Monday, February 9, 2009

Interviews, Medical homes, Paul Grundy - IBM Continues Health Care Innovation Hunt

IBM has a long and distinguished track record of hunting for innovation, being organized for it, and being managed to exploit it.

Latest Efforts

Here are two efforts, announced in February.

• IBM, Google Health, and Continua Health Alliance have developed software to converge and stream patient information from doctors’ mobile devices into online data stores. The idea is to keep patients’ health records constantly up to data and to enable patients to store, manage, and share their medical records with doctors online in real time. Big Business and Big IT firms have become convinced their future growth depends on exploiting health care inefficiencies in health care, America’s largest single economic sector and the only currently showing economic growth and rising employment. Hunting for innovation, inside and outside of IBM, is a formula for growth.

• IBM has teamed up with UnitedHealth Group to monitor patients’ progress and to test the commercial viability and quality impact of the Medical Home concept, a primary care-based delivery system. The biggest test will come in Arizona. In Arizona, UnitedHealth is IBM’s sole health plan for 11,000 of the company’s employees and dependents. IBM executives are outspoken in their dissatisfaction with the current health system. Paul Grundy, MD, Director of Healthcare Transformation. who buys $2 billion worth of health care coverage for IBM employees worldwide, says of U.S. care, “What we buy is garbage.” By this, he means IBM has a hard time buying comprehensive, coordinated care focusing on preventive health rather than on disease that has left the barn.. He says, for example, it is easy to buy care that includes amputating a diabetic’s leg, but not for care that may have prevented it.

The Arizona Experiment

In its Arizona experiment, UnitedHealth will work closely with doctors and will bear some of the initial costs for developing medical homes. United will give primary care doctors more authority and money in return for offering coordinated, comprehensive, and preventive care. Doctors will use EHRs to monitor patients inside and outside the office, and when the go to specialists or are hospitalized. Broad primary care, delivered by personal physicians, says Grundy, costs less, improves outcomes, and enhances patient-doctor-patient satisfaction.

Arizona doctors will be paid an average of $50 for an office visit, a quarterly management fee for overseeing panels of patients, and bonuses for care for keeping patients happy, following treatment guides, and avoiding hospital stays.

IBM has long prided itself on its systematic, organized, and purposeful approach to health care innovation, which includes health care innovation centers worldwide, innovative partnerships with multiple business partners, innovative delivery models like the Medical home, promoting and developing data shortage and electronic medical records, and in general, concerted efforts to “blow medical records wide open” and to “overhaul health care payments.”


Like a wise old corporate owl, IBM is on a health care innovative prowl,
Driven by employee dissatisfaction, costs, and outcomes gone afoul.
IBM executives are issuing a howl,
Saying it's no longer enough to scowl,
growl, or cry foul.
Never throw in towel,
Stay on the innovation prowl.

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