ROCHESTER, Minn. — It's time the health care field tears down its walls and welcomes outsiders with fresh ideas.
That was the message delivered by speaker after speaker Monday during the second day of the Mayo Clinic's Transform 2013 conference. There are all sorts of innovative ideas out there to re-energize care delivery, but clinicians and health care leaders ignore them because they're outside the normal construct, says Archelle Georgiou, M.D., a physician and consultant.
As an example, she pointed to a video game called Remission, which allows teen cancer patients to blast away at cancer cells. It's free and has been proven to positively impact patients, but it's barely used in the industry.
"I think that, with a $2 trillion system that isn't meeting our nation's health care needs, we need to begin considering these types of approaches to really deliver care to people that they need and deserve," she says. "I know that we have health care reform and an accountable care organization movement that seems promising to some, but as I see it, I think they all [still have] the same ingredients of people, places and things that's the same old, same old. It's the same thing being tossed around in a different formula with different financial incentives. What we need is not more of the same."
The call for out-of-the-box thinking was echoed by many others Monday. Why not try using smart watches, with simple and nonintrusive alerts, to tell patients when they need to take their medication or visit the doctor? Two clinicians gave a presentation about combining medicine with comic books for the benefit of both the patient and the doctor. Opening a clinician up to his or her creative side to write a comic can help improve their empathy for the patient and improve their skills as a diagnostician, asserts MK Czerwiec, who teaches at Northwestern and co-runs a website called Graphic Medicine.
David Herman, M.D., president and CEO of Vidant Health system in eastern North Carolina, gave a thought-provoking presentation about reshaping how hospital leaders perceive the emergency department. He opened with a video of a professional equestrian repeatedly trying — and failing — to coax a horse to jump over obstacles. There seems to be a "communication problem" between horse and rider, the announcer intoned, but, in fact, Herman said, the opposite was true. The horse was clearly communicating that it had absolutely no interest in making the leap.
In the same fashion, patients keep communicating to hospitals that they like using the emergency department, despite all the clinics and deterrants to keep them away. Last year, Vidant clocked about 308,000 ED visits. Nationwide, there were some 120 million ED visits in 2010 alone.
About 63 percent of patients who visit the ED either don't pay at all, Herman estimates, or use Medicare or Medicaid, so affordability isn't an issue. And many do not need urgent care — only about 12 percent of patients who come to the ED are admitted, 3 percent get stitches, and less than 1 percent need a cast for a broken bone. The attraction for patients is being able to show up for their care without an appointment, and receiving all their treatment under one roof, rather than going to three different places to see a PCP, specialist and X-ray technician.
So, Herman says, hospitals can either listen to what patients are telling them, or completely ignore it and keep trying to steer their visitors into other care settings. Why not change the assumptions about the ED, decrease the waste, increase value, and give the patient what he wants?
"If we are going to scale the health care system for the things that are right, what we really need to do is leverage the behaviors that people already have," Herman says. "We do not have enough time, attention or effort to be able to change the behavior of everybody in the United States."
Also on Monday, Target announced a new health care-related contest that it's rolling out called the Simplicity Challenge. The retailer is asking the nation for innovative ideas on how to transform the health care system in the areas of lifestyle and prevention, as well as chronic disease, with submissions due on Oct. 24. Here's a video I shot with Target's José Barra on the challenge, and the company's vision for the health care industry.
