Inspiring The US Innovation Engine For Health Care

Eric Dishman

I am on a plane returning from the annual HIMSS conference on health information technologies. As I watch the borderless states go by far below, I can see the lines and circles of our interstates and highways, which previous generations had the vision and audacity to create for us. Even with the depressing news headlines in the seat pocket in front of me about violence in Libya, continued economic uncertainty, and the threat of $5 gas prices, I find myself, well,inspired.

Last Friday I had the honor of attending President Obama’s visit to Intel in Oregon. Our CEO, Paul Otellini, gave us some much-needed good news about an additional 4000 jobs Intel will create in the U.S. this year as well as investment in a new Arizona lab. Then the President, humbly and humorously, took the stage in celebration of the accomplishments of some student winners who had invented amazing things in Intel’s education and science fair competitions. In his State of the Union address weeks ago, the President said we should celebrate the science fair winners as much as we do the winners of the Super Bowl, and we did exactly that. Then the President celebrated the magic of Intel’s microprocessor manufacturing. It was nothing less than inspiring.

As part of the President’s “Winning the Future” message, he and Paul reminded us of the importance of investing in education, science, and technology to help a nation solve its own problems and to compete globally. Afterwards, I had the thrill of shaking the hand of the President and speaking with him ever so briefly in what, for me, was the best receiving line of my life. I thanked him for having the courage to push for healthcare reform, introduced myself, and he shocked me when he thanked me for Intel’s work on healthcare innovation to move care into the home. Yes, I was star struck. I was, for once, speechless. I was inspired.

In today’s world, it is easy to be cynical. It is easy to be partisan. It is easy to simply dismiss “Winning the Future” and the President’s visit to Intel as mere electioneering or advertising. And I well recognize that the word “innovation” is fast becoming hackneyed and cheapened in our discourse from overuse and manipulation. It is actually harder to choose to be inspired–and to invest the effort to make these words and slogans real. But here’s the thing: I believe in winning the future. I believe in investing in new technologies, industries, education, and jobs that help us compete globally. And I believe we have to do all of these things for healthcare in particular, with urgency.

Which brings me back to the HIMSS conference, where I had the good fortune to share the stage with the President’s Chief Technology Officer, Aneesh Chopra, in a panel about healthcare innovation and the hot topic of the conference: Accountable Care Organizations or ACOs. Aneesh gave a rousing call-to-action for those on the front lines of healthcare to re-imagine and reinvent our healthcare system. He explained how elements of the reform bill such as the CMS Innovation Center and the transition to value-based payment (through care models like ACOs) are meant as mechanisms to open up healthcare innovation, not to prescribe one-size-fits-all solutions from Dr. Government to the medical masses. And, echoing Paul and the President’s Friday messages, Aneesh reminded us that healthcare–like every other part of our society–faces a global competition and that the United States must become an exporter–not just an importer–of new technologies and services for next generation healthcare.

There was a great deal of discussion about ACOs at HIMSS–some decrying them with gloom-and-doom scenarios, some celebrating them as utopia. But I think those positions miss the real spirit and intent of the healthcare reform legislation. Neither Aneesh, nor the President, nor the Secretary of Health, nor the federal agencies rushing around to implement these reforms are claiming that ACOs will solve all of our problems or that they have it all figured out. They are, quite simply, instigating innovation and creating the conditions (investment, incentives for quality, regulatory support, collaboration, innovation training, data mining, etc.) in which American ingenuity can come to the rescue of our outdated, unsustainable healthcare system. Healthcare innovation in America is going to happen–indeed, it hasto happen–whether in the form of ACOs or something else we haven’t imagined yet. We just have to get started without delay.

It is important to realize that healthcare reform is a global competition to invent the 21^st century care infrastructure, technologies, services, and jobs that each country needs to solve its own
demographic/economic challenges and to export to the rest of the world. Healthcare reform and economic stimulus are intertwined. At HIMSS and here in this blog, I have described this as the race to invent “gray technologies for Global Aging,” just as the U.S. and other nations are in a global competition to create green technologies, industries, and jobs to address Global Warming. Same message: solve our problems; grow our economy by exporting our solutions.

The United States can’t bury our heads in the sand on the issue of Global Aging, but it feels like we are doing just that. Meanwhile, other countries heed and lead. The European Union recently announced Aging as one of its top priorities, launching a new EU Active & Healthy Ageing Innovation Partnership. Intel just joined a Global Coalition on Aging effort with APEC (Asia Pacific Economic Cooperation) as well as the China Public Private Partnership for Health to help other countries put together strategies and action plans to deal with the age wave and the resulting healthcare challenges it has created. But somehow the U.S. has failed to face this other inconvenient truth with equal intensity and urgency.

Thus, I call upon the President to inspire innovation–to bring his “Winning the Future” message–to healthcare and to work with Congress to do four simple, powerful things to get us started:

1) Create a national commission on Global Aging preparation, innovation, and competitiveness to catalyze U.S. imagination, investment, and action in this sector;

2) Convene a White House Conference on Aging on the topic of Global Aging, with Presidential sponsorship to bring together the nation’s brightest minds and ideas for building out our aging-in-place infrastructure and healthcare system;

3) Make aging-in-place and innovative models of long term care a fundamental pillar in the reauthorization of the Older Americans Act;

4) Build innovation capacity within every federal agency that touches healthcare, so that we keep iterating and improving healthcare quality, cost, and access over time. After all, no one healthcare reform bill, no single care model like an ACO, no one wave of health information technology will solve all our problems; we need to create a culture of continuous innovation in healthcare. All that innovation that the President celebrated at Intel–from the 7^th grade students to the fab workers–is not really “magic.” It is innovation, education, process, and rigor that can be brought to government, too.

Let’s inspire the U.S. innovation engine for healthcare–that could be our most important Sputnik moment in the midst of Global Aging. And that could help insure that we, like the generations before who gave us the highway system, the airport transportation system, and so many other national capabilities that empower modern life, leave behind a healthcare system that is available, affordable, and amazing for ourselves and all who come after us.