Monday, September 21, 2009

Future Connectivity: Healthcare Revolution for Community Development

by Hardy F. Schloer; SCG, Schloer Consulting Group, Spain

Speech at the International Conference on China’s Urbanization and Community Development under Globalization

Good Afternoon, ladies and gentlemen

First of all, let me thank the organizers of this event that invited me here today, to give me the opportunity to speak to you.

I am the last speaker for the day, and I am sure you are all a little tired by now, so therefore I will try to be quick, and hopefully I shall keep your interest focused on this presentation.

I prepared on the subject of “Healthcare revolution for Community Development in China”, and indeed; this is a most fashionable topic these days, as now nearly every nation has began to recognize the importance of managing healthcare more efficiently and more economically.

Clearly; healthcare is a basic need within society, just as clean water, pollution free air or the need of basic security. It is a none-negotiable provision that our community leaders should provide in an un-politicized fashion for the common good of all.

Unlike common believe, it is healthcare that is the oldest profession on earth. In fact, in agent societies it was a duty of the spiritual leaders to practice healthcare. The druids of the Celtic villages 2000 years ago are an example that comes readily to mind. Even today the so-called medicine man of African natives is still a leftover of this agent practice. So, we can safely say, that healthcare is a central and important aspect of our lives for many millenniums.

In the beginning of my presentation I will now talk about the current healthcare conditions in the west, and I will explain some important facts about them. Naturally, you expect relative information pertaining to China, so please bare with me, I will get to China in due time during my talk.

The current practice of healthcare in the west offers just such perfect example of “how NOT to do it”, that I simply cannot resist using it also here today.

Some say, that we must improve Healthcare substantially, so that the pace of improving healthcare matches that of advancements in, lets say modern biology.
In past years technology and science have made significant progress in nearly all areas. Nevertheless, only little has translated into the day-to-day practice of building sustainable, safe and well managed healthcare communities around the globe.

In fact, the situation in healthcare is so dire, especially in the west, that it threatens the very existence of commercial businesses, communities and even the economies of whole countries.

For example, the US currently spends nearly 3 trillion dollars on healthcare with very little to be proud of, considering the enormous problems that exist in their healthcare system in spite of enormous spending; yet it still claims to be one of the best in terms of results…..

So I guess one can only begin to wonder how bad it is elsewhere.
Lets talk about some current examples:

General Motors is spending currently more money on healthcare then it spends on steel; but making cars from steel is their primary business; not healthcare.
Clearly, looking at such numbers, it is no wonder that this company got into great financial difficulties in past years.

Additionally we can notice, in spite of the horrendous expenditures, that the healthcare, which General Motors employees are receiving, is consistent with that of any other healthcare community:

It is ineffective, expensive, full of medical errors, plagued by corruption due to the strong influence of special interest groups, and most of all badly managed from bottom up, and also from top down.

Naturally, we don’t have to look only west, to see fundamental problems in healthcare. South America, Asia, Africa are plagued equally or worse with just very few exceptions in between.

One of the premier problems in today’s healthcare is, that we practice it exactly as we did some 50 or 100 years ago.

For example, there is no centralized and coherent flow of patient data management that supports the entire healthcare management of any community such as, lets say, a company, a village, a city, a country or maybe even the human community of whole planet.

Think about this:

Every single time, that there is an interaction between a doctor and a patient, anywhere in the world, there is some extremely valuable knowledge created that should be preserved, compared and analyzed.

This information is not just valuable for the patient, and important enough to be preserved for her or him; but more importantly, for the whole field of medicine, because we can statistically track important conditional correlations between drugs, illnesses, environmental and sociological conditions, genetics, and many other such vital factors.

Yet, in spite of this empirical fact, doctors treat patients, and store the results of treatments in outdated record systems mostly on paper, or if electronic, then at places where they are inaccessible by the general healthcare process; and often on incompatible standards, and worse of all, never re-analyzed after the patient has left the office.

And why should he? The case is closed, the bill is paid; and after all….. the patient is in our modern healthcare process simply just a profit-center! Nothing more! Nothing less!

Beyond the problems this process creates for the individual patient, this is also the single most amazing case of wasted knowledge imaginable.

Envision, what all this information could produce in terms of identifying epidemics, drug deficiencies; or on a more complex scenario, the hidden combinations of drug and health conditions that escalate into new illnesses undetected, just because we don’t have coherent and broadly machine analyzed access to the collective information of all healthcare records.

But there are other additional problems with current systems in ambulant applications!

Preventable errors and inconsistent quality of care are some of the main areas of concern in how we practice medicine in our communities.

A recent 2008 “Institute of Medicine” report states the following:

“Between 44.000 and 98.000 Americans die each year from medical errors. At least 90% of these are preventable. Many more die or have permanent disability because of inappropriate treatments, mistreatments, or missed treatments in ambulant settings."
“More people die each year in the United States alone from medical errors than from highway accidents, breast cancer or AIDS combined.”

If this is not shocking to you then lets try this:

In 2007 a multinational study was performed in 27 countries to evaluate the frequency and the possible causes of medical errors.

Altogether just 113 intensive care units with a total of 1328 patients.

The care units self-reported for one specific single day the frequency and the probable cause of the errors committed.

Remember! We are talking her about a very small sample on one single day!
The results are simply shocking:

A total of 861 errors occurred to 1.328 patients! 19% of these cases were exposed to multiple errors. This means, that 191 patients, that is 14%, experienced more then one error!

14 patients who experienced errors died or were permanently handicapped as a result.
The reported reasons for these errors lay clearly in the insufficient communication and information structure in today’s healthcare systems.

It is clear, there is a major opportunity here to bring about change, and this finally leads me to the subject of Healthcare as Community Development opportunity in China.

We begin by looking carefully at 2 interesting factors:

First of all, lets talk about the development of data processing technology and its current levels of readiness:

Today we have powerful networks, computer systems and databases that are capable to handle in real time the complete health care history of every human living on this planet… and still would not show any signs of computational overload.

We could without any problems give every patient and every health practitioner on this planet a convenient and secure web interface that would allow everybody to enter and store every single health record update in a central data processing system, without compromising any privacy issues. To the contrary, such system would enforce privacy better then anything we got today.

Such systems and the their current and emerging network technologies could be configured powerful enough to let every doctor practicing on this planet; every pharmacist; every medical researcher use this system in real time; in parallel, and still, such system would easily manage to real-time process all data, store every record, and background-analyze all records every 24 hours against all new medical knowledge gained in every previous 24-hour period.

We could easily automate all clinical research in the view of billions of doctor-patient interaction records, and very quickly find out, what treatment would work, under what conditions; however complex; and what would not!

We could build such system completely patient-centered and give the patient the right and responsibility to check and update his own record whenever needed, become a active and responsible part in his or her healthcare process, rather then just be an uninformed spectator of current systems.

When we talk to visionary healthcare practitioners all over the world and present them with this idea, they seem to all agree: this is the ONLY way, how we can solve the cost and quality problems in modern healthcare. Without exception; all agree!
So; why are we not using it? Well, this leads me to my second point:

Nearly all countries in this world manage community development as a decentralized task. In fact it became a real trend in the 1980s under Ronald Regan in the US to abandon all centralized governmental procedures and let communities figure out themselves, how to solve the problems of such community development.

Nearly all bought into this analogy, and today most countries suffer extensively from those effects…..

except one: CHINA

China has more then 1000 years of solid experience in how to develop communities from a completely centralized perspective.

At no other time in history could this pay more dividends then now, when finally modern communication technologies will allow China to implement efficient and centralized healthcare systems similar to those described just a moment ago.

China will be able to do this natively, because its system is ready for it; for 1000 years.

And in such way, China will be able to take fully advantage of globalized knowledge, and reuse it through centralized processing and communication systems in real-time, to thrive community development, whereby every community can take advantage of new knowledge developed in any other community, even communities outside of China, in a intercultural and interdisciplinary way.

Not only would this usher in a true revolution in healthcare for China, but moreover, it would give China the tools today to leapfrog the entire global community in healthcare, setting so a new standard and leadership in this area.

What are the chances, that such revolution could take place here in China in the near future? They are very high! All conditions are present in this moment.

No country has adapted in the last 2 or 3 decades to global technological developments as radically and as uncompromising as China.

If you have missed this fact about China, you have not been looking very carefully.
If the potential of the healthcare revolution will be realized by China, it will become a most successful prove of concept, in how to use the power of technology within the framework of a centralized framework to foster high-quality community development in most efficient manner.

There is no doubt in my mind, that a Chinese technology driven centralized community development strategy, if realized vigorously, will result in global leadership in many areas in the shortest time, and set so new global standards.
The magic formula is:

Centralization + Technology = Winning Strategy

The question is: will the rest of the world adapt?

As we all well know from the laws of evolution:

It is not the strongest that survives…. It is the one that is most adaptable to change!

Time will tell!

Thank you, and good evening!


Blogger kr said...

One might say that there is many adaptive challenges amongst the tribes. \adaptive challenges if to be of economic fortitude must recognize and work within the constrains of value criteria.One criteria is preventability. How should we concentrate limited resources to effect preventable problems. Another might be,Resource availability. How much leverage shall we extend to health situatons that will effect the greatest change? Another one is prevalence. Must resources be applied in direct proportion to the prevalence of community problems? Ramification, What actions will we undertake in order to concentrate on problems with the mostimpact versus impacts on several other outcomes or self contained problems? Unmet needs, should we recognize the unmet needs with resource allocation which might not have been done in the past? Do we allocate resources on specific client groups to the exclusion of others, not respecting the demands of service. These are but a few. What should we focus on diagnosis or treatment....


November 29, 2009 9:38 AM  
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