JCPH

Prescriptions for Excellence Winter 2016 Issue 25

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TABLE OF CONTENTS ISSUE 25 | WINTER 2016 A little more than a decade ago, the Picker Institute commissioned the Institute for Alternative Futures (IAF) to help create "a shared vision for patient-centered care." Back in 2004, patient-centered care was not even in the lexicon of most hospitals, nursing homes, or medical practices – this was true for Canada and Europe as well as the United States. Barak Obama was still an Illinois state senator and the notion that sweeping health care reform might take hold in the United States would have been met with skepticism or even ridicule. The IAF developed 10 alternate "forecasts" as the basis for interviews with 50 prominent health care industry leaders. From these interviews, researchers created 4 possible scenarios for patient- centered care in 2015. Scenario 1 foresaw "almost everyone" having access to basic health care, employers shifting to defined contributions, and providers engaging more affluent consumers in patient-centered care to boost their patient satisfaction scores. Scenario 2 foresaw continued double-digit health care inflation, a health care system collapse in 2009, government-instituted price controls, a growing number of "health care refugees" with no access to care, and a nosedive in health care quality and safety (except for the top 10% of wealthiest Americans). More optimistically, Scenario 3 foresaw a convergence of scientific knowledge, information tools, and public understanding and acceptance of a transformed health care system. High quality, safety, and patient-centeredness prevailed at a cost (16% of gross domestic product). Finally, Scenario 4 foresaw a collaborative environment with health services structured to allocate accountability and incentives to patients, physicians, and other stakeholders. Hallmarks included: open access to information, coaching, and support; advanced biomonitoring systems; and advances in medical, social, and spiritual technologies. I find it fascinating that, although no scenario got it 100% right, we've made tremendous strides toward EDITORIAL Back to the Future David B. Nash, MD, MBA Editor-in-Chief This newsletter was jointly developed and subject to editorial review by Jefferson College of Population Health and Lilly USA, LLC, and is supported through funding by Lilly USA, LLC. The content and viewpoints expressed are those of the individual authors, and are not necessarily those of Lilly USA, LLC or the Jefferson College of Population Health. Editor-in-Chief David B. Nash, MD, MBA Managing Editor Janice L. Clarke, RN, BBA Editorial Staff Deborah C. Meiris Alexis Skoufalos, EdD Prescriptions for Excellence in Health Care is brought to Population Health Matters readers by Jefferson College of Population Health in partnership with Lilly USA, LLC to provide essential information from the quality improvement and patient safety arenas. PRESCRIPTIONS FOR EXCELLENCE IN HEALTH CARE A COLLABORATION BETWEEN JEFFERSON COLLEGE OF POPULATION HEALTH AND LILLY USA, LLC CONTINUED A Message from Lilly: The Reverberating Human and Economic Effects of Medication Nonadherence Across the Health Care Continuum Ashish R. Trivedi, PharmD and Ora H. Pescovitz, MD ........................................2 Working Together to Transform Health Care: "It Takes a Region" Marjie Harbrecht, MD ........................................5 Care Guidance for Quality and Efficiency in Transitions of Care Jeffrey S. Rose, MD ............................................8 Building a New Ambulatory System of Care: Using Population Health to Achieve the Triple Aim Christopher T. Olivia, MD..................................9 Mobile Integrated Healthcare Practice Eric Beck, DO, MPH, EMT-P ........................... 13 The Windmills of My Mind Marcia Guida James, MS, MBA, CPC ........... 16 The Innovation Conundrum: Practical Strategies for Transforming Health Care Prathibha Varkey MD, MPH, MHPE, MBA .... 17

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