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November 7, 2011

Six aspects to make US Healthcare Sustainable...A thought

Making healthcare affordable, accessible & accountable is not any unique initiatives to any health care system. The pivotal concern has been always to make the healthcare system sustainable. If I have correctly analyzed the prevalent facts & figures, I can well claim that the current US healthcare system is absolutely operating under an unsustainable bubble with a perfect mismatch of cost and quality giving rise to the increasing trend of inequity, inequality and inefficiency. Moreover, with the fast pace in healthcare market the future provisions are never an easy one to grasp. Changes are certain in medical technologies, management of chronic illness, reimbursement patterns, coverage policies & etc. In such a situation, if a healthcare system can't move towards a comprehensive system-wide reform or just aims (even with incremental changes) to address either financing or delivery system problems but not both, it is bound to be dysfunctional, lose its credibility and we will ever continue to waste billions of dollars and thousands of more lives every year. So, as an answer to this issue let me now weave the concept of a "True" sustainable healthcare system". Yes, I agree quality, cost, delivery & financing mechanisms are the four pillars, and still the open question is what is beyond these to reap the full impact in cost, affordability and accessibility and make health-care sustainable and for all including the most vulnerable ones.

I look at "disruption & innovation" or what I say a "transformational force"- unique conglomeration of simplified technology, innovative business model and a valued network that will practically balance the cost structure within the existing ecosystem for achieving the challenged sustainability. A broader refocused approach delving on the following 6 aspects might help today's US healthcare to reshape for a better future and meet the targeted standards set by its peers around the world- 

1. Transformation to orchestrated business models having a neat, higher degree of integration of value-adding processes and facilitated networks namely evidence based practice, closed loop medication, retail health, PCMH, ACO & etc.
2. Moving away from the status quo to open market innovation (e.g. mobility, digital hospital etc.) with integrated public health utilities (e.g. automated public health surveillance, focused primary care to facilitate preventive care in place of reactive care & etc.) and aiming for a larger focus to achieve the WHO's "Health for All".
3. Enabling true consumer empowerment with technology supporting them to get "only" what they need, e.g. Interfaced intelligent devices synced up with portals for self-diagnosis, decisions & social interactions- A trending shift from consumerism to prosumerism. Thus, enabling convenience, ensuring responsiveness and a better healthcare experience.
4. Redefining the existing care cost structure with a pulse of accountability and ownership- A paradigm shift from so called global to bundled to condition based reimbursement models.
5. Going GREEN, consolidation & virtualization of Healthcare IT infrastructure to reduce operational cost & adoption of cloud to respond the impending healthcare information explosion.
6. Adoption of pervasive computing to enable remote automated patient diagnosis, treatment & monitoring e.g. telecare, telesurgery, remote sensors that will ensure continuous capture and analysis of patients' physiological data.

Difficult though, but healthcare organizations need to disrupt themselves with a focused investment of energies, talent, and resources and start playing a more proactive role in orchestrating these emergence compared to the reactive posture they have taken in the past. The very fluidity of the current healthcare market will further make these aspects more promising and attainable. Just my 2 cents before I think to conclude- If we act from today and if we act together to remove the cobwebs of rhetoric (political and commercial) - the goal to make the current healthcare system fiscally sustainable is absolutely within reach.