# Presentation: 545615

- .

**Why Transformation **
**In Healthcare. **
**Is Needed to Allow    **
**Technology to work **

## How do you start to fix the foundational issue around why our healthcare system is so expensive and yet so broken??

**How do you start to fix the foundational issue around why our healthcare system is so expensive and yet so broken??**

- Average spending on healthper capita ($US PPP)

- Source: K. Davis, C. Schoen, S. Guterman, T. Shih, S. C. Schoenbaum, and I. Weinbaum, Slowing the Growth of U.S. Health Care Expenditures: What Are the Options?, The Commonwealth Fund, January 2007, updated with 2007 OECD data

## USA worse/19

- Countries’ age-standardized death rates, list of conditions considered amenable to health care Source: E. Nolte and C. M. McKee, Measuring the Health of Nations: Updating an Earlier Analysis, *Health Affairs,* January/February 2008, 27(1):58–71

- 37th by WHO

## “We do heart surgery more often than anyone, but we need to, because patients are not given the kind of coordinated primary care that would prevent chronic heart disease from becoming acute.”

- “We do heart surgery more often than anyone, **but we need to**, because patients are not given the kind of **coordinated primary care** that would prevent chronic heart disease from becoming acute.”
*IT is insufficient, the accountability and incentives are not in place - it is not centered on the patient’s needs. *
- George Halverson’s (CEO Kaiser)
-  *Healthcare Reform Now*

## It is not the lack of technology --We Do NOT know how to play as a team.

**“ ****We don't have a healthcare delivery system in this country. We have an expensive plethora of uncoordinated, unlinked, economically segregated, operationally limited micro systems, each performing in ways that too often create sub-optimal performance, both for the overall health care infrastructure and for individual patients."**

**To fix this the fundamental and**
** ****foundational issue, a change in the ****covenant**** between **
**buyer and provider is needed so the provider has the technology. **

- Teaming, prevention, care linkage deficiencies abound - can cripple care delivery ----- we just can not pass the BALL

**Notes:**

In 2004, health care spending in the United States reached $1.9 trillion, and projected to reach $2.9 trillion in 2009. Health care spending is projected to reach $4 trillion by 2015.  Today tat is $6,280 per person growing to over $12,000 per person in 8 years if nothing chages. 
The government can’t afford healthcare. Employers can no longer afford healthcare and with an average HH income of $46,326 the average American can not afford these increases in Healthcare.

## Visiting with dozens of citizens, they all love their doctor. 

- Implemented universal - Patient Centered Medical Home 1992
- System wide universal eHIT with clinical decision support started 1993
- Denmark is the most advanced country in the world for clinical information technology systems in primary care** **
- Efficiency of hospital transfer from 7 hours to seconds.
- Decreases in administrative cost to 1.3% Vs. 31% USA
- Lowest medical error rate in the World .2 chance of death in Danish healthcare system do to medical error.
- Euro eHealth award 2002,2003,2004,2005
- Satisfaction at 94% highest in Europe in 2006
- Transparency – Hospital, Doctors ranked by outcomes
- In Denmark, the doctor has the complete history available. No matter where a patient visits a doctor, their electronic health record is available. This level of comfort is to be found nowhere else in the world.  YET
- Visiting with dozens of citizens, they all love their doctor.

- Data source: commonwealth fund/NZMJ 09/06/MOHI Denmark10/06/New England Journal of Medicine 8/03

## Conclusion we need to move to action - walk the talk 

**“****Knowing is not enough...**
**	****We must apply.”**
**	****	****	****~Goethe****	**

## PAUL GRUNDY MD, MPH, Chairman Patient-Centered Primary Care Collaborative 

- Director, Healthcare, Technology and Strategic Initiatives
- IBM Global Wellbeing Services and Health Benefits
- SUMMARY:
**Paul Grundy MD, MPH, FACOEM, FACPM  is IBM’s Director of Healthcare, Technology and Strategic Initiatives for IBM Global Wellbeing Services and Health Benefits, part of IBM’s Corporate Headquarters Human Resources group.  **
**Chairman of the Patient Centered Primary Care Collaborative a coalition he lead IBM in creating in early 2006.  The PCPCC is dedicated to advancing a new primary-care model called the Patient-Centered Medical Home as a means of fundamentally reforming healthcare delivery, which in turn is essential to maintaining US international competitiveness. Today, the PCPCC represents employers of some 50 million people across the United States as well as physician groups representing more than 330,000 medical doctors, leading consumer groups and, most recently, the top seven US health-benefits companies. **
**Prior to joining to IBM, Dr Grundy worked as a senior diplomat in the US State Department supporting the intersection of health and diplomacy.  He was also the Medical Director for the International SOS, the world’s largest medical assistance company and for Adventist Health Systems, the second-largest not-for-profit medical system in the world. **
**Dr. Grundy attended medical school at the University of California San Francisco and trained at Johns Hopkins University.  He has work extensively in International Aids Pandemic, including writing the United States’ first piece of legislation addressing AIDS Education in Africa.**
**Dr. Grundy presently serves on The Medical Education Futures Study National Advisory Board and is Chairman of the Patient-Centered Primary Care Collaborative (PCPCC), Dr Grundy is also the Chair of Health Policy of the ERISA Industry Committee. **