Instrumented Interconnecteds Intelligent

Ever wonder why your cat gets a note from the vet when it’s time for his immunization but you don’t get a one from your doctor? With all the focus on healthcare, it seems like improving on the basics is the best place to start. How about your family doctor?

This month, the New England Journal of Medicine and Health Affairs feature stories on the important role of the family doctor and how the face of primary care is changing in a way that just might keep us all healthier.

My colleague, Holli Haswell, spoke with Dr. Paul Grundy, IBM Director of Healthcare Transformation, about why primary care is important, and about the growing movement among doctors, patients, insurers and employers to embrace the idea of the Medical Home – the idea of having a real relationship with a primary care physician that acts as a coordinator for all your care. Here’s a transcript of their conversation:

Paul GrundyQ: Why is primary care such a big area of focus for improving healthcare worldwide?

A: There is something really powerful about the healing relationship between a patient and a doctor that is foundational to keeping people well. When there is a real relationship and trust between the doctor and patient, it amplifies how important health and wellness are in life. People who have this type of relationship with their docs are sick less frequently, have fewer chronic illnesses, and this pays huge dividends for society in the end.

Q: How will primary care grow even more important in the future?

A: As our society ages and demography changes, not everyone will need new hips and knees. The healthcare system does much better at partial care delivered by specialists, but primary care is key to helping patients navigate a complex system and reduce costly diseases like diabetes and asthma. The Medical Home model of care, where the patient is supported by a primary care physician who advocates on the patient’s behalf, has proven results and has reduced the cost of care while improving quality everywhere it is practiced.

Q: What’s the payoff for Medical Home?

A: In most practices we see at the minimum a 5-20% reduction in medical costs all while providing patients with a much higher level of care and a more satisfying relationship for the patient.

In communities across the nation, employers, health insurance companies and primary care doctors are coming together to improve how primary care is delivered. A Washington state pilot saw a 20 percent drop in emergency room visits. A North Carolina project experienced a 40 percent drop in hospitalizations for asthma and a 16 percent drop in emergency room visits. A Pennsylvania health care system reported $3.7 million in net savings in its pilot. The federal government has also emphasized primary care as the centerpiece of its plans for the Veterans Administration and Department of Defense health care programs.

Q: How does technology help keep people healthier?

A: The simple ability to contact a caregiver 24/7 via e-mail, telephone or access to information via a patient portal can reduce the number of doctor visits and keep people out of the emergency room. Tools like remote monitoring and wellness devices allow doctors to keep a close eye on patients while keeping them in the comfort of their home.

Technology can also lighten the administrative burden on doctors — I believe most practices spend 30 percent of their time, energy and resources on administrative tasks. There are so many ways the right technology can help improve processes and efficiency — from making it easier to share electronic medical records to e-prescribing to improve prescription drug safety and accuracy. These tools have an important role in the medical practice of the future.

Q: What is IBM’s role in this transformation?

A: IBM is one of the nation’s largest purchasers of health insurance so we have a vested interest in finding ways to improve care and keep our employees healthier. When one of our employees has a primary care provider as their usual source of care. it costs IBM 1/3 less money, the mortality rate drops by 19 %, and the employee is 12 % less likely to be obese and 7% less likely to smoke.

IBM also develops a broad range of technology for healthcare and life sciences – from drug discovery, to health supply chains, to genetic research, to modeling the brain. We have a worldwide staff of more than 4,000 employees dedicated to healthcare, including more than 60 medical doctors and 350 other healthcare professionals. Creating a smarter, more connected healthcare system that puts the patient at the center of care is an important goal for all of us.

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