Rethinking Health Care: Insights from Regional Variations
Elliott Fisher, MD, MPH, Director, Health Policy Research, Center for the Evaluative Clinical Sciences (CECS); Professor of Medicine, Community and Family Health, Dartmouth Medical School; Co-Director, VA Outcomes Group
This session will review the findings of recent research on regional and health systems variation in spending and practice, and discuss the implications of the findings for efforts to reform the US health care delivery system. How recent policy developments (medical home, bundled payments, accountable care organizations) offer a potential path toward health care reform at local, regional, and state levels will also be explored.
Solving America’s Health Care Challenges Using 21st Century Solutions
Robert M. Pearl, MD, Executive Director and CEO, The Permanente Medical Group; President and CEO, Mid-Atlantic Permanente Medical Group
The design of the US health care system has changed minimally over the past 50 years, even though the clinical conditions, treatment modalities, and available technology are dramatically different. Unless reform includes changes to care delivery, the US will find it increasingly difficult to provide high quality, universal coverage that is affordable. This session will describe a health system design that includes 21st century solutions such as an integrated structure with prepayment, advanced IT systems, and clinician leaders who are equipped to provide efficient, effective medical care that fulfills IHI’s vision of the Triple Aim.
Special Interest Keynotes
How to Develop Resilience as a Patient with a Chronic Condition and a Bad Attitude
J. Galen Buckwalter, PhD, a Research Scientist for the Institute for Creative Technologies
This session will discuss resilience as a crucial component in the process of recovering from, and coping with, medical conditions. Using personal examples and observations, the interaction between the health care system and the development of a positive approach to traumatic and chronic conditions will be explored. The case will be made that health care providers frequently have the implicit capacity, within their roles, to assist patients in developing resilience.
What Health Care Has to Do: Change the Whole System by Rethinking Primary Care
Douglas Eby, MD, MPH, Vice President of Medical Services, Southcentral Foundation
There are many “answers” for health care — managed care, think like a business, Six Sigma, care coordination, pay for performance and now, the medical home and accountable care organizations. Using the IHI Triple Aim initiative work on primary care, medical home, and socially complex individuals — and using the 12-year revolutionary story of Southcentral Foundation’s Nuka Model of Care at the Alaska Native Medical Center as a real life illustration of what is possible — this session will pull it all together and lay out a clear path forward for community and primary care, specialty care, and whole system transformation. Better outcomes, lower total costs, safer care, and significantly happier people on both sides of the clinical encounter are all possible!
Mind the Gap: Building Bridges Between Health Care and Housing
Rosanne Haggerty, President, Common Ground Community
Social determinants of health directly and significantly impact individual health outcomes and are the center of cohesive public health policy. Homelessness overlays a host of issues that determine health outcomes: poverty, lack of social supports, hunger, unemployment, and lack of access to consistent health care. Only 5% of patients account for 50% of Medicaid costs; one-third of these patients are homeless and one-third are unstably housed. This session will examine the strategic partnership between Common Ground, an international leader in the development of solutions to homelessness, and IHI to foster similar partnerships between health care, social service, and housing providers in many US cities.
Designing Services for People with Fatal Conditions
Joanne Lynn, MD, Bureau Chief, Cancer and Chronic Disease, Department of Health, Washington, DC
Each clinical practice has a few dozen people who are sick enough to die, and some practices have many more. This phase of life requires continuity, honest care plan formulation, caregiver support, symptom control, and advance planning — all of which can be built into office practice and community redesign. This session reviews the key concepts, the track record on improvement, and the tools needed to promise excellence and high value to those living with fatal conditions.
A 2050 Vision for Sustainable Large System Improvement
Sir John Oldham, MB, ChB, MBA, Family Doctor and National Clinical Lead for Quality and Productivity, NHS England
This session will discuss large system change and drivers for improvement, quality efficiency, and productivity. The experiences of several countries that have implemented sustainable quality improvement will be shared. Participants will gain an understanding that facilitates their own strategic thinking and practical implementation of sustainable improvement.