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Innovation Digest – August 2017 vol. 1

The first August 2017 issue of the Innovation Digest is out! In this issue:

  • How Multi-Sector Health Partnerships Evolve
  • Don’t Blame Doctors for Nonadherence
  • Google Spent 2 Years Studying 180 Teams. The Most Successful Ones Shared These 5 Traits
  • The Smart-Medicine Solution to the Health-Care Crisis
  • After a diagnosis of multiple sclerosis, Danny van Leeuwen describes his relationship with his neurologist
  • Evidence based medicine manifesto for better healthcare
  • From Evidence Based Medicine to Medicine Based Evidence
  • FDA Sets Inaugural Meeting of First-Ever Patient Engagement Advisory Committee
  • Price Transparency In Medicine Faces Stiff Opposition – From Hospitals And Doctors


Innovation Digest – June 2017 vol. 2

The second June 2017 issue of the Innovation Digest is out! In this issue:

  • Building the ‘Tesla’ of health systems: Where Marc Harrison plans to take Intermountain next
  • 3 Health Care Trends That Don’t Hinge on the ACA
  • Apple is quietly working on turning your iPhone into the one-stop shop for all your medical info
  • Why GE, Boeing, Lowe’s, and Walmart Are Directly Buying Health Care for Employees
  • Yale School of Medicine to launch app to help patients collect EHR data, participate in studies
  • NIH’s All of Us precision medicine program gets rolling
  • Can pharma deliver both patient value and shareholder value?
  • Factors Affecting States’ Ability to Respond to Federal Medicaid Cuts and Caps


Innovation Digest – May 2017 vol. 1

The first May 2017 issue of the Innovation Digest is out! In this issue:

  • Letter: Fix health care? Give us more AHCCCS
  • Vital Directions and National Will
  • All Americans deserve quality health care
  • Medicaid Overhaul to Hit Millions of Medicare Beneficiaries, Too
  • California Tries Again To Move On Universal Health Care


My View: Response to President Trump’s 5 Principles for Healthcare Reform 

The president called on all Democrats and Republicans to work together on healthcare going forward.

Source: Trump outlines 5 principles for healthcare reform

Words have meaning, yes; and yet, the actions taken from here forward by both parties and in both the executive and legislative branch are what matter the most. Here are my own 5 principles that I challenge ALL who are in decision-making positions to keep in mind. Lives depend on it.

  • Listen to real patients: Seek constituents in your communities if you don’t trust patient organizations (although you ought to partner with these noble and under-appreciated institutions). Spend time explaining your ideas, but also listen to what they are experiencing and their highest priority needs. Don’t dismiss the reality of their experience. These voices have value.
  • Remember that there is NO SILVER BULLET: Rhetoric implies that any “replacement” has the “right” way to deliver care. There is no such one right way. Policy to support universal access to care should make use of every tool in the box to ensure Americans can access the right care at the right time. Nothing should be off the table, even if it’s not ideologically “your idea.” That’s true bipartisanship.
  • Prioritize the most vulnerable. Those that can’t afford bus fare to their appointments, live with disabling chronic conditions or have already spent their life savings on care will have little use for HSAs or tax credits. The do need the earliest and most robust health care interventions to get well, stay well and thereby not become an unintended drain on already stressed health system resources. So flexibility for Medicaid is a good thing, but the end goal must be to ensure that no one gets left behind.
  • Foster innovation from the front line. Stop pretending that Washington has all the answers and ignite creativity and solutions at the front line. Innovative health systems are already doing this and CMMI was created to foster this culture. It’s not perfect, but we need to expand that culture. Take ideas from direct care professionals and patients themselves, rather than PhD analysts or career legislative staff. Well-intentioned though they may be, you have a better chance of understanding the dynamics, barriers and potential solutions from ground zero.
  • Be transparent about success AND failure. This is complicated (times 10) and you’re not fooling anyone with the bravado and promised sweeping reform plans. You won’t get it right this time (or next), just like the ACA. It isn’t perfect, but it achieved something no other plan has been able to: slashing the rate of uninsured Americans by historical numbers. That translates into millions of Americans being able to get actual care. So go forth and attempt to fix what’s broken, but be honest and transparent with Americans about what is working and what isn’t. Be willing to fail and adapt (it’s called governing).  Trust and goodwill, and the willingness of all stakeholders to explore the necessary compromises will depend on how fast you learn to fail and pivot to capitalize on success.


Fail To Scale: Why Great Ideas In Health Care Don’t Thrive Everywhere

Fail To Scale: Why Great Ideas In Health Care Don’t Thrive Everywhere | At the intersection of health, health care, and policy.

Source: Fail To Scale: Why Great Ideas In Health Care Don’t Thrive Everywhere

This is a great and timely commentary on why change in healthcare is so hard. Other examples:

  • Recent reports from the CDC reveal that hospitals still aren’t consistently lowering healthcare-associated infection rates, despite intensive education, guidelines, public reporting and regulatory requirements.
  • Slow and variable implementation of strategies related to stemming antibiotic resistance and addressing outbreaks of emerging infections like Zika demonstrate the challenge of developing common public health responses.
  • Despite common wisdom about the importance of treating the whole person, consistent integration of care, particularly for complex, chronically ill patients, remains elusive in many practices.

The Centers for Medicare and Medicaid Services (CMS) pours money into efforts to stimulate innovation in health care delivery, quality measurement and defining value to drive healthcare reimbursement. These are noble pursuits, but as this article rightly points out, such efforts cannot yield national-scale, universally relevant solutions. It can, however, identify and test new strategies, connect them with outcomes and highlight the issues of patient preference, culture, local health trends and workforce that must guide translation to other settings and inform similar activities in other areas of the country.

Innovation and implementation support must be present locally, with the ability to help stakeholders adapt their efforts to nuances in leadership, culture, health status, infrastructure and market dynamics. National policymakers must embrace the fact that local solutions may be most sustainable locally, rather than force a “scale up” mentality that cannot succeed everywhere.