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January 26, 2009
Health care: The good, the bad and the ugly

Fred Sanfilippo is executive vice president for health affairs, CEO of the Woodruff Health Sciences Center, and chairman of Emory Healthcare.

This year marks the beginning of a new political and economic era. With recent changes in our economy and the inauguration of a new president, the time is ripe to examine new solutions for our broken health care system.

The good news is that our country has the best medical specialists in the world. We have the finest researchers, the best educators, and the most exciting discoveries being pioneered today. Our technology is peerless, with the best diagnostic and therapeutic options available anywhere in the world.

And yet, we all know that our health care costs are skyrocketing. We don’t always get the outcomes and safety we expect and deserve. Tens of millions of Americans can’t access the system at all. And those of us who do are all too often dissatisfied with the service we receive. The value we receive for U.S. health care expenditures is far below that of dozens of other countries by many measures. That’s the bad news.

But it really gets ugly when we look at the fundamental problems at the root of our broken system.

Reimbursement treats health care more like a commodity than a professional service. Payment is focused on “encounters” and volume instead of quality and value, and fewer resources are provided for prevention than for treatment of disease. Reimbursement for the same services varies widely, depending on coverage and payer. And health care has one of the lowest rates of any industry in terms of applying information technology — in spite of its potential to significantly improve effectiveness and efficiency as it has in every other service industry.

Clearly, the health care system we have today must undergo a revolutionary transformation. And Emory’s Woodruff Health Sciences Center is helping to lead that much-needed change. In fact, I think there are three straightforward steps to transforming health care, and we’ll be focusing our energies in the coming year on initiatives that address each of them.

First, we’ve got to reform the way we finance health care. There needs to be oversight and accountability of the payment system. Providers, including those here at Emory, need to be paid based on quality, value and efficiency. That means improving outcomes, safety, and service; focusing on efforts to prevent disease in all populations; and applying existing information technology to improve processes.

Second, we must provide care that is personalized and predictive. Health care should focus on what matters most — the patient. The system must find better ways to communicate with patients and engage them in their own care. We must take better advantage of recent progress in science and technology and focus on translating this ever increasing knowledge into practical, individualized decision support tools to help predict, treatand even cure the specific illnesses we each face.

Finally, we need to reform the way health care is delivered to provide predictive, personalized care that is accessible 24/7. This means creating new health care specialties and professions and developing truly multidisciplinary health care teams that take into account the key social determinants that drive health and illness. An academic health center, such as the Woodruff Health Sciences Center, is the primary resource to develop the needed new programs and specialties.

You’ll hear more about our efforts to help improve the healthcare system in the months ahead as we continue transforming health and healing…together.