surprisingly, Grundy explained that he had received questions from the
IBM CFO about the regional cost of care in the U.S., which the
company was considering when deciding where to locate jobs. As it turns
out, IBM decided to locate a call center in Dubuque -- partly as a
result of the low health care costs there.
And when looking at the costs of various health care markets, Grundy
noticed "tremendous waste." Depending on which economist one listens to,
administrative costs and overhead make up 19 to 30 percent of the health care
costs, he said.
When asked what
kind of health care they wanted, IBM employees stressed the importance of
the relationship with physicians. "We decided that we really
fundamentally wanted to change the covenant between the buyer and the
provider of care," Grundy said. "And that is happening today."
While the U.S. has some of the best partial care in the world, the country is poor at coordinating care. "We do not know how to play as a team," Grundy said.
As a solution, Grundy put forward the concept of the Patient-Centered
Medical Home, which emphasizes collaboration. The system has been
backed by Anthem, Wellpoint, and government agencies such as the
Department of Defense.
Grundy explained that, in a recent study with IBM employees, the new
delivery system model resulted in the following gains in efficiency,
which he ascribes to "robust prevention in primary care:"
- 36 percent drop in hospital days
- 32 percent drop in ER use
- 9.6 percent drop in total cost
Another study by CareMore that tried out the Patient-Centered Medical Home model found the following:
- a hospitalization rate 24 percent below average
- hospital stays 38 percent shorter
- an amputation rate among diabetics 60 percent lower than average
- these improved outcomes have come without increased total cost
Next, Kohn, chief medical scientist of care delivery systems
at IBM Research, gave the audience at FutureMed an in-depth look at the
medical applications of Watson, which famously bested human competition
in Jeopardy! about a year ago. "Our
goal, with [Paul Grundy]'s leadership, is to understand what is
necessary to support the transformation of health care to the
patient-centered evidence-based outcome-based system that actually makes
people healthy and reduces cost," Kohn said.
Kohn explained that Watson in health care could offer the following benefits:
- improve quality of care
- reduce errors
- engage patients
- improve audit trails
- improve efficiency
- better utilize skills
Watson was developed for Jeopardy! and, on the game show, could only
access internal data. In the future, the system could be used to
actively look for new data from multiple sources, including the Internet.
While Watson now only understands English, in the future it could
understand multiple languages, which it can leverage to process even