Newt Notes: The Top Health Transformation Stories of the Year
1. Electronic Health and E-prescribing Come of Age
Health and Human Services (HHS) Secretary Mike Leavitt has proven to be a true leader in the fight for accelerating the adoption of Health Information Technology, including e-prescribing. CMS Acting Administrator Kerry Weems recently announced that the agency expects to expand a five-year demonstration project, started in October, where participating physicians who use Electronic Health Records (EHRs) would be paid a bonus each year.
While Congressional gridlock has presented a roadblock, Health Information Technology is emerging, more and more, as one issue that many Republicans and Democrats agree on. A new national poll finds that seniors in rural areas by a 2-1 margin think e-prescribing sounds like a good idea and support requiring rural Medicare providers to use the technology. The Center for Health Transformation is currently working on this issue with U.S. Senator John Kerry, with whom we recently co-authored an op-ed in The Wall Street Journal and held a news conference with three other senators on Capitol Hill to advocate and advance the adoption of electronic prescribing.
In addition, in late January 2007, The Center hosted a Georgia e-Prescribing Summit. All of the major stakeholders in Georgia participated in this event where I vigorously challenged the participants to make Georgia the first state in the nation to achieve 100% e-prescribing. As a result of the Summit, a working group was formed which has met on a quarterly basis since the Summit, identifying challenges and opportunities. In addition, Project Director Jim Frogue recently co-authored an op-ed with Michael Ciamarra, Vice President of the Birmingham-based Alabama Policy Institute, titled “100 percent e-prescribing will save lives,” which highlights the power of e-prescribing.
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2. Candidates Pay Attention as Health Becomes the Number One Domestic Issue
Recent polls show that health is now the number one domestic issue – something that has drawn the attention of candidates from both sides of the aisle.
U.S. Senator Hillary Clinton is one candidate who did a good job this year calling attention to the issue of health. She gave three major speeches on lowering costs, improving quality and covering the uninsured. These are exactly the right problems to address. Dave Merritt and I wrote an op-ed for National Review praising her command of the subject and her commitment to solve these issues, but disagreeing with her strategies. We at the Center are willing to work with anyone, Republican or Democrat, who shares a passion for transforming health, and Senator Clinton clearly does.
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3. Contaminated Pet Food and Other Imports Draw Federal Scrutiny
Earlier this spring, the Food and Drug Administration (FDA) began recalling tainted pet food. Prompted by reported instances of cats and dogs in the United States that developed kidney failure after eating the affected products, the FDA found a substance called melamine in samples of recalled pet food and in the wheat gluten used as an ingredient in the pet food. The federal government, under the House Energy and Commerce Committee, took relatively swift action in starting investigations into the tainted pet food. The outcry from Americans nationwide to this story – and to other stories this year and last related to animal abuse and to pet evacuation during emergencies – reminded everyone just how central our pets and animals are to human welfare and health. Recognizing the importance of this issue, the Center recently launched a Healthy Pets and Healthy People project led by CEO Nancy Desmond.
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4. Transparency Brings Consumer Education and Improves Healthcare Services
This year, the Centers for Disease Control (CDC) has made a point to discuss the skyrocketing concerns surrounding the surge in how healthcare-associated infections happen and how to develop appropriate interventions. A new report from CDC updates previous estimates of healthcare-associated infections. In American hospitals alone, healthcare-associated infections account for an estimated 1.7 million infections and 99,000 associated deaths each year. Of these infections:
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32 percent of all healthcare-associated infection are urinary tract infections
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22 percent are surgical site infections
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15 percent are pneumonia (lung infections)
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14 percent are bloodstream infections
The Center continues its push for a state-by-state agenda to be more transparent with its reporting data. An excellent example is the State of Pennsylvania’s recent decision to publish its infection rates for its hospitals. This type of transparency empowers the individual’s Right to Know the true price and quality of healthcare services where they live so they can make wise decisions. One way to combat infection rates is for the public to be educated about the quality of healthcare when making decisions about where to go for health services.
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5. Health Justice Transformation
Medical liability in the U.S. is at a critical juncture. Inaction on the part of the federal government to create viable national medical liability legislation underscores the Center’s philosophy that states will take the lead. Texas is a great example of a medical liability insurance crisis not only being averted but actually being reversed. In August of 2003, the State of Texas implemented its plan and now insurance rates are lower, more insurers are offering coverage and doctors are returning to the state. (We invite you to visit the Center’s new online multimedia learning library to view a video of Dr. John Gill, discussing the Texas success story.)
In September, The Center hosted the first ever meeting of the Health Justice Transformation advisory panel comprising a group of our members and other leaders dedicated to creating a 21st Century Intelligent System of Health Justice. The advisory panel heard a presentation on specialized health courts and state-based success stories from Texas and Georgia. Additionally, the advisory panel, through the work of Project Director Wayne Oliver, is examining specific solutions directed toward eliminating frivolous medical liability lawsuits and expediting initiatives which would enhance patient safety and implement quality improvements. The advisory panel is also examining voluntary alternative dispute resolution and other innovative ways to provide patient protection while ensuring appropriate access to healthcare services.
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6. deCODE Release of Consumer Product for Genetic Testing
Amazing progress was made in moving the health system to one that is individual-centered and personalized, through advancements in genetic testing. Through a subscription to “deCODE me” at www.decodeme.com, an individual can learn what their DNA says about their ancestry, their body – traits such as hair and eye color – and whether they may have genetic variants that have been associated with higher or lower than average risk of a range of common diseases. This information will be continually updated as new discoveries are made. deCODE genetics is supporting The Center’s Healthy Georgia Diabetes and Obesity Project, led by Project Director Laura Linn, by working with the Center and the Columbus Research Foundation to assess the prevalence and association of genetic risk for Type 2 Diabetes and heart attack with individuals who have metabolic syndrome or conditions associated with metabolic syndrome.
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7. Playing Politics with Kids’ Health
The most contentious debate this year was over reauthorizing the State Children’s Health Insurance Program (SCHIP). Nearly everyone involved agreed that the first ten years of the program, which started in 1997, were a great success. Where that agreement broke down was over the program’s future. Dave Merritt and I wrote two op-eds on SCHIP. The first one critiqued the radical expansion of the program, proposed by the House Democrats, and the second one offered a bipartisan way forward which would not play politics with kids’ health insurance. This debate is still ongoing, as the program has been only temporarily extended, but it promises to be part of an even larger debate over healthcare that is likely to dominate much of the debate in 2009.
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8. Georgia Project Highlighted in Times Square
An amazing story about The Center literally lit up Times Square in New York City when the National Committee for Quality Assurance (NCQA) recognized Georgia’s 100th physician, Dr. Elizabeth Martin from Columbus, for providing the “Best Standards of Care for Diabetes.” I was in Columbus to present Dr. Martin with the certificate of recognition. Recognition programs such as these are critical to improving the care of those with diabetes through establishing standards of care and quality metrics. Meanwhile, by partnering with large employers, insurers and physicians to implement Bridges to Excellence in Georgia, we have created one of the largest pay-for-performance initiatives in the country.
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9. Study Group Formed to Develop National Alzheimer’s Strategy
This year The Center worked with partners to launch the Alzheimer's Study Group (ASG). Alzheimer’s poses an immense challenge to our nation. I’m co-chairing the Study Group with former U.S. Senator Bob Kerrey, and our aim is to create an Alzheimer's National Strategic Plan to overcome the mounting crisis. We are joined by a remarkably talented team ranging from Justice Sandra Day O’Connor to Nobel Laureate and former National Institutes of Health director, Harold Varmus. The Center’s Alzheimer’s Project Director, Robert Egge, is serving as the ASG’s executive director. We will assess the adequacy of the country's current efforts to combat Alzheimer's and recommend strategies to accelerate progress toward defeating this terrible disease. In so doing, I hope we’ll create an aggressive, transformational battle plan that can help guide our approach to combating many other diseases as well.
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10. Stem Cell Breakthrough Illustrates Continued Rate of Scientific Advances
One of the most important health stories of the year may prove to be the success scientists had in reprogramming skin cells to function as embryonic stem cells. In time, this may be viewed as a pivotal advance in a stream of research that transforms our approach to treating a range of conditions. More generally, it is a leading example of the unrelenting pace of scientific progress along a range of research fronts. Certainly, our ongoing challenge is to sustain, or even increase, the rate of such advances. These fundamental breakthroughs that can remove the moral question of stem cell research can change how we approach science. Even more important, we need to create fundamentally new systems that accelerate how quickly we translate such breakthroughs into real benefits for those who need them. The Center’s projects on Cancer and Alzheimer’s focus on this level of dramatic change.
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11. Breakthroughs in Cancer Offer New Hope
A new test that can tell physicians during surgery whether breast cancer has spread will allow them to remove affected lymph nodes during a lumpectomy or mastectomy. This capability offers new promise in terms of intervening quickly and ultimately increasing breast cancer survival rates. In addition, a new protein-screening test will increase our ability to detect lung cancer earlier, thereby aiding in early treatment that can save lives for countless people.
Early this year it was reported that the number of Americans dying of cancer declined for the second year in a row, this time by a much greater number, according to the American Cancer Society. Experts considered this a signal that decades of advances in prevention and treatment are paying off.
These positive stories illustrate the impact that scientific breakthroughs can have on the length and quality of our lives and the reason why we must accelerate the discover-develop-disseminate-deliver model of cancer research, prevention, and treatment.
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12. Launching Missouri Project Moves The Center Across the Country
The Center’s four box model serves as a broad, yet simple depiction of what needs to be done to transform health and healthcare. At the heart of this model is a focus on individual and the society around them that needs to be supportive of health. It is through state projects that we can implement and test our transformational solutions. On June 19, I kicked-off the Missouri Project, led by Julie Eckstein, with an event in St. Louis where we hosted a CEO roundtable focusing on the major areas of healthcare needs for Missourians. By August, The Center member-based Missouri Project Advisory Board (M-PAB) held its first meeting and reviewed the results of an environmental scan of current initiatives in the “Show Me State.” The project continues to expand and its success will propel us into more states.
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13. Denny Sanford Gives the Gift of Opportunity
Sioux Falls businessman and philanthropist T. Denny Sanford announced a donation of $400 million donation to what was known as the Sioux Valley Health System. Renamed in honor of Mr. Sanford, the new Sanford Health has become a driving force of talent and research at the forefront of healthcare. The Center was pleased to be consulted regarding the vision of the project and we look forward to working closely on this amazing effort and opportunity.
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14. U.S. Helps Lower the Number of Uninsured by Opting for Health Savings Accounts
The response to HSAs has been overwhelmingly positive. In just two years, three million Americans have signed up for an HSA. More than one-third of HSA enrollees were previously uninsured, which means HSAs already may have reduced the number of uninsured by 1 million. Deloitte Consulting L.L.P. reports that, for two years running, insurance premiums for HSA-related health plans rose at about one-third the rate of increase for other types of coverage.
The Center’s Insure All Americans project works to expand insurance coverage to every American citizen within five years. We can achieve 100% coverage by reducing healthcare costs, which will make insurance more affordable. This can be done by fundamentally changing four central tenets:
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The way individuals view their health and healthcare;
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How culture and society influences individual behavior;
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The way we deliver care; and
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How health insurance is financed.
Health Savings Accounts put the consumer in the driver’s seat, prompting a fundamental shift in how we think about health. For more information, I encourage you to read our white paper: A Guide for State Legislators: Creating an HSA State by Senior Fellow Ronald E. Bachman FSA, MAAA.
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15. The Center Becomes Georgia’s “Community Leader for Value-Driven Healthcare”
U.S. Department of Health and Human Services (HHS) Secretary Michael Leavitt this year launched his Value-Driven Healthcare, including naming community health leaders to lead health transformation in the states. The Center for Health Transformation was pleased to be one of the four initial community leaders named, with our Georgia Center being named as Georgia’s “Community Leader for Value-Driven Healthcare.”
I was honored to receive the award on behalf of The Center, and to stand alongside Georgia Governor Sonny Perdue in pledging our support for Secretary Leavitt’s national “Four Cornerstones” initiative to improve healthcare quality, information and cost-effectiveness for employees and their families.
Representatives from leading participants in our Georgia Project, including Aetna Inc.; AT&T; UPS; Piedmont Healthcare; WellStar Health System; and the Georgia Hospital Association, joined us in signing the official support for value-driven healthcare.
GA Governor Sonny Perdue, The Center CEO Nancy Desmond, HHS Secretary Mike Leavitt, CDC Director Julie Gerberding, MD, MPH; The Center Founder Newt Gingrich
