Directory

Health Policy

Sponsored
 
 
What does the nephew of the 41st American President and the cousin of the 43rd have in common with an Indian doctor?

They're both passionate about using new technologies to provide high quality healthcare at affordable cost.

Bush and Shetty
Jonathan Bush, a relative of two former American Presidents, is the co-author of Where Does it Hurt? which calls for a healthcare revolution to give patients more choices, and affordable quality care.

A former Army medic and ambulance driver, Bush is the cofounder and CEO of athenahealth, one of the fastest growing American cloud-based service companies, which handles electronic medical records, billing, and patient communications for more than 50,000 US health providers.

Dr Devi Shetty is a brilliant heart surgeon, and veteran of more than 30,000 operations. However, his growing international reputation rests less on his medical skill, and more on his business brain. He wants to do for healthcare what Henry Ford did for the motorcar: "make quality healthcare affordable."

Shetty is the founder and chairman of Narayana Health, and by thinking differently to traditional healthcare providers, he's built, India's largest private hospital group comprised of 23 hospitals in 14 Indian cities.
 
Shetty practices what Bush preaches
Bush suggests that the only way America will provide convenient quality healthcare at affordable cost, is if doctors do what they're trained to do, others perform routine services for less: for example, nurse-intensivists relieve surgeons from ICUs, and most importantly, if healthcare entrepreneurs are encouraged to tap into the transformative power of the marketplace.

For the past 15 years Shetty has been practicing what Bush is now preaching.  Narayana Health provides high quality healthcare, with compassion at affordable cost on a large scale. For instance in 2013, its 1,000-bed specialist heart hospital in Bangalore alone, performed a staggering 6,000 operations, half of them on children. By contrast, in the same year, Great Ormond Street Hospital in London performed less than 600.

In addition to hospitals, Shetty has developed a telemedicine practice, which reaches 100 facilities throughout India and more than 50 in Africa. Narayana Health is also India’s largest kidney-care provider. Shetty has started a micro-insurance program backed by the government that enables three million farmers to have health coverage for as little as US$2 in annual premiums. Over the next five years, Shetty plans to grow Narayana Health four times its present size and become a 30,000-bed hospital chain.
 
Healthcare change will come from developing nations
Bush says, the only way to build a flourishing health marketplace that everyone wants and can afford is for Americans to demand more from their health providers, and accept greater responsibility for their own health.

This will not happen, and Shetty explains why.
 
Shetty argues that the greatest advances in healthcare will not come from wealthy nations like the US and UK, but from developing nations. Rapidly changing technologies provide opportunities for developing nations to leapfrog wealthy nations, which are encumbered by entrenched and aging technologies.
 
Hospitals in developing countries with few advanced procedures can quickly leapfrog world-class hospitals such as those in the US and the UK, says Shetty. Instead of slowly replacing aging technologies, they can quickly implement innovative operational designs, and state-of-the-art technologies, which gives them a competitive advantage.  
 
Narayana Health City Cayman
This is what Shetty has done in the Cayman Islands. Backed by Ascension, the largest private health network in the US, and the Cayman government, which has designated a 200-acre site for the development of Narayana Health City Cayman.
 
 The first phase, which opened in February 2014, is a 104-bed tertiary hospital, which provides surgeries for less than half the average US price, with quality outcomes that match or exceed the very best US hospitals.  Narayana Health City Cayman is expected to develop into a 2000-5000-bed conglomeration of JCI accredited multiple super speciality hospitals in a single campus providing affordable healthcare to thousands.
 
Takeaway
Americans will have access to high quality healthcare at affordable cost, but it won’t happen in the way that Bush anticipates. Grand Cayman is only a 30minute flight from Miami.
view in full page
joined 10 years, 5 months ago

Yike Guo

Professor of Computing Science

Yike Guo is a Professor of Computing Science in the Department of Computing at Imperial College London. He leads the Discovery Science Group in the department, as well as being the founding Director of the Data Science Institute at Imperial College.

Professor Guo also holds the position of CTO of the tranSMART Foundation, a global open source community using and developing data sharing and analytics technology for translational medicine.

Professor Guo received a first-class honours degree in Computing Science from Tsinghua University, China, in 1985 and received his PhD in Computational Logic from Imperial College in 1993 under the supervision of Professor John Darlington.

He founded InforSense, a healthcare intelligence company, and served as CEO for several years before the company's merger with IDBS, a global advanced R&D software provider, in 2009. He has been working on technology and platforms for scientific data analysis since the mid-1990s, where his research focuses on knowledge discovery, data mining and large-scale data management.

He has contributed to numerous major research projects including: the UK EPSRC platform project, Discovery Net; the Wellcome Trust-funded Biological Atlas of Insulin Resistance (BAIR); and the European Commission U-BIOPRED project. He is currently the Principal Investigator of the European Innovative Medicines Initiative (IMI) eTRIKS project, a €23M project that is building a cloud-based informatics platform, in which tranSMART is a core component for clinico-genomic medical research, and co-Investigator of Digital City Exchange, a £5.9M research programme exploring ways to digitally link utilities and services within smart cities.

Professor Guo has published over 200 articles, papers and reports. Projects he has contributed to have been internationally recognised, including winning the “Most Innovative Data Intensive Application Award” at the Supercomputing 2002 conference for Discovery Net, and the Bio-IT World "Best Practices Award" for U-BIOPRED in 2014. He is a Senior Member of the IEEE and is a Fellow of the British Computer Society.


view this profile

 

"The next ˜big thing" in healthcare . . . . is IT, which will dramatically change the way health professionals interact with patients. Every step of a patient's care will be determined by protocols on a hand-held device. This will make healthcare safer and shift many hospital activities into the home," says Dr Devi Shetty, world-renowned heart surgeon, founder and chairman of Narayana Health, India's largest multi-purpose hospital group and the person said to have, "the biggest impact on healthcare on the 21st century".

Shetty also warns that, "Despite the advantages of such technologies, the medical community is reluctant to accept them."

Although doctors and patients have iPads and smartphones and use social networks, the healthcare community, "fights like mad to resist change", and fails to embrace life-saving technologies, which would improve patient care and reduce costs. ld improve patient care and reduce costs.
 
Open systems
In 2012 UK Health Secretary Jeremy Hunt issued a Mandate that by 2015, modern communications technology would play a substantially bigger role in the UK's healthcare system. The NHS remains a near bankrupt, inward looking public monopoly driven by proprietary systems rather than customer needs.

 

Saving lives didn't invoke change
Healthcare professionals invariably refer to privacy and security issues to protect the status quo, but these are equally applicable to other sectors, such financial services, which have embraced change and open standards.
 
An explanation why healthcare systems resist change is in a 1970 BBC Reith Lecture by Donald Schon, formerly Professor of Philosophy, University of California.
 
Schon borrowed a story from Elting Morison's 1968 book, Men, Machines and Modern Times, to describe entrenched social systems' resistance to change. 
 
During wartime, a young Naval officer named Sims invented a device that improved the accuracy of guns on ships by 300%, but the US Navy rejected it.
 
The device, "continuous-aim firing" used a simplified gearing mechanism that took advantage of the inertial movement of a ship. What previously a whole troupe of well-trained men had done, now one person, keeping his eye on the sight and his hands on the gears - could do.
 
To survive and grow, every major industry in today's network-centric world, except healthcare, has abandoned proprietary systems, embraced open standards and actively licensed technologies.  

 

 
Rejected on scientific grounds
Despite it's obvious advantages especially in a time of war, Sims found it extremely difficult to get his device adopted by the US Department of Navy. When finally the Navy did agree to test his system, they did so by taking it off the moving ship and strapping it onto a solid block on land. Since the device depended on the inertial movement of the ship, it didn't work and the Navy rejected the device on "scientific" grounds.
 
Eventually, Sims attracted the attention of Theodore Roosevelt, who saw the advantages of the device and immediately insisted that it be adopted in the Atlantic and Pacific war theatres where it achieved a 300% increase in accuracy.
 
The American Navy's rejection to Sims's lifesaving technology is similar to Healthcare systems' reluctance to embrace technologies, which improve patient care and lower costs.
view in full page
joined 10 years, 6 months ago

Gordon Moore

Professor of Population Medicine (on leave), Harvard Medical School

Gordon Moore is a Professor of Population Medicine (on leave) at Harvard Medical School.

He was one of the founding group of Harvard Community Health Plan and rose to become the Medical Director and Chief Operating Officer prior to the organization’s split into Harvard Vanguard and Harvard Pilgrim Health Care.

Following his move to the Medical School, he was responsible for the design and development of the New Pathway, Harvard’s ground-breaking student directed curriculum. He designed and started the Harvard Vanguard-Brigham Primary Care Medical Residency program, which is now one of the most highly sought-after in the country.

In addition to educational, health services, and health care management research and development, Gordon has consulted widely in educational strategy and health care system design and management.

He has over 100 publications.

He was the recipient of the 2008 President’s Award from the Royal College of General Practice in the United Kingdom, in recognition of his role in supporting primary care worldwide.


view this profile