Center for Improving Value in Health Care
Aug 14, 2013 | 0 comments | Posted by Philip B. Kalin
Collective Impact, Colorado Health Foundation, Colorado Health Symposium, Triple Aim, CIVHC Partners
Every year the Colorado Health Foundation brings together over 300 people from throughout Colorado and the U.S. to explore a wide array of health-related issues and drivers of change in the health and health care eco-system. This year’s Colorado Health Symposium topic was "Health Forward: Harnessing the Energy of Change". Throughout the three days, participants were encouraged by national experts to contemplate the forces of change — policy, consumer demand, marketplace and others — in an effort to identify innovations at play that will impact our mutual efforts to achieve the Triple Aim….better health, better care and lower costs.
This was my fourth year attending the Symposium and I came away more optimistic and enlivened than ever before. The presentations and discussions cemented my belief that we’ve reached a tipping point where dramatic and disruptive changes are reshaping healthcare and there isn’t any going back. For those of us in the healthcare field, the decision we each have to make is whether we embrace change and help shape it or either voluntarily step aside or get pushed aside. The combination of the Accountable Care Act, big data, consumerism and a country being sucked dry by the inexorable rise in healthcare spending has unleashed transformative forces that will dramatically reshape healthcare in the next ten years.
While I’ll mention a few special parts of this year’s Symposium, one of the constants each year is to have the wonderful opportunity to spend time with 300 talented, caring and committed people who are fellow travelers in trying to make Colorado the healthiest state in the country. As hard as it is to put the “system” into healthcare I get tremendous energy from being surrounded by such expert and creative people. If it indeed “takes a village” then we are very fortunate here in Colorado to have so many people united in their efforts to make Coloradans healthier.
A special part of each year’s Symposium is bestowing the annual John K. Iglehart Award for Leadership in Health Policy. The award recognizes individuals whose wisdom, involvement and leadership have helped define and move forward positive health care reform. Our friend Marguerite Salazar who is finishing her leadership role at HHS Region 8 to become the incoming Commissioner of Insurance received the 2013 Iglehart award as well-deserved recognition for her years of leadership in Colorado healthcare. Congratulations, Marguerite!
As I scanned the list of prior awardees of the Iglehart Award, I was struck by how many of the six other awardees have connections with CIVHC. Among past awardees, Bill Lindsey ( led the 208 Blue Ribbon Commission for Health Care Reform which recommended creating an organization with CIVHC’s mission; Joan Henneberry took that recommendation and incubated CIVHC within the Department of Health Care Policy and Finance (HCPF) prior to CIVHC becoming a stand-alone non-profit; Dr. Jay Want served as our first and long standing board chair and is now CIVHC’s Chief Medical Officer; and, last year’s awardee, Barb Yondorf, has helped CIVHC from its earliest days as thought leader, trusted adviser and board member. What good fortune for our organization! It’s also an important reminder of how much we at CIVHC and across Colorado build upon the work of others.
While nearly every presentation at the Symposium had its “ah hah!” moments, two particularly stand out in my mind and are worth noting. The first was by evolutionary biologist, consultant and radio personality, Dr. Rebecca Costa. She talked about the speed of change and the amount of new data coming at us that is overwhelming our brains’ ability to process and assimilate it. As this complexity grows she described the human tendency to move from “knowledge” based decision — i.e. where we have the capacity to have a comprehensive understanding of the relevant facts that can allow a fact-based debate — to decisions based upon “belief” where we base our perspectives and decisions on past life experience, cultural bias, and our gut feel on various topics. She points out that as complexity grows we often move from knowledge to beliefs which in turn can lead to gridlock because the arguments and perspective are more akin to a religious debate than one based on facts. Her description resonated as I thought about the highly partisan debates about how to fix healthcare, global warming and other complex societal issues. Our task is to find ways to get back to a place of “knowledge” in light of the data overload we sometimes face today. (I’m hoping next year’s Symposium will get us to that answer.)
Another point Dr. Costa made was that in any complex environment (healthcare being a perfect example), it is unknowable what solutions will work. She described us as living in a High Failure Rate Environment (HFRE) and exhorted all of us in healthcare to try many solutions, to fail fast (decrease cycle time), learn from both successes and failures, and work on constant improvement. She used the metaphor of the venture capital community that funds a 100 companies knowing they’ll wildly succeed if 15 or 20 do well. These venture capitalists fund a large number of good ideas, and go through a series of culling out the laggards and increasing funding for those that show promise; all with an expectation of high failure rates, rapid cycle times and a focus on growth and learning. The model has important lessons for both our funding of solutions and our need as healthcare leaders to be constantly innovating and trying new things with an expectation and permission to fail often and fast but constantly improve.
Dr. Martin Kohn, Chief Medical Scientist, Care Delivery Systems, at IBM Research kept everyone’s rapt attention with his presentation about “Watson”, the computer made famous by defeating the TV show Jeopardy’s past champions and which most recently has gone through programming to simulate being trained as a resident in Oncology. He demonstrated how through natural language processing and machine learning that Watson can become an invaluable asset to providers and patients. His presentation was given context by his noting that medical information is doubling every four years, there are 75 new clinical trials started daily across the world, and that 20 percent of diagnoses are either inaccurate or incomplete. Likewise, nearly 25 percent of the medical care provided in the U.S. does not add value for patients.
Besides being blown away by the capacity of a computer to serve as an adjunct to the care provider, another takeaway from the presentation was a powerful reminder that in thinking about solving healthcare issues over the next years, we won’t be constrained by the same old systems and solutions. New technology, innovative uses of our workforce, big data and a whole host of new approaches to engagement will provide a new set of tools to solve our old problems. It is an exciting time to be part of improving health, healthcare and lowering costs.
View more Health Symposium highlights
About the Author: Phil Kalin is CIVHC's President and CEO. Contact him at email@example.com.
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