What will it take to create health care that delivers high-quality results and promotes good health while controlling costs?
On February 19, four of the world’s thought leaders in health innovation posed this urgent question to a packed audience of health care professionals, business leaders, Darden faculty, students and community members.
According to Dr. Delos “Toby” Cosgrove, president and CEO of the Cleveland Clinic, Tim Brown, president and CEO of the design consultancy IDEO, and Darden Professors Elizabeth Teisberg and Scott Wallace, dramatic improvement in health and health care value can be achieved with multidisciplinary teams, the measurement of patient outcomes, and design of services that support healthier behaviors.
The Health Innovation Symposium was hosted by Darden Professor Elizabeth Teisberg, who is internationally recognized for reframing the health care debate to focus on improving value, and Visiting Professor Scott Wallace, who is an authority on the transformation of health care delivery to support chronic health.
Dr. Cosgrove, a world-renowned cardiac surgeon who invented numerous medical devices and new surgical techniques, has led stunning innovation in the organization of patient care in the Cleveland Clinic’s $4.6 billion health care system. Starting from a conviction that every aspect of the organization should be devoted to serving patients, Cosgrove restructured the Cleveland Clinic around diseases and patient problems, not medical specialties — an innovation that groups professionals from various disciplines into patient-centered teams. This interdisciplinary approach improves outcomes, reduces waste and accelerates learning. And it is, indeed, the application of the approach put forward in Professor Teisberg’s pathbreaking book, Redefining Health Care, co-authored with Harvard Professor Michael E. Porter.
“Innovation,” Cosgrove said, “happens at the borders of disciplines,” as professionals from different fields interact to address patients’ issues.
Under Cosgrove’s leadership, the Cleveland Clinic is a leader in measuring and disseminating patient outcomes, an effort that drives ongoing improvement in the already-renowned organization. To Cosgrove, the reforms at the Cleveland Clinic are about health care instead of the usual model of “sickness care.”
To that end, he champions a culture of health not just for patients but also for employees and area residents. Cleveland Clinic programs have reduced smoking in their county from the highest in the state to the lowest in the state, improving health and thus reducing health care costs.
Teisberg and Wallace, whose research is sponsored in part by the Batten Institute at Darden, help organizations to design and build interdisciplinary teams that offer dramatically improved solutions for patients with chronic diseases. As part of the Health Innovation Symposium, the Darden professors met with 30 medical professionals on Thursday, to share insights into their ongoing initiatives to create interdisciplinary services that promote chronic health, rather than just treat the compounding problems of chronic disease.
As Wallace explained, “We can’t treat our way out of the problems of chronic disease. We have to enable chronic health.”
Promoting good health was also central to the comments of Tim Brown, whose global, award-winning design firm, IDEO, now does 40 percent of its work in health care. “The root cause of high costs in health care is our behavior,” he said, “not a bug that can treated with a vaccine.”
Drawing from IDEO’s work in such areas as financial services and energy conservation, Brown presented examples of the design thinking for which IDEO has become famous. Changing rules, influencing social norms, introducing new tools, establishing participatory systems, enabling self-measurement, engaging communities and reframing problems are among the ways to design the behavior changes that could alleviate some chronic diseases.
The symposium concluded with a panel discussion in which Cosgrove, Brown, Teisberg and Wallace discussed the need for strategies in health care that envision different possibilities for the future and new models for care delivery.
Founded in 1954, the University of Virginia’s Darden School of Business is a professional school that improves society by developing principled leaders for the world of practical affairs.
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