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Co-Production: Reframing Innovation in Healthcare

One of the panelists today at ACT-IAC’s Health Innovation Day was Verily’s Vivian Lee, MD, Ph.D.  Asked for her thoughts on what will drive innovation in health care forward, Vivian offered a new mental model, organized around the idea of co-production. Industrial engineers look at co-production as a problem and solution when an organization’s pursuit of its mission depends on the behavior of actors outside of its control.  As Vivian observed, co-production occurs in our system of producing elementary and secondary education.  While teachers and schools deliver curriculum, parents support the production of education in their homes and through their contributions to the school community.  Another example is trash removal.  Municipal trash services take our trash away for processing, but they depend on residents putting their trash in bins and taking their bins to the curb. Co-production is a problem in need of solutions throughout healthcare.  Clinical outcomes depend on the actions of patients and their healthcare providers.  Payors and providers are not aligned in their pursuit of the quadruple aim, yet they offer differentiated capabilities to improve quality and cost of care.  There are some co-production issues that are event harder to tackle, stemming from social determinants and implicating…

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Is It Too Soon for Blockchain in Healthcare?

Blockchain generates a lot of hype and more than a little notoriety because of its ties to cryptocurrencies. While the healthcare industry understandably seeks to avoid hype and notoriety, and mostly waits for emerging technologies to prove themselves in other industries, ignoring blockchain would be a mistake. The main reason is that it alters the strategic mindset: It offers a fresh perspective for solving some of the vexing business challenges in health IT. In a fragmented health system, the business challenges swamp the technical ones. An example of how blockchain alters perspective is illustrated in a new white paper, Crowdsourcing Provider Directory Maintenance, written by a team led by Kyle Culver of Humana and Andrew Beal of Ernst & Young. Kyle was one of the winners in the 2017 Blockchain Challenge sponsored by HHS’ Office of the National Coordinator for Health IT. In the paper, the authors examine how to keep provider directories current through a blockchain lens. In setting up the problem, the authors observe that health plans currently manage separate provider directory silos that are rife with inaccuracies. Provider demographics can change so rapidly that it is hard to keep these directories up-to-date. I’ve seen how quickly the…

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