Declaration of Innovation
by Chris Langston
Friday, October 16, 2009 12:39
Fundamentally, the Foundation’s mission is to make the nation’s health care system more responsive to the needs of its population. In our view, the growth of a population of older adults and the growing burden of chronic disease and complexity that come with them pose challenges that require us to break out of the complacency of “business as usual” in health care education/training and service delivery. Thankfully, we are not alone in this belief. Plenty of other funders stand with us. As we have talked with our colleagues about our common concerns, we have been trying to identify a set of common principles upon which we can base our work to spread innovations.
An inspiration in this process has been the preamble to the Declaration of Independence. The preamble was a concise effort to publicly report the basic principles from which the founders derived our inherent rights to rebel against an iniquitous status quo. In this case, some of us who attended the Health Funders Forum in July have agreed to take a whack at writing a preamble to a “Declaration of Innovation in Health Care.” In the preamble, we will lay out the basic principles that must underlie our efforts to create an improved health care system that best serves the common good.
Here is my effort. Let me know what you think; even Thomas Jefferson took edits. I’ve included a link to the original text so you can see the beauty of the Founders’ words and ideas, as well as how far I fall short. All I can say is that my preamble is 39 words shorter–count for yourself.
Health care is vital to the present well-being and future possibilities of our citizens and our society. Today’s health care system struggles to meet reasonable standards for quality and efficiency. The health care system and the health of the public face major challenges in demographic shifts, continuing technological advances, and a workforce mismatched to our needs. In the near future, the unsustainability of health care, as currently conceived, will undermine the economic and physical well-being of families, communities, and the nation. Change in how health care is delivered, organized, staffed, and financed is therefore an obligation, not an option. Looking into the future, improvement in the speed, reach, and judgment applied to managing change in health care is a prerequisite for all other improvements.
We believe, as the Institute of Medicine has described, there is a yawning chasm between the health care system of today and the safe, effective, patient centered, timely, efficient, and equitable system we need – and that the status quo is intolerable.
We believe that, while many innovations in health care, such as drugs and devices, are rapidly incorporated into practice, many more fundamental organizational and cultural changes are not, and that they are under-researched, under-appreciated, and under-utilized.
We believe that the special and privileged position of health care institutions and professionals is predicated upon a social compact that includes a commitment to staying current in the science and practice of health care to best serve the interests of the public.
We believe that innovators, institutions, providers, professionals, and payors (including JAHF)–the “health care system”–are jointly and severally responsible for continuous improvement in the health of the population.
To meet the current and future challenges, the health care system must not only change now, but it must become fundamentally better at the very process of change.
In the next step, a few of us will hash out a collaborative draft of this preamble to share with our Health Funders Forum colleagues. Any thoughts on the content? What should we include—or leave out? We of course hope that the “Declaration of Innovation” will be the prelude to a revolution in the way we deliver health care in America.
Jim Gallagher says:
October 21st, 2009 at 2:23 pm
I haven’t read the DOI since high school and was struck again by its urgency. Moreover, after reading it again in the context of your post I understand the power of the simple frame employed its authors: that resistance to tyranny is self-evident.
I am surprised by the inability of experts in the administration and across the health care spectrum to stay on point with a similar, simple case for the self-evident urgency to reform health care. Overshadowing the core concern that the current system is unsustainable and threatens our very well-being are more media-catchy “micro” frames like death panels, socialism and middle class-draining entitlements.
Indeed, the debate is complex, and some manner of reform will eventually arrive, but I fear that the public is already out of the loop, trapped inside a Beltway “Tower of Babel” populated by interest groups beholden to staying as close to the status quo as possible – whether through partisan politics or shareholder pressure.
As you suggest in the post and the draft, we need expert, consistent voices which are beholden only to a social compact to improve the health and well-being of all Americans. Hopefully, the Forum can be part of a growing chorus to help frame the issue in constructive terms that are backed by data and success stories rather than doom and sound bites.
Ken Covinsky says:
October 27th, 2009 at 7:09 pm
Hi Chris: I liked your declaration of innovation—Here are some
suggested edits and comments:
The United States health care system remains woefully unprepared to face
its major emerging challenges and fails to meet reasonable standards for
quality and efficiency. A new culture of innovation is essential if our
health system is to continue to contribute to the well being of our
citizens. Our system fails to meet the needs of the rapidly expanding
aging population and needs innovation in order to address the complexities
of aging patients. We need innovations that assure that technological
advances benefit patients without bankrupting the system. And we need a
workforce that is matched to the needs of the population and dedicated to
continuously upgrading its skills in both the art and science of
medicine. Our health system is unsustainable and without innovation it
will undermine the economic and physical well-being of families,
communities, and the nation. Innovation in how health care is delivered,
organized, staffed, and financed is a moral imperative.
Comments:
1) I think the language needs to be considerably stronger—and that was
where most of my suggested edits were focused
2)I thought the first sentence, while true, is kind of obvious and not that
strong of a lead in. One possibility is to just start with the second
sentence which is stronger.
3) I was not sure what you are aiming at with your last sentence. I think
it is something important, but it needs more clarity and probably should be
reworked. Are you trying to say we need to be more innovative in how we
think about change? It may help to think about what you are trying to say
with each of the key words in this sentence–improvement, speed, reach,
judgement, managing, change.
4) Are the other foundations you are working with focused on aging? If
not, to what extent do you want to use this statement to nudge them more
towards an aging focus—to get them to sign on to a statement that says
that if they want to focus on innovation, they will also have to focus on
aging? Such a motivation may affect how you think about this.
-Ken
Health Wonk Review | Colorado Health Insurance Insider says:
November 12th, 2009 at 4:00 am
[...] Chris Langston, writing at the John A Hartford Blog, has drafted a “Declaration of Innovation” (modeled on the Declaration of Independence) pertaining to health care. He’s primarily focused on geriatric care and health care for an aging population, but his words are appropriate for health care in general.[...]