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System Science: A Wil Rogers Prescription For Healthcare Delivery, Health and Our Health System

System Science: A Wil Rogers Prescription For Healthcare Delivery, Health and Our Health System . ISSH, Pittsburgh, PA May 26, 2011. M-J. Sepúlveda, MD FACP IBM Fellow & Vice President. Content. Disclosures Why does IBM care? Performance: medical care delivery system

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System Science: A Wil Rogers Prescription For Healthcare Delivery, Health and Our Health System

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  1. System Science: A Wil Rogers Prescription For Healthcare Delivery, Health and Our Health System

    ISSH, Pittsburgh, PA May 26, 2011 M-J. Sepúlveda, MD FACP IBM Fellow & Vice President
  2. Content Disclosures Why does IBM care? Performance: medical care delivery system Affordability, competitiveness, productivity Health and Health System Definition Framework Some evidence Wil Rogers
  3. Disclosures
  4. Medical Care Delivery System in Crisis Cancer and CT
  5. Our Healthcare System Performance Is Low Quality Received Rec. Screening./Prev.Care Mental Health Dx Received Rx Chronic Disease Under Control Care Coordination @Discharge Unsafe Drug Use Children w Medical Home Adults w Accessible Primary Care Received Rec.Rx MI, CHF, Pneumonia Commonwealth Fund 2011

  6. Our Costs Are High and Affordability Low

    Annual Cost Increases v. CPI-U Affordability Chiasm Widens 2011 Towers Watson Healthcare Cost Survey Bureau Labor Statistics, US DOL
  7. And the cost outlook is grim for nation… $4.6T E’er 50% increase$1.2T (26%) Total NHE $2.6T $4.6T (77%) -Employers $0.8T $1.2T (50%)
  8. $30,000 +166% $25,000 $20,000 $15,000 +118% $10,000 $4,918 $5,000 $0 2001 2009 2019 Hewitt - Employee Payroll Contributions Hewitt - Employer Cost Hewitt - Employee Out of Pocket Expenses a And grim for you, me and our employers $28,530 Costs continue their upward climb… $10,743
  9. Health/Care are business issues, not benefits issue
  10. Affordability …which continues to impact global competitiveness India $500 China $1500 Russia $1500 Brasil $2500
  11. Fatigue Obesity Anxiety Arthritis Back/Neck Depression Chronic Pain Hypertension Sleeping Problem High Cholesterol Top 10 Medical Conditions by Annual Total Cost Per 1000 FTEs for All Four Employers (N=15,380) Journal of Occupational and Environmental Medicine (JOEM) V.49 N.7 July 2007
  12. What is Health … a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. (WHO Constitution 1946)…a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. (WHO Ottawa Charter 1986)
  13. Our health is an outcome of nature, nurture and behaviors in a complex, dynamic, and highly interrelated system-of-systems Media Communications Transportation Education $ 1.36 Tn Water Medical Care $2.7 Trillion (17.5% of 2010 GDP) Energy And Climate Health is system-of-systems Other Govt. Agencies Employers Govt. Public Health Housing $ 4.58 Tn Agriculture & Food $ 4.89 Tn Source: IBM IBV analysis based on OECD

  14. Case

    16 y.o. Latina, obese 1 of 4 children, both parents work, one overweight, other obese Recent dx type II diabetes Care in world class Primary Care Medical Home Received all recommended coaching, counseling, training: e.g. diet, activity, behavioral health support Prescribed metformin to lower blood sugar Keeps appointments, non adherent, no change
  15. Counting Classroom Seats in a Booming City Our Health System is in Crisis
  16. Health System: Schools
  17. Decatur, GA Health System: Housing, Built Environment
  18. Health System: Income
  19. Health System: More Education, Longer Life More Maternal Education, Better Infant Survival
  20. Higher Income, Chronic Disease Health System: Higher Income, Longer Life

  21. Health System: Food, Government Zoning

    NYC Department City Planning, IOM 092010 New York City Department of City Planning IOM, Public health Strategies to Improve Population Health, 09 2010
  22. Supermarket High Need Areas Health System: Food, Government Zoning New York City Department of City Planning IOM, Public health Strategies to Improve Population Health, 09 2010
  23. NYC FoodRetailExpansion to SupportHealth New York City Department of City Planning IOM, Public health Strategies to Improve Population Health, 09 2010
  24. Our Health System Improvement Plan Needs Systems Science Desperately
  25. Wil Rogers
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