Instrumented Interconnecteds Intelligent

Among the many highlights of the Smarter Cities summit we hosted in New York City October 1 and 2, Dr. Denis Cortese’s presentation ranks among the top. As the CEO of the highly esteemed Mayo Clinic, Dr. Cortese has a unique perspective on the state of health care in the United States. Given the prominence of the issue in public debate, I wish there were some way to mandate that every citizen watch his very lucid, very pragmatic 18-minute conversation on how to design a better health care system. You can see the whole thing here by clicking the image below (it will launch a player based on your browser’s preference).

Dr. Denis Cortese, President and CEO, Mayo Clinic Great Expectations for U.S. Health care

Length: 18:08

On Friday, Irving Wladawsky-Berger published his own lengthy post in response to Dr. Cortese’s presentation:

Dr. Cortese then discussed some of the most important new concepts that should be part of any future healthcare system.  The first is personalized medicine.  How can you translate new discoveries into incremental value for each individual patient?  This involves not just major research advances such as genomics medicine, but also the ability to reach everyone in cases like the H1N1 virus, where untreated people can compromise the health of the whole community.

The second major concept involves the science and engineering of healthcare delivery.  Our country invests a lot in medical research, a great portion of which is funded by the National Institute of Health.  However, there are no major academic programs focusing on healthcare delivery, the very core of any healthcare system. 

We have been trying to build such programs at MIT, and so have other institutions like Georgia Tech and Arizona State University.  There is great interest on the part of faculty and students but little funding so far to help organize the efforts.  The funding available from the Department of Health and Human Services for such programs is miniscule compared to the funds available for medical research.

We also have to figure out how to measure the value created by the healthcare system we are designing.  Value for each patient must be defined in terms of better outcomes, better quality and better service divided by the cost of providing care for that patient.  It must be concrete and measurable, otherwise you don’t know how well your system is performing and whether you are getting adequate returns for the money you are spending.

If you can spare the 18 minutes, please take some time to watch the video, then read Irving’s post, explaining more of the framework Dr. Cortese outlined in his presentation.

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1 Comment
 
October 14, 2009
6:11 pm

I have a few questions re. this project, some of which I was hoping would be answered by the video. I clicked on the video & it popped up a WMV video; not very helpful given that I’m running Linux.

So I thought I’d post them as a comment …

Firstly & most importantly: what is your position on individual freedom w.r.t. your proposals for changes to cities, healthcare, etc.?

I’m worried by the fact that your approach seems top-down. For example you talk about designing a healthcare system. What does that _mean_?

Does it simply mean providing information to citizens so they can make informed choices as to how to spend their own money?

Or – and this is what worries me – are you talking about using tax money (i.e. by money taken without consent) to build a system which people will be forced to deal with (e.g. through compulsory insurance, or by legislation imposed by a federal monopoly like the FDA)?

Also, I have a few questions regarding IBMs involvement. I can’t imagine that IBM would enter into a campaign like this without having built a business case for it.

I’d love to see the numbers on this. What sort of expenditure on IT infrastructure do your BAs project for these plans (smarter cities, improved healthcare)? What proportion of this expenditure does IBM hope to capture through this campaign? Or is it seen as a marketing / PR exercise, not lobbying? If so, what sort of return do you expect?


Posted by: Duncan Bayne
 
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