NEHI, the Network for Excellence in Health Innovation, recently released Health Care Without Walls: A Roadmap for Reinventing U.S. Health Care. By combining technologies such as telehealth with a reconfigured work force, the report says, the nation’s health care system could be transformed into one that better anticipates individuals’ needs; works to keep them as healthy as possible; and brings prevention and care out of conventional institutional settings into peoples’ homes, workplaces, and other convenient locations.
“We finally have a roadmap to fix the U.S. health care system,” said David T. Feinberg, MD, MBA, President and Chief Executive Officer, Geisinger Health System, of NEHI’s report. “Health Care Without Walls is a must read for everyone in health care and for anybody who believes there has to be a better way to care for individuals and communities.”
NEHI is a nonprofit, nonpartisan organization composed of members from across the health care system. Its “Health Care Without Walls’ report, published as an e-book and paperback on Amazon, calls for a series of steps in technology development, health care payment, regulations, the work force, and other areas to bring about a more “distributed” care system.
These steps include the following:
- New payment models should be adopted by Medicare, Medicaid, and private health insurers to encourage technology-enabled innovation in health care delivery that increases access and convenience.
- Regulations at the federal, state, and local level should be amended to better support “Health Care Without Walls’ systems. For example, state-based licensure of health professionals should be augmented with a new national licensure system. Federal policy should encourage and incentivize the extension of affordable broadband internet service and 5G technology nationwide.
- Health care workers should be trained to operate virtually and in multidisciplinary teams. Vastly more community health workers should augment the current work force to serve as the first line of engagement for patients in their communities.
- Developers should produce technologies for “Health Care Without Walls’ systems that are usable by many different types of patients and providers — from children to the very old. For intelligent devices and systems that operate according to algorithms, these rules should be transparent so that they can be fully understood and examined.
“Not all health care will or should move outside of the traditional institutional settings, such as doctors’ offices and hospitals,” said Susan Dentzer, NEHI’s President and Chief Executive Officer. “We’ll still want to be treated in intensive care units and trauma centers when we’re very sick or injured. But much of health care is about exchanges of information, rather than the traditional laying on of hands. And those exchanges of information about health care can increasingly take place virtually — making it more convenient and accessible for all of us.”
“Health Care Without Walls describes an exciting future state to which the U.S. health care system clearly needs to evolve,” said Robert M. Wachter, MD, author of The Digital Doctor, and Chair, Department of Medicine, University of California San Francisco School of Medicine. “Many of these innovations are already beginning to occur, but they are patchy, uncoordinated, and often related to the specific circumstances of a health care delivery system or payment model. They need to become the norm.”
“American health care is in the midst of dramatic change,” said Nancy Howell Agee, President and CEO, Carillion Clinic, and Chair, American Hospital Association. “NEHI’s Health Care Without Walls provides valuable insight into the trends that are reshaping care and provides welcome inspiration for a field that’s ripe for change.”
NEHI’s Health Care Without Walls initiative, which produced the report, drew on the collective insights of approximately 200 individuals, including leaders of five separate work streams focused on technology, the health care work force, payment, regulatory, and human factors issues. The report is intended to serve as a springboard for NEHI’s future work dedicated to advancing this distributed model of health care nationwide, and in rural areas in particular.
The full Health Care Without Walls report is a book exclusively on Amazon, in both a Kindle ebook and paperback format. Charitable organizations can request a prepaid copy of the book by completing a form on the NEHI website. The executive summary and a one-pager are also available as a free download on NEHI’s website.