Bruce Broussard

Bruce BroussardIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — Doing more with less: health care inspiration from the developing world — is reprinted below. To see all of his blog posts, click here.

I had the opportunity to attend the World Economic Forum in Davos, Switzerland. It’s always an amazing experience to learn about new ideas in health and other societal matters from around the world. As a strong believer in the importance of lifelong learning, Davos is a place where there is always something new to learn.

This year what struck me the most was how innovators in underdeveloped countries are overcoming economic challenges and lack of infrastructure to meaningfully advance health care delivery. Despite limited resources, these people are providing ingenious solutions to health care issues, some of which have actually put their countries further along than the U.S. in scaling digital health solutions.

Here’s a quick recap of three meetings I had with individuals who are advancing health care delivery through innovative approaches that leverage a wide variety of care access points, mobile technologies, and less-specialized clinicians. These solutions transcend economic and infrastructure challenges.

 

Integrated training and technology, distributed access points, and unconventional providers can be brought together to improve access to care. At the top of this blog, you’ll see a photo of Dr. Dixon Chibanda and me. Dr. Chibanda is the founder of The Friendship Bench and a psychiatrist from Zimbabwe, and he is one of just 12 psychiatrists practicing in Zimbabwe, a country of over 16 million. He’s an amazing individual whose Friendship Bench provides a relaxed and natural setting where people can speak comfortably about what’s bothering them.

Dr. Chibanda shared that he uses grandmothers as providers, using mobile apps to teach them to provide basic mental health services. He said grandmothers bring a level of empathy to the process that has been instrumental in getting people to open up about their problems. This successful program is not just in Zimbabwe; it’s been launched in the United Kingdom and New York City.

Mobile apps and transportation are changing health care in Venezuela. We’re all sadly familiar with the crisis in Venezuela. But despite the challenges they face, Venezuelans are innovating around access to care.

I sat down with Dr. Andres Gonzalez, Director of Venemergencia, which provides telehealth and a unique form of house calls to enhance care. For example, Venemergencia’s doctors and nurses, with their diagnostic equipment, use mopeds to see their patients. Combined with a mobile app, patients can schedule appointments, and doctors are able to access patients’ medical records to provide personalized care. It’s a great example of boldly delivering care locally without the constraints of brick-and-mortar clinics.

Telehealth is transforming care delivery in challenging rural markets. Sangita Reddy, Managing Director of Apollo Hospitals, is using technology to help people who live in rural parts of India and struggle to access care.

In 2018, she and her company facilitated 2.4 million telehealth visits in India and nine other countries in which Apollo operates. During my conversation with Sangita, she spoke to the benefits of telehealth as a means for specialists in metropolitan areas to connect with their patients living with complex diseases. Primary care physicians and nurses benefit as well, because the work advances their training.

 

As I reflected on these learnings, it reminded me of underdeveloped countries going directly to cellular telephone technology, skipping landline technology. I experienced this firsthand, as my father’s career began with AT&T, installing landline switches in those brown cement buildings located in every U.S. city. In the later stage of his career, he was installing cellular technology in underdeveloped countries that had no telecommunication, bypassing the less-agile and building-dependent landlines. Fast forward 20 years, and mobile has become the preferred technology.

Could this foreshadow the evolution of the traditional health care system, which is more institutional and expert-dependent, making it more difficult to access and more costly? The future system — with expanded access points through less-trained individuals aided by technology — will come, but it requires the current system to actively invest in the technology infrastructure, governments to change public policy, and companies to transition to new business models. I hope we will embrace the transition more quickly than we embraced the conversion from landlines to cellular service.

Access to care is a global issue, but solving it happens on a local level. A report from Oxfam found that “every day, 10,000 people die because they lack access to affordable healthcare.” Solving for this is a global imperative and especially hits home for those of us in the health care industry. It requires bold and innovative approaches that meet people where they are, ever mindful of the non-health challenges that impact their access to care.

I’d be interested in your thoughts. What assumptions about health care do we need to challenge? In your community, how are innovators helping to improve access to care?

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Humana CEO Bruce Broussard – who is attending the World Economic Forum in Davos, Switzerland – appeared on the CNBC program “Squawk Box” and talked about the importance of value-based medicine, technology and coordinated care in the U.S. health care system.

You can watch the interview here. 

The World Economic Forum Annual Meeting is a yearly gathering that brings together leaders of global society — the heads and members of more than 100 governments; top executives of the 1,000 foremost global companies; leaders of international organizations; important non-governmental organizations; and the most prominent cultural, societal and thought leaders.

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The lack of funding and support to alleviate the social determinants of health (loneliness, food insecurity, lack of transportation) are making it very difficult, especially for seniors living with multiple chronic conditions, to improve their health. In a blog post for the World Economic Forum, Humana President and CEO Bruce Broussard examines what the U.S. health care system can do to better address the challenge.

Read the blog here.

 

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Bruce BroussardIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — What does 2019 look like for health care? — is reprinted below. To see all of his blog posts, click here.

In the current environment, constant and negative debate over health care makes it easy for us to be down on our industry. But I’m excited about health care’s potential, and I’m proud of the progress we’ve made.

I believe we are at the pivot point of greatly improving health care. More people are being treated under reimbursement models – like Medicare Advantage – that incent complete health, not just the delivery of care. In addition, advancements in digital technologies – such as home-based monitoring devices and personalized science – are increasing the opportunity to leverage the growing sophistication of analytics, artificial intelligence, natural language processing, and machine learning.

Progress today and on the horizon

I’ve seen promising advancements in interoperability, which is empowering patients and resulting in better care. Interoperability gives doctors and other clinicians a complete view of the patient’s medical history, which increases the personalization and timeliness of care interventions.

We have been critical of electronic medical records, but EMRs have digitized millions of paper medical records, increasing the velocity and volume of information and allowing for more complete and timely decisions.

I see parallels in the history of banking. Interconnecting and digitizing bank transactions – and implementing interstate banking laws — permanently changed the banking structure, creating a more convenient and cheaper system. An example is how stock trades decreased from $75 to $.05 per trade. In health care, that degree of cost reduction would greatly expand the affordability of care and significantly reduce our federal and state deficits.

As I’ve written before, the Centers for Medicare and Medicaid Services (CMS) has challenged the health care industry through the Blue Button initiative, which was designed to drive the necessary, useful interoperability to enable all physicians and all consumers to manage their health online, like they do with their bank accounts and investments.

Patient information needs to be shared, and we can’t encourage business models that impede the process. The good news is we’re moving in the right direction.

Experiencing it myself

For the last few months, I’ve experienced the future of interoperability firsthand by using my Apple Health Kit to download my own health data to my iPhone. Thanks to FHIR, which helps enable this process, I can easily view my patient information — from annual checkups to data such as blood pressure, weight and BMI.

Apple Health Records was launched just 11 months ago, and the company has been the first to gain traction on the EMR. Imagine what will happen when more iPhone users like me do this and the 100 million Android users in the U.S. catch on.

Such data doesn’t just help patients; it’s helping the physicians who care for them. At Humana, we’ve asked our 3.5 million Medicare Advantage members for permission to access their Medicare information – scripts, doctor visits, etc. We can then use this information to design and price health products specifically for them.

Data sharing, fueled by true interoperability, will stimulate innovation. Yet for adoption to increase, our industry must ensure that the experience is on par with online shopping, travel and financial experiences. In health care, this might show up as a primary care physician having real-time access to a list of all the drugs a patient is taking. That’s especially important in treating seniors, many of whom are living with multiple chronic conditions.

So what’s in store for 2019?

More companies will access data to create consumer-engaged business models that encourage competition, foster innovation, and, ultimately, disrupt and force our industry to evolve. We’ll see new and innovative products that help people with their health.

Successful innovations won’t be siloed; interoperability will help physicians make decisions supported by analytics. But technology will only take this so far. It’s up to physician and clinician offices, health plans, and government to help consumers have a real-time, detailed understanding of their health. Physicians, too, will have a truly holistic view of their patients.

Let’s continue to construct a competitive system that fosters a climate of innovation. In the end, we’ll make it easier for physicians to help their patients and for patients to help themselves.

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Bruce BroussardIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — 21st Century Solutions for 20th Century Problems — is reprinted below. To see all of his blog posts, click here.

We all know health care is being transformed: from the emergence of remote, real-time monitoring to the continued adoption of value-based-care payment models, disruptive technologies are improving health care.

Yet despite the progress, health care is facing challenges.

Take demographics, such as population. Each day, 10,000 Americans turn 65, and the number of people over 65 is expected to grow from 46 million today to 98 million by 2060. We’ll need more caregivers, as there are now about 34.2 million people who have provided care to an adult age 50 or older.

Now look at the health of those people. Three in four Americans over the age of 65 are living with multiple chronic conditions. Unlike episodic treatment, caring for those with chronic conditions requires proactive prevention, assistance with lifestyle decisions, and multiple specialists to treat complex, serious diseases such as congestive heart failure, diabetes, etc.

So with more unhealthy people over the age of 65, how do we prepare primary care physicians, nurses, social workers and caregivers to handle this wave of change?

Primary care physicians are the centerpiece

These population and health factors are putting significant demands on nurses, social workers, pharmacists and primary care physicians who assist people living with chronic conditions.

Research has shown growing demand for these key professions. For example, there is a projected shortfall of between 14,800 and 49,300 primary care physicians by 2030.

These demographic and health challenges require the health care system to evolve – away from episodic care and toward holistic health, where the care for a person living with multiple chronic conditions is managed by the primary care physician.

If we’re to help prepare the next generation of health professionals, their education and training must evolve as well. Clinical models that slow disease progression and payment models that incentivize quality and cost savings must be integrated into the system. In addition, daily workflows that allow more time with fewer patients are essential.

Yet it’s not just the clinical. It’s important to partner with local charities and community agencies to address social determinants of health – food insecurity, social isolation and loneliness.

Medical schools are starting to change

Today, a select number of medical schools are evolving their curriculums to help the next generation of clinicians, including primary care physicians, embrace holistic health.

Holistic care is most effective when care is integrated, which occurs when multiple clinicians (e.g., physicians, nurses, pharmacists, social workers and optometrists) are all aligned in a value-based model and working with one another to deliver a better patient experience and better outcomes. We need to build an integrated educational system to care for patients in this value world, and everyone has to work well together to make this a reality.

Recently, Humana and the University of Houston’s newly established College of Medicine announced that we’re going to build the Humana Integrated Health System Sciences Institute at the University of Houston. We’ll train physicians and other clinicians in integrated care delivery through a collaborative partnership with a focus on “advancing population health, improving health outcomes and expanding the use of value-based payment models.”

The new school will also integrate Nursing, Optometry, Pharmacy and Social Work. Social workers will be an integral element for taking care of underserved populations because they’re a key link between patients and community resources.

Working, thinking and building differently

Better management of chronic conditions, and addressing the social determinants of health that amplify them, is essential for transforming our health care system.

If we want to help primary care physicians and clinicians, then all entities in health care — universities, industry and government — must band together to advance the science of primary care. We’re moving to a consumer-focused health care system that’s integrated and personalized, and it will improve the health of the people it’s meant to serve.

Advancing care means we have to work differently, think differently and build differently.

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