The Learning Healthcare System
This week I am talking to Vivian Lee, MD PhD MBA, (@vivianleemd) President Verily Health Platforms (@verilylifesci) and author of “The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone” (W.W. Norton) and a Senior Lecturer at Harvard Medical School.
Dr Lee started out like many doctors do with a traditional view of what healthcare and medicine would be like and had shadowed a local phsycian in her home town
Caring for patients and understanding them as people and helping them by treating them and their clinical conditions. But unexpectedly got drawn into teaching and administration. A core question of why our healthcare systems were not performing as well as we hoped (or expected). This driving force around improving healthcare through Academic Healthcare systems and was asked to join the University fo Utah Health and was so intrigued by their ranking as the top academic healthcare institution. As she described the experience, Dr Lee became a “student of success” learning from a system (a learning health system) and indeed the nearby health systems who managed to set high standards of care and successfully incentivize and deliver good quality care. It is notable that Utah is one of the healthiest in the country which is an important foundation and built on this with programs that were driven by a health plan that focused on data
You cannot improve what you do not measure
(I’ve talked about the importance of data to drive behavior many times before quoting Lord Kelvin) with one of the early leaders in Medical Informatics, Homer Warner, MD, PhD.
We discuss the problems with our current system and Fee for Service, how we move to paying for improvements in health with more “Global Payment” methods and concepts of Capitated payments or payments for success vs for doing.
We can learn from others who have managed to save money and improved health and while there is plenty of resistance from the established incumbents, the Utah Medical system was forced to pivot from a Fee for Service Systems to a Fixed payment successfully with some incremental steps including:
- Capturing relevant data
- Equipping patients and doctors with tools necessary for success
- The challenge of risk especially with medical education costs
- Using a crisis but learn from the past and data
Listen in to hear how these new data and insights helped health systems and successful programs successfully pivot to a new model for care delivery and how we can learn from them to use this crisis and incremental steps to build a better Learning Health System
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
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