Receivers, Givers, and Takers
I had the good fortune to hear billionaire Dr. Patrick Soon-Shiong discuss how to migrate from an “outcome” centric medical delivery system to evidence based delivery system. This immediately reasonated with my experience in managing evidence based disbaility claims. We had started with the notion of rating driven (outcome based) as opposed to evidence based like Patrick suggested. The effect of changing the paradigm is significant, and frankly, very difficult to implement given the socio-political climate here in the U.S.
Nevertheless, Patrick used the paradigm of Receivers (patients), Givers (providers and payors), and Takers (all others). The secret he suggested was to to follow the patient. So in designing electronic records, we should make EHRs as close to PHRs as possible to ensure “patient” driven use of medical evidence. He said the focus is not healthcare, but on health. He also spoke about the need to have massive data (summarized as appropriate) instantly available to both the patient and the provider to enable optimal decision making. The latter, he contended, will improve the specific medical treatment provided, and thereby improve outcomes. After all, 5% of patients account for over 55% of the healthcare costs. He suggested that decision makers must always ask what additional information is needed that will lead to a different decision. His key inputs that reasonate with my objectives are:
1. Inter-operability of data across systems to ensure that we have “instant” access to health records and health analystics.
2. Patient in the loop technology and universal records to trend and develop optimal care.
3. Quantitiative, predictive, preventative and unbiased care – not dependent on rating codes and financial restrictions.
4. The role of EHR with a focus to enhance the quality of care.
5. Expanded notion of the cloud – “service oriented science”.
All these are valid points, and I will be incorporating his ideas into my work. His coalition for connected healthcare NCHI is an organization worth following.
