Healthy profits

By Ben Thompson, Senior Editor

To build a smarter system, healthcare solutions need to be instrumented, interconnected and intelligent. IBM believes it has the answer.

“If we are going to address the issues of access, cost and healthcare quality, we have to have better information technology to support that”

We live in an unpredictable world. You know it when you get caught in an unforecast storm on a sunny summer’s day; you know it when the stock market tanks and your previously rock-solid investments are reduced to worthless junk; you know it when you hit unexpected gridlock on the way to that all-important business meeting. What you don’t always know are the hows, whys and wherefores – the myriad combination of variables that fell into place in order for those events to unfold.
 
But what if you did? Given better intelligence, is it possible to predict how such permutations might play out in future – thus avoiding the storm, selling high and dodging the worst of the traffic? Can a better understanding of the way systems work help solve some of the challenges we face as a global society? And what implications could this have for that most complex system of all: human health?
 
IBM Chief Executive Sam Palmisano doesn’t claim to have the all the answers – but he’s working on it. From financial crises to climate disruption, energy geopolitics to food supply hazards, Palmisano believes solving the global challenges of today and tomorrow will be about the smarter use of information, and has spent over $50 billion on acquisitions and R&D in preparation for the seismic shift in thinking such a move will require.
 
“The first decade of the 21st century has been a series of wake-up calls with a single subject: the reality of global integration,” he explains. “In business, global integration has changed the corporate model and the nature of work itself. In the last few years, our eyes have been opened to global climate change, and to the environmental and geopolitical issues surrounding energy. We have been made aware of the vulnerabilities of global supply chains for food and medicine. We entered the new century with the shock to our sense of security delivered by the attacks on 9/11. And, of course, we are now in the midst of a global financial crisis. These collective realizations have reminded us that we are all now connected – economically, technically and socially.”

And as the world continues to get flatter, smaller and more interconnected, IBM is banking on something happening that holds even greater potential: the prospect of our planet becoming smarter. “This isn’t just a metaphor,” asserts Palmisano. “New intelligence is being infused into the way the world literally works – the systems and processes that enable physical goods to be developed, manufactured, bought and sold; services to be delivered; everything from people and money to oil, water and electrons to move; and billions of people to work and live. The future now beckoning us is one of enormous promise.”
 
His confidence is based on three key developments. Firstly, the world is becoming instrumented. IBM claims that by 2010 there will be a billion transistors per human, each one costing one ten-millionth of a cent, while sensors are being embedded into everything from cars, appliances, cameras, roads and pipelines to medicine and livestock. Secondly, with over a trillion networked devices, the world is also becoming more interconnected, producing rising volumes of data each year. Finally, things are becoming more intelligent. Algorithms and powerful systems can analyze and turn those mountains of data into actual decisions and actions that make the world work better. Real insight, in real time, is now a real possibility.
 
“With so much technology and networking available at such low cost, what wouldn’t you enhance?” he asks. “What wouldn’t you connect? What information wouldn’t you mine for insight? What service wouldn’t you provide a customer, a citizen, a student or a patient?”

Healthcare is one such sector set to benefit. “Our current approach to healthcare is just not sustainable,” says Sean Hogan, IBM’s VP for Healthcare Delivery Systems. “However, the financial crisis has highlighted the burden that healthcare costs are placing on our society, and as such is prompting a very engaging debate about what to do about it. And the conclusion is that if we are going to address the issues of access, cost and healthcare quality, we have to have better information technology to support that.”

Rising costs, limited access, high error rates, lack of coverage, poor response to chronic disease and the lengthy development cycle for new medicines – Hogan explains how most of these could be improved if we could link diagnosis to drug discovery to healthcare providers to insurers to employers to patients and communities. Today, these components, processes and participants that comprise the vast healthcare system aren’t connected. Duplication and handoffs are rampant. Deep wells of lifesaving information are inaccessible.

IBM believes that a smarter healthcare system starts with better connections, better data, and faster and more detailed analysis. It means integrating data and centering it on the patient, so each person ‘owns’ his or her information and has access to a networked team of collaborative care. It means moving away from paper records, in order to reduce medical errors and improve efficiencies. And it means applying advanced analytics to vast amounts of data, to improve outcomes.

“If you had a map of all industries and plotted the sophistication of the use of information technology within those industries, healthcare would be on the lower end of the spectrum – despite the fact that it is a very technology intensive and information intensive sector,” says Hogan. “But IT can help make the administrative process smarter and more efficient; it can enable health information to be shared between care providers and eliminate redundant procedures; and it can better support the process of care so that physicians have the right information available to support the decisions they need to make.”

For instance, Sainte-Justine, a research hospital in Quebec, is automating the gathering, managing and updating of critical research data, which is often spread across different departments. With the help of IBM technology, the center is applying analytics to speed childhood cancer research and improve patient care while drastically lowering the cost of data acquisition and enhancing data quality. Another example is Geisinger Health Systems, which is integrating clinical, financial, operational, claims, genomic and other information into an integrated environment of medical intelligence that helps doctors deliver more personalized care. This enables them to make smarter decisions and deliver higher quality care, all because they can easily turn information into actionable knowledge.

And true to the premise of Smarter Planet, healthcare systems like these hold promise beyond their particular communities, patients and diseases. “The smart ideas from one can be replicated across an increasingly efficient, interconnected and intelligent system,” says Hogan. “This should result in lower costs, better-quality care and healthier people and communities. In other words, we’ll have a true healthcare system with the focus where it belongs – on the patient.”

In fact, much of smarter healthcare is not focused on the next big breakthrough in medical research. Smarter healthcare solutions start with the individual. Take the Medical Home model, for example, where primary care physicians act as ‘coaches’, leading a team that manages a patient’s wellness, preventive and chronic care needs. The doctor spends more time with each person, is available via e-mail and phone for consultation, offers expanded hours and coordinates care across the individual’s entire care team. Interest in the Medical Home is building in the United States and has caught on globally as well. Physicians, healthcare leaders, insurers, legislators, large companies and other stakeholders are focused on the fact that the Medical Home model of care improves quality and patient satisfaction and contributes to lower overall healthcare costs.

But while medical homes can be a cornerstone of transformation, they are not what Hogan calls “a silver bullet”. They hold a great deal of promise, but many more supportive measures need to be undertaken to fully realise the benefits. For example, steps needed for full implementation include improved access to patient information and clinical knowledge to improve prevention, diagnosis and treatment; changes on the part of other stakeholders (consumers, other physicians, hospitals, health plans, employers, governments and such life sciences as pharmaceuticals); and a robust infrastructure to support comprehensive, coordinated care.

Nevertheless, he believes the strides being made by IBM in terms of harnessing the power of technology for better healthcare solutions are significant. “We are taking advantage of the fact that our society is much more instrumented, connecting that information and using intelligence to take actions that create benefits,” he concludes. “It’s a very exciting area.”

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This article was first published in EHM magazine: www.executivehm.com/article/Healthy-profits