An Upside-Down System Waiting to be Righted: Working Template for a Right-Side Up Health Care Manifesto
Here’s my radical and revolutionary idea:
Be more rational and logical in how we conceptualize and utilize the health care system by turning it the right side up. Instead of pouring majority of resources and energies in fixing illness and poor health while hoping that health and wellness will spontaneously flourish on the other end of the health scale, let’s push for better cost-effectiveness by deliberately and substantially investing in health and wellness interventions so to gain greater success in preventing and driving down the burdens and cost of illness and disease. Let’s be smarter and work on the antecedent factors to directly reduce the consequences and not just focused on the consequences and hoped the antecedent factors would somehow make progress on their own. (As I often tell my patients, we need to fix the leaks upstream and not just keep mopping the water downstream.)
So, here’s what we should consider:
Health and wellness metrics to measure, monitor, analyze, and improve health outcomes.
Health and Wellness Index =
*(HD x PA x MRR x WC x QS x SC x WPA x LVT x PT x TDF x FS x LL) /
**(CHF x GMCPAE x FLL x TUSPA x TEUWFS)
*Numerators
HD (healthy diet), PA (physical activity), MRR (mental relaxation and reflection), WC (weight control), QS (quality sleep), SC (social connection), WPA (work and personal achievement), LVT (leisure and vacation time), PT (personal time), TDF (tobacco and drug free), FS (financial security), LL (lifelong learning)
**Denominators
CHF (cost of healthy food), GMCPAE (gym membership cost and physical activity expense), (FLL) fee for lifelong learning, (TUSPA) time used for social and personal activity, (TEUWFS) time and energy used for work and financial security
Now that you have an idea what this new health care paradigm looks like, and if you’re still with me, here’s how this right-side up system may work:
Health “data set” is to be entered in (as one would for a check balance book) and sent to a secured network monthly or, preferably, have wearable and IoT tech to measure and automatically send to a secured network daily.
The health data set is used to calculate the “Health and Wellness Index”, which is converted to a grade of excellent, good, fair, poor, or unwell (in health status). One will have real-time results and messages of congratulations and/or instructions.
If the grade is “excellent” or “good”, the person will earn reward points accordingly and those points can be added up over time to cash in for a vacation getaway, musical concert, movie ticket, restaurant meal,…
If the grade is “fair”, the person earns no reward points and will receive electronic messages and tips to guide in reaching for a higher ranking, “good” or “excellent”.
If the grade is “poor”, the person will have virtual meetings with a health coach to help make progress. If no improvement within 1 year, then the person will have in-person meetings with a nurse and a nutritionist to help make progress and improvement.
If the grade is “unwell”, the person will have virtual and in-person meetings with a health coach, nurse, and nutritionist to help make progress. If no improvement over 6 months to 1 year, then the person will have in-person meetings with a nurse practitioner or a physician to help make progress and improvement.
In-person meetings are encouraged to be in “natural”, community settings, not in a hospital or medical clinic; for examples, in hotel meeting rooms, library, YMCA/YWCA, quiet park and recreational areas…
The primary advantage for meeting in natural, commonplace but not medical settings is to minimize the mental and physical suggestions or impressions of illness and disease. The interactions, then, are focused on health and wellness without having anyone placed in a sick role or associated disposition.
Virtual and in-person meetings are also encouraged to be in a group of 10 to 12 persons instead of individually-based, when suitable. This is to add the benefits of group support, group synergy, and cost-effectiveness in the use of time and resources.
Chief Medical Officer @ MDstaffers | Clinical Forensic Medical Expert Witness | Medical Criminology | Expert Panel Chair @ MDexperts | Emergency Physician
5 年I am looking to create my own healthcare paradigm shift and plan to steal some of your ideas here.
Medical Director at Optum Enterprise Clinical Services
5 年Seems more common sense than radical. And while each factor might not be weighted correctly, the relationships seem intuitive. Have you gathered any data?
ORTimes.org - Healthcare: Expert integration of data, risk management, and clinical, finance; 25+yr MD- Anesthesia & ICU; 2yr MBA: Risk mgmt, Data mgmt, Finance mgmt; TOC, Lean, 6sigma
7 年Reminds me of China's Barefoot doctors: https://www.who.int/bulletin/volumes/86/12/08-021208/en/ 'China’s village doctors take great strides Village doctors have dramatically improved access to health care in China’s rural communities over the last few decades. Cui Weiyuan reports. China’s barefoot doctors were a major inspiration to the primary health care movement leading up to the conference in Alma-Ata, in the former Soviet Republic of Kazakhstan in 1978. These health workers lived in the community they served, focused on prevention rather than cures while combining western and traditional medicines to educate people and provide basic treatment.'
Innovative Transformation Expert | Enhancing health & performance
7 年I like the idea of a health and wellness index especially if it provided tips to improve the result. What happens if medical offices were designed in ways that inspired health and wellbeing. Create a meditation space, add some treadmills or walking desks and have informational videos or materials on how to live a healthy lifestyle. Too often the magazines selected for waiting rooms provide no informative value to the healthcare consumer. It would transform any waiting time and the consumer experience of healthcare.