To Innovate and Transform , Think Globally, Act Locally

Think globally, act locally.

Maxim for Entrepreneurs

January 30, 2013 - Ideas invented in the garage of a local inventor or fledging capitalist enchant Americans.    Creators of Hewlett Packard,  Apple, and Microsoft come to mind.  Many of us believe the best innovations and the most profound transformations come from the bottom-up rather than the top-down.  Take it for a test drive on the local streets before you go on the federal highway.

Two press releases today, remind me of the importance of the “think globally, cat locally”maxim.  What has changed is that local innovations often start with organizations rather than individuals.

• The first emanates out of Leawood, Kansas, where TransforMED, a sudidiary of American Academy of Family Physicians, is located. TransforMED, in conjunction with VHA, Inc, the big non-for profit hospital corporation, and Phytel, an IT company based in Dallas, announced it was kicking off a training program in seven local community organizations –
• Charleston Area Medical Center, Charleston, W.Va.
• Columbus Regional Hospital, Columbus, Ind.
• Huntsville Hospital, Huntsville, Ala.
• Northeast Georgia Health System, Gainesville, Ga.
• North Mississippi Health Services, Tupelo, Miss.
• Greater Baltimore Medical Center, Baltimore
• INTEGRIS Health, Oklahoma City

The idea behind this joint effort with community health systems is to transform Patient-Centered Medical Homes to provide communities with the resources to coordinate improved outcomes, quality, with reduced costs.

• The second press release appeared in Kaiser Health News and reads as follows. For Medicare Innovations – Think Locally

By Ankita Rao, January 29, 2013

"Reforming Medicare – from changing the way doctors are paid to streamlining patient care – could benefit from a grassroots approach, according to experts and physicians at a policy summit held by National Journal Live in Washington, D.C., Tuesday.

“We need to focus more on responding to and joining local initiatives,” said Len Nichols, director of George Mason University’s Center for Health Policy Research and Ethics. As an example, he pointed to an initiative in Rochester, N.Y., that brought local doctors and hospitals together to successfully reduce hospital readmissions.

The panelists agreed that solutions to address the system’s inefficiencies should begin at the ground level with physicians, community members and patients, who could provide valuable feedback and ideas when designing new approaches to quality care and cost control.

“What the ACA has done is to set up an environment where there is support for new innovation,” said Gail Wilensky, an economist who previously directed the Medicare and Medicaid programs.

With much of the health law going into effect in 2014, the U.S. will likely see increased coverage, insurance marketplaces and an expanded Medicaid program.

But Wilensky said the health law’s limited role in changing payment models and encouraging patient engagement in the health system operations could prove to be a “fatal flaw” in what should be an overhaul of the system. “These are huge constraints in how and how fast Medicare can move,” she said.

Dr. Edward Murphy, a professor of medicine at the Virginia Tech Carilion School of Medicine, said physicians’ attachment to the status quo was slowing down efforts to move to a system that rewards better health outcomes and lowers consumer costs. He said doctors need to adopt fundamental new practices.

“To get a broadwave movement of change across the country, it seems to me, we need a cultural shift,” he said."

Tweet:  To be effective,  health reforms must start at the local rather than the federal level.