could be used for any patient with a chronic disease.

2. Consumer-Centric Care Delivery

Marcus Osborne is the vice president for "health and wellness transformation' at Walmart corporate headquarter. He asked: What if the healthcare system is not broken? What if it is working perfectly for all the different players, the providers and payers, and device makers and patients?

The hope is: "If we develop solutions that ensure all of their interest are aligned and ensure all their needs are addressed, the system will work better," he said. "If you believe that is the correct paradigm, you've got it all wrong. "

He suggested a system that is "100% about the consumer." That would require an "explosion" of digital services that would allow "consumers to engage with technology directly to get them the care they need, without having to engage with providers or professionals."

The doctor, he said, would no longer be at the center of care. He cited Lemonaid Health as an example. The company offers $15 online consults and prescriptions for simple, but common problems such as urinary tract infections.

Osborne also noted that a recent glucose and cholesterol screening initiative conducted by Walmart served 300,000 people four hours, half of whom had never been screened before.

3. Closing the Disparity Gap

Other speakers talked about the quality issues related to disparities and cancer care.

"Upstreamist" Rishi Manchanda, MD, is the founder of Health Begins a group that helps providers and communities address the so called "upstream" living conditions such as diet and housing that make people sick.


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He urged hospitals to screen for "food insecurity," and take steps to address the lack of access to healthy foods that can, for example, keep diabetics from eating properly.

Laura Esserman, MD, the director of the University of California San Francisco breast care center, doubled down on her criticism of routine cancer screening—often ineffective, and clinical trials—often inefficient.

She urged a reimagining of the healthcare system. "I am sick and tired of watching other industries outpace innovation in health care delivery," she said. "It is time for that to change."

Tinker Ready is a contributing writer at HealthLeaders Media.


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