By Richard Asinof
WARWICK – Dr. Donald Berwick, the former head of the Centers for Medicare and Medicaid Services, brought a message of quality improvement to the sixth annual Lifespan Patient Safety Symposium held Thursday evening at the Crowne Plaza hotel.
Berwick’s message to the more than 550 mostly Lifespan employees and health professionals attending was that health care must adapt to changing river of health needs, moving from a hospital-centric to a patient-centric model.
To illustrate the problem, Berwick showed a slide of bridge built in 1938 in Honduras, so strong that it survived Hurricane Mitch in 1995 intact. The problem was, he continued, showing a second slide, was that the river had totally changed its course, and the bridge was no longer astride the river.
Berwick detailed numerous innovative approaches showing that improving care and lowering health costs go together, an antidote to the current U.S. health care system that provides low value at high cost, with enormous waste in uncoordinated care and unnecessary treatment.
The transformation will not be easy, Berwick said, given the political and economic climate and the tendency of entrenched systems to preserve the status quo.
Before his talk, Berwick met privately with the Lifespan board of directors. Lifespan, the state’s largest hospital network as well as the largest private employer, is the midst of transforming its health care delivery model from a hospital-centric to a patient-centric system, according to Dr. Timothy J. Babineau, president and CEO of Lifespan.
In an interview after his talk, Berwick told Providence Business News said he didn’t know what was going to happen with health care reform, but he remained optimistic.
“Tonight, I’m in a room with 600 people that care enough to come together to learn, and I wanted to give them a short in the arm,” he said. “We have a lot of obstacles to overcome to get the health care system we need. Change is hard.”
Berwick called the new health care IT infrastructure build out and the use of analytic engines in population health management promising at its best.
“It ought to be the equivalent of turning the lights on, where finally we can see how we’re doing, and how others are doing, and find leaders with the best practices to learn from, and also to find laggards that need to be helped to get out of the ditch,” he said. Unfortunately, Berwick continued, “there is a long history of [using health IT] to game the system. But I’m an optimist about transparency. A system in which we have the lights on is one that actually can improve.”
Berwick also voiced optimism about the role that community health centers can play in bringing innovation into the health care system. “Correctly supported, community health centers can be the jewel in the crown of the health care system,” he said. “They deal with the people with the most stress, they have a tradition of population health focus, they are engaged; they are quite wonderful.”
The challenge, he continued, is “if we can find a way to link the community health centers to the broader system of hospitals in a new environment. They have a chance of showing us a tremendous amount of innovation.”