“The paths of healthcare systems in many countries are increasingly unsustainable.” This judgment provides the context for a new report from IBM in its Healthcare 2015 series, Healthcare 2015 and care delivery: delivery models refined, competencies defined.

“Unsustainability” in health care comes in the guises of health cost growth, quality problems and preventable errors, lack of access for many people, and increasing incidence of chronic disease.

IBM expects that some short-term changes will address these problems, including:

  • Piecemeal health reforms such as targeted prevention programs — but not comprehensive, systemic reform.
  • Increasing consumer responsibility for financing personal health services.
  • Globalization and local ‘coopetition’ among health providers.
  • New delivery models.

IBM believes that information technology (IT) underpins health care value over the longer-term. Greater access to clinical knowledge and access to relevant patient information requires a robust and secure IT infrastructure. Personalized care, IBM says, is “more science than art,” and involves integrating both clinical knowledge and patient information. This competence will lead from a “fix me” health system to activating citizens for personal health management, the IBM nirvana-vision for the future health system.

In this health system nirvana, “the citizen and provider will ‘co-produce’ healthcare,” IBM describes. To accomplish this, people will need coaching in three areas: for health, for value, and for wealth. Coaching will occur through channels that people like to us, whether via phone, the Internet, of ‘high touch’ in person.

IBM concludes the paper with a typology of service delivery models, which include the community health network, center of excellence, medical concierge, and price leader. Each of these leverages different competencies to succeed, from empowering consumers and collaboration, to innovating, optimizing operations, and implementing IT.

Health Populi’s Hot Points: I appreciate IBM’s approach to activating citizens presented in this vision, as we move from a “fix me” health culture to a “co-production,” personal responsibility mentality.

In Together for Health: A Strategic Approach for the EU, the Commission of the European Communities codifies that, “Individuals must play a role in taking care of their own health, and therefore citizens’ and patients’ participation and empowerment need to be regarded as core values in all health-related work at the EC level” (see page 4 in the document).

Could such a positive, insistent, and universal stance take hold in the U.S. as we seek to solve our challenges of expanding access and stemming costs? This position, I think, is a requisite platform on which to base a new-new U.S. health system.

IBM concludes the white paper with new perspectives on truisms. The last one is the most potent: an Old School truism was, “This, too, shall pass.” In our new health world, the truism is: “This time, the world is fundamentally different.”

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