LA QUINTA — Big-picture topics, such as large-scale data gathering, impediments to information sharing and the problems associated with implementing a preventive health care system, dominated panel discussions at the 3rd annual Health Matters Conference last week.
The conference, which drew close to 500 people, has become an annual offering of the Clinton Foundation’s Health Matters Initiative. The Clinton Foundation has chosen two regions of the United States in which to focus its initiative — Arkansas and the Coachella Valley in Southern California.
Former President Clinton said the Health Matters Initiative started by addressing the child obesity epidemic. The foundation is now working with 20,000 schools across the nation to provide exercise programs and improve food served in school cafeterias, he said.
During his opening remarks, Clinton stressed that attention needs to be directed toward bringing what Americans pay for health care closer to the global average. He said Americans spend 17.2% of their income on health care, while residents of other wealthy nations spend 11.8% on average.
“We are trying to change the whole ecosystem of America as it relates to health and wellness. We’ve still got a long way to go,” Clinton said.
He pointed out that the incredibly high costs associated with poor health can cripple the economic stability of a nation, and that the U.S. ranks between 25th and 33rd for health and wellness indicators among all wealthy nations.
“We can do better, and we have to change it ourselves,” he said.
EHRs: ‘Medical Bridges to Nowhere’
Moderated by Clinton, the day’s first panel discussion veered into a frank conversation about the challenges of health care reform.
Billionaire philanthropist Patrick Soon-Shiong identified the gaps he thinks are holding back the American health care system. The present health care delivery system is disorganized, lacks coordination of care and does not reward doctors for keeping patients out of the hospital. He pointed out that a payment system exists in which there are codes for medical treatments but no code for a healthy diagnosis.
“Nobody has looked at health care as a systems approach,” he said. “When you look at the knowledge system, delivery system and payment system, you need to integrate them continuously and seamlessly and put them together as one unit.”
Soon-Shiong identified the inability to share information across delivery systems as a critical barrier. He said electronic health records are “medical bridges to nowhere” because health care reform legislation did not require health systems to be able to share EHRs.
Soon-Shiong, who said he met with President Obama and cautioned him against funding EHRs that were not integrated, set about building an operating system that he contends can talk to any software across all delivery systems. The Intelligent Clinical Operating System (iCOS) will be deployed in Central Arkansas and the Coachella Valley.
Implementing Preventive Care
Panelists also shared their perspectives on whether the Affordable Care Act would improve access to care. “Our hospitals are right at the epicenter of trying to make this work,” said Trevor Fetter, CEO of Tenet Healthcare Corporation.
He noted that the nation is in a period of transition from a fee-for-services payment system and is moving toward a system based more on outcomes and prevention.
“It is a model for the future, but I think we need to be realistic about how long it will take,” he said.
“The conditions have to exist in a particular community for this to work,” he added.
Digital Platforms
During a panel discussion on leveraging digital platforms to promote health, the Knight News Challenge announced it would grant $2.2 million to seven projects, many of which involved designing apps that use health data to promote change. Some of the projects’ goals include decreasing prescription drug misuse, preventing suicide, detecting chemical contamination and connecting individuals with community resources.
Chelsea Clinton kicked off the panel discussion by asking how digital platforms can improve health care access.
Peter Tippet, chief innovation officer at Verizon, stressed the need to implement digital solutions within the health care industry, much as the financial industry did more than a decade ago.
“Health care as an industry is dead last in the use of information technology,” Tippet said. “We don’t use cloud computing in health care. Doctors don’t actually communicate with each other digitally.”
Travis Bogard, senior vice president of Jawbone, described how through digital wristbands and mobile phone applications, consumers can track their habits and vital signs and monitor their health. Large-scale data collected through these platforms can then be used for public health campaigns, he said.
He said data collection can be used to target specific trends and evaluate whether a public health campaign is effective.
“Is it working, and if we slightly change the message is it working better?” he asked.
He added that social media platforms also can be used to reach specific populations.
“It’s really about sparking conversations, so we can share what we’re learning,” he said. “We’re talking about simple little tips that can help us lead healthier lives.”