Sustainable RHIO Model Focuses on Continuous Quality Improvement

We have just presented a breakthrough RHIO (regional health information organization) model to a group of businesses, providers and payors in northeast Pennsylvania. It views a RHIO as something more than an information technology organization for exchanging patient data. It is, in a sense, like a “community healthcare utility” that supports better decision-making in ways the RHIO membership determines. This is analogous to and electric company, which makes electricity available to the community to use as they wish, except instead of electricity, the RHIO supplies information and decision tools to a network of collaborators focused on the continuous improvement of care effectiveness, efficiency, safety, timeliness and affordability.

This model enables financial stability and sustainability to the membership by bringing measurable value to each of their constituencies – including healthcare providers across all disciplines, employers/purchasers, payers/insurers, researchers and educators, and patients/consumers – though the way it benefits each constituency varies. It stresses active buy-in and participation of the employer/purchasing community, which enables it to enforce disciplines of transparency/accountability on the health care community, thereby encouraging market stability. It enables and reward providers for delivering top-quality care, e.g., through building a high-fidelity healthcare system, offering P4P incentives, building practitioner-researcher collaborative networks, and complementing sick-care with well-care. And it operates through a community-based, not-for-profit organization hosted under the auspices of a neutral party, like a university.

The audience was very receptive to this RHIO model.

What I love about this model is its economic sustainability and focus on delivering health and financial benefits to all community stakeholders, while focusing on continually improving care saftety, effectiveness and efficiency through the implementation and evolution of scientific knowledge.

Here are three recent articles in the press:
http://www.timesleader.com/mld/thetimesleader/2006/07/27/business/15132660.htm
http://www.nhds.com/nepa_rhio_times_tribune.htm
http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemID=123673

Disease Management: What it is and what it could be

There’s a great deal of discussion about “disease management” as a model for improving healthcare quality. Disease management should be:

“… a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant.

Disease management:

• Supports the physician or practitioner/patient relationship and plan of care;
• Emphasizes prevention of exacerbations and complications utilizing evidence-based practice guidelines and patient empowerment strategies; and
• Evaluates clinical, humanistic, and economic outcomes on an on-going basis with the goal of improving overall health.

Disease management components include:

• Population identification processes;
• Evidence-based practice guidelines;
• Collaborative practice models to include physician and support-service providers;
• Patient self-management education (may include primary
  prevention, behavior modification programs, and compliance/surveillance);
• Process and outcomes measurement, evaluation, and management;
• Routine reporting/feedback loop (may include communication with patient, physician, health plan and ancillary providers, and practice profiling).
  

Note: Full service disease management programs must include all six components. Programs consisting of fewer components are disease management support services. ”[1]

According to this definition, many disease management practices are actually providing support services only; there are few full service disease management programs in operation today.

Nevertheless, this is an excellent definition, and it is quite comprehensive. It suffers from several crucial gaps, however, which is endemic of American healthcare today:

• It doesn’t include personalized care, which means generic guidelines are used instead of developing guidelines tailored to a person’s particular needs and preferences. This means that with disease management every person with a particular illness (diagnosis) receives the same basic treatment, even though no two people are exactly alike. It’s like a sledgehammer approach to care, rather than a precise scalpel-like approach. For example, might a HemoglobanA1c of 7.5 be perfectly OK for some Type 2 diabetics, and for others 6.5 is too high, even though they have the same blood pressure and cholesterol readings, because other factors are having a affect? Since evidence-based guidelines change as new evidence is discovered, there needs to be much more research focusing on the differences between people with the same diagnosis, which disease management doesn’t address.
• It doesn’t stress the importance of practitioner-researcher collaborative networks facilitate the development and evolution of evidence-based guidelines by, for example, including patient data and lessons learned from everyday practice, and by having clinicians offer ideas for research. This also addresses the need to complement administrative (claims) data with comprehensive encounter (clinical) data.
• Nor does it address the health information technology gap, which must be bridged in order to support effective disease management programs. For example, more advanced software tools for decision-support, care-execution management, data management and sharing, and public health protection are needed.
• And it doesn’t stress the importance of supporting research on complementary and alternative medicine/interventions, which are not currently considered part of conventional healthcare.

[1] http://www.dmaa.org/definition.html

Our hole-ly healthcare system

Healthcare in the U.S. is full of holes. There’s a quality chasm, knowledge gap, health information technology (HIT) gap, leadership abyss, and a rift between conventional “sick-care” and “well-care.” To fix our healthcare crisis we must transform the current system by filling these holes — a remedy called the Wellness-Plus Solution™.

This transformation would change American healthcare from an overly expensive and error-prone system to a value-based system that supports and rewards high-quality — effective, efficient, safe, timely and affordable care.

This can only be accomplished using a “high-fidelity” healthcare model that offers financial incentives and health information technologies to collaborative networks of practitioners, researchers, patients/consumers, and health plans that focus on reducing healthcare costs and improving outcomes through:

• Continual learning and knowledge-building
• Advanced decision-support and information-sharing
• The use of evolving evidence-based guidelines
• Integrated, coordinated, multidisciplinary care.

Our country should focus on providing the resources and leadership required to fill the systemic holes and pave the way to substantial and sustainable improvements in American healthcare.

U.S. healthcare: A broken system lacking proper focus

All this talk about Health Saving Accounts and High Deductible Health Plans as a means to help solve the healthcare crisis is dangerous! This is because:

• Our country continues to focus on fiscal maneuvering, which is little more than playing with the numbers to find a short-term fix for escalating insurance costs for certain segments of the population (i.e., the healthy and wealthy) and increased liability for other segments.
• We continually fail to address key underlying problems: We don’t focus adequately on learning how to keep healthy and at-risk people well, and on discovering the safest and most cost-effective ways to treat ill patients. There is not enough investment in gaining and implementing the necessary knowledge through clinical research, evidence-based decision-support, and financial incentives.

Reasons given for our fixation on short-term fiscal quick-fixes in lieu of focusing on the other underlying problems are multifaceted and complex. They include capitalism run amuck, corruption of the political process, accountability avoidance, inertia, ignorance, fear, self-deception, ego, and the lack of socially responsible leaders.
I contend that it is impossible for any fiscal policy to improve the healthcare system long-term until we broaden our collective focus and start concentrating on doing what’s necessary to transform the system. This transformation should focus on bringing sustained improvements in healthcare safety, effectiveness, efficiency, affordability, timeliness, and availability – which is how I define high-quality care.
In addition to reforming current economic models, the transforming steps should include:

• Investing heavily in useful clinical outcomes research and evolving evidenced-based care aimed at overcoming the knowledge gap
• Funding the development and implementation of next-generation health information technologies – having advanced decision-support, knowledge generation, and public protection capabilities – which bridge current-day gaps
• Helping people stay healthy longer, recover more quickly, and avoid complications of chronic illness by balancing reactive “sick-care” with proactive well-care
• Increasing healthcare fidelity and collaboration
• Redirecting competition
• Focusing on unversal, consumer-centered, personalized care
• Addressing the mind-body connection
• Understanding and taking advantage of the value of complementary and alternative medicine and human genetics and genomics.

Measuring provider performance using claims data

Consumer-directed healthcare reform models, such as health savings accounts with high deductibles, depend on giving consumers the information they need to select the providers best suited to their needs and pocketbooks. This requires transparency of cost and effectiveness. In addition, such models are designed to rewards providers with incentives for doing good work, such as "pay for performance."

This post is not focused on the debate about whether providers' performance should be evaluated. Rather, it addresses the issue of using insurance claims (administrative) data to evaluate provider effectiveness and improve the quality of care.

Claims data provide some useful measures of clinicians’ performance, including mortality rates, complications, and cost of care. These data are grossly inadequate metrics, however, for incentives, transparency of cost & effectiveness, and continuous quality improvement.

This is because claims data do not include information necessary to determine, for example, how much a patient improved after treatment, if errors were made, if lower cost treatments of equal or greater effectiveness could have been used, if the patient was educated adequately in self-care and complied with the prescribed plan of care, and if coexisting conditions affected results. Without such clinical outcomes data, it isn't possible to evaluate a provider's performance accurately nor gain the knowledge needed to improve healthcare effectiveness and efficiency.

So, instead of using claims data in isolation, they should be augmented with detailed clinical outcomes data that (a) offer more valid measures of performance, and (b) enable researchers to establish and evolve evidence-based practice guidelines.

For an in-depth technical discussion of these issues, see this WellnessWiki page.

Filling the HIT Gap by Satisfying the Unmet Needs

We present the Patient Life-Cycle Wellness™ (PLCW™) system at http://wellness.wikispaces.com/Filling+the+HIT+Gap.

It is the first comprehensive health IT (HIT) blueprint to address the six unmet needs of mainstream HIT.

The PLCW system overlaps some other HIT systems in that it:

• Provides a collaborative space with single sign-on portal technology supporting EHR/EMR/PHRs, CPOEs, e-mail, forums, HIPAA compliant file transfer, voice over IP, and end to end encryption
• Promote secured access to specific patient data using authorization rules for Trusted Partners, as well as biometrics scans and SMART Cards for authentication
• Protects patient privacy by allowing only the information a patient permits to be shared with each authorized recipient (i.e., “Trusted Partner”)
• Interoperates with third-party applications.

But what makes the PLCW blueprint unique, is it is the first to satisfy the following six unmet HIT needs:

1. Bridging the Knowledge Gap
2. Managing Plan of Care Execution
3. Coordinating Care
4. Protecting public health
5. Enabling complete connectivity
6. Management of extensive data sets.

Defining the HIT Gap

In my prior post, I discussed what HIT is now and what it needs to be. I now define the HIT Gap.

The HIT gap is a result of not making six essential needs a top priority; that is, current HIT does not adequately focus on:

1. Bridging the knowledge gap — using comprehensive, detailed knowledge of each person and the scientific research to (a) make the best possible treatment decisions within a personalized care framework, (b) deliver that care efficiently and effectively, and (c) enable all consumers to be informed participants in the healthcare decision process and in promoting their own health.
2. Managing care execution — Helping providers execute their plans of care.
3. Coordinating care — Coordinating care across multiple providers in the healthcare continuum, so such tools are needed.
4. Protecting public health — Implementing processes for ongoing biosurveillance, post-market surveillance, and first-responder assistance in case of emergencies, so such tools are needed.
5. Enabling complete connectivity — Enabling all stakeholders — patients, providers (including RHIOs, facilities, and individuals across all healthcare specialties/disciplines), purchasers, and payors — to compile and share all the data they need for which they are authorized.
6. Managing extensive data sets — Fostering the fluid access, exchange, analysis and reporting of an enormous diversity of healthcare data sets, including a wide range of physiological (medical and non-medical) and psychosocial data, across patients’ entire lifetimes, about (a) people's disease/dysfunction-specific symptoms and functioning levels; (b) treatment-specific process, clinical outcomes, and practice guideline variance data; (c) genetic data; and (d) expense/financial/utilization data.

Next time I'll present an innovative solution for filling the HIT Gap by satisfying these six unmet needs.

What HIT Is Now and What it Needs to Be

Health information technologies (HIT) are improving, but there is still a huge gap between what HIT needs to be and what HIT is now. Only by closing this gap can HIT deliver what’s needed.

What it Needs to Be

As the USA struggles to deal with the healthcare crisis, mandates for change — such as the National Health Information Infrastructure (NHII) initiative — focus on the use of HIT to help increase healthcare effectiveness and safety, and reduce errors and costs, by:

• Deploying decision support tools with guidelines and research results


• Fostering collaboration and accelerating diffusion of knowledge


• Improving use of resources
• Increasing workflow efficiencies
• Reducing variability in care quality and access


• Advancing the consumer role
• Strengthening privacy and data protection
• Promoting public health and preparedness.

Achieving these objectives requires changes in healthcare policies and practices, as well as interoperable HIT that:

• Helps people know the safest and most cost-effective ways to care for each patient and deliver that care in a coordinated manner across the entire healthcare continuum with minimal error and omissions (see Consumer-Centered Care).


• Helps people understand each patient’s health problems and needs in fine, clear detail, to support accurate diagnostic and treatment prescription decisions (see Personalized Care).


• Helps people create and use evidence-based practice guidelines.
  Helps people know how to prevent illness and promote wellness for each person, and deliver such wellness/prevention programs.


• Promotes consumer/patient participation through increased knowledge and decision-support, which benefits them by increasing their ability to select the right providers and health plans, prevent illness/complications/accidents by focusing on self-care and wellness, and reduce complications of chronic disease by complying with plans of care.


• Promotes provider participation through increased knowledge, decision-support, and workflow efficiencies, which benefits them by increasing their ability to deliver more cost-effective treatment and increase patient safety (reduced errors and omissions).


• Promotes payer participation through increased knowledge, decision-support, and workflow efficiencies, which benefits them by increasing their ability to contain costs and take advantage of new business opportunities.


• Promotes purchaser participation through delivery of more cost-effective care to employees, which benefits them by reducing healthcare expenditures, absences, and turnover, as well as improvements on-the-job productivity.


• Enables collaborative networks to improve healthcare quality by helping them;
  
  • Perform clinical research in the field and lab through streamlined collection, sharing, and analysis of large quantities of diverse clinical outcomes data
  
  
  • Build evolving health science knowledgebases based on the clinical research and transform this knowledge into evidence-based practice guidelines
  
  
  • Disseminate, implement, and evolve the guidelines
  
  
  • Communicate easily and efficiently to share observations and lessons learned, handle disputes, and help run collaborative organizations.
  
  
  
  
• Protects populations by offering an efficient and effective way to obtain, transmit, and analyze biosurveillance and post-market surveillance data and by assisting first responders in the event of a wide-spread emergency (e.g., bioterrorism, epidemic).


• Helps utilize resources more efficiently.
• Helps people transfer data and information in a shared environment.


• Helps people use scaleable, integrated software applications.

What HIT is Now

Efforts these days focus on the most basic functional level of HIT, i.e., the development of interoperable architectures and the use of applications for inputting, validating, storing, securing, and exchanging basic patient data. Current HIT also offers some decision-support through reminders (e.g., of follow-up appointments, inoculations, etc.) and alerts via medication prescription checks, and streamline certain workflows. All this is a necessary first step, but it is grossly insufficient.

Does anyone disagree?

In my next post, I define the HIT gap and what can be done to bridge it.

Making Sense of the Complexity and Keeping Perspective

After several decades studying our healthcare system and seeking solutions to the crisis, we've had to address multiple complex issues concerning such things as evidence-based medicine, clinical outcomes, performance measurement, quality improvement strategies, cost control methods, transparency of cost and effectiveness, health information technology, and the use of incentives. I found it is easy to get lost and confused unless you have a big picture view to help keep the details in perspective.

One way to keep such a perspective is to see the solution as a series of changes in healthcare policies and practices focused on enabling all patients to receive the most cost-effectiveness care – be it well-care (i.e., prevention), catastrophic care, and compassionate end-of-life care. This means:

• Patients and providers must know the best (most cost-effective) treatments/interventions for each particular health problem/risk
• Providers must be able and motivated to deliver that care
• Patients must able to select the best providers to treat them and be motivated to comply with their plans of care.

Accomplishing this requires addressing the following issues (among others):
1. We have to replace ignorance (see the Knowledge Gap) with a concerted collaborative effort to gain the knowledge needed to make better decisions. Two tactics to achieve this are;

• The development, dissemination, and implementation of evolving evidence-based practice guidelines, which includes dealing with the difficulty of using outcomes data to evaluate performance. Implementing this tactic requires addressing several problems with current practice guidelines and quality improvement (QI) programs.

• The use of evolving health information technology (HIT) tools, including advanced knowledge tools for supporting diagnostic and treatment prescription decisions and driving an evidence-based decision support process. There are several concerns about HIT and solutions.

2. Current day policies and practices, which impede providers from spending the time and having the resources to give patients the best possible care, should be changed (See Healthcare Fidelity )

3. Treatment decisions should be tailored to the specific needs of the individual patient taking into account the person’s age, gender, race, genetics, environment, concomitant treatments, quality of life preferences, and other factors that may be relevant to a high-quality plan of care (see Personalized Care ).

4. Increasing provider motivation to change is another issue needing resolution. This is related to the Pay for Performance (P4P) issue.

5. Creating a sane payment system would certainly help, including addressing the issue of transparency of care cost and effectiveness.

6. Consumers should be better informed so they can distinguish among levels of quality by knowing the relative cost and degree of defect (underuse, overuse, and misuse) of healthcare resources.

7. Consumer education and wellness programs are also important so people can help prevent their own health problems and managed chronic conditions effectively.

Not Enough Patient-Centered Care

The Commonwealth Fund recently reported on a study that only 22% of physicians practice “Patient-Centered” care. Also called "Consumer-Centered" care, it is an approach to that includes a list of practices designed to improve care quality and patient experiences.

Why is this? The authors conclude a lack of training and knowledge about how to adopt patient centered care into their practices, as well as a concern about costs.

"With the right knowledge, tools, and practice environment, and in partnership with their patients, physicians should be well positioned to provide the services and care that their patients want and have the right to expect."

Another way of saying this is that we need a "high-fidelity" healthcare system. Fidelity exists only when healthcare systems enable:

• Patients to make their care needs known to providers through adequate access and communication
• Clinicians to have the time, knowledge, skill, and attention necessary to recognize a patient needs and intervention
• Interventions to be delivered properly, safely, and in a coordinated manner.

A high-fidelity healthcare system:

• Makes it possible for coordinated teams of clinicians to render care across the entire healthcare continuum
• Assures that providers have adequate resources, and competent information and decision support tools
• Is fully committed to consumer-centered care.

Shouldn't we be focused on changing policies and practices that block high-fidelity and prevent patient-centered care from being the standard?

Steve

Proposal: Linking Communities of Healthcare Blogs with Wikis

Collaborating communities of healthcare professionals and consumers are essential to solving the healthcare crisis. Through news feeds, conversation and knowledge-sharing, these communities help increase people's understanding, spark innovation, provide decision-support, enable better problem-solving, and mobilize grass-roots efforts.

The most practical way to do this is through "virtual communities" using communication vehicles such as blogs, wikis, forums, list serves, and real-time workspaces. Each of these technologies has certain unique capabilities, as well as overlapping functions.

Following is a proposal that combines these different vehicles in an optimal way enabling virtual communities to generate, evaluate, evolve, and implement strategies and tactics for solving the healthcare crisis from the "bottom-up" through grass-roots action.

Unlike a blog, a wiki is an excellent vehicle for organizing content, like an encyclopedia, using links to pages via a table of contents or taxonomy, which gives a comprehensive “whole-picture” view. It enables the reader to navigate quickly and easily from topic to topic, category to category, and can handle many different links to reference materials and other external information sources. And it allows collaborative editing by authorized contributors who can modify and add content right on the wiki pages. They also enable comments, as does a blog.

Blogs, on the other hand, do not organize content into a comprehensive view. Instead, posts appear chronologically, not organized by topic. This is a good way to deliver a variety of different issues for review and discussion, like a news feed. The reader scans through the issues of the day, reads the ones they want, and post comments as desired. When the comments stimulate community dialogue, blogs help surface new ideas, challenge people’s assumptions, and lead to greater learning.

So, wikis are like encyclopedic organizers and blogs are like newsfeeds, both of which enable conversations. How can they be used together for maximum benefit?

Well, when it comes to focusing virtual communities on something as complex as finding solutions to the healthcare crisis, I suggest using our Wellness Wiki as a vehicle for organizing and growing content, and using a community of blogs to “feed” the wiki. What I mean is that the blog posts would:

• Present timely information (news, studies, insights, opinions, experiences, questions, etc.) on different topics of interest (some of which might even be based on content from the wiki itself).
• Engage people in short-term dialogue about that information.
• Have links to them from the appropriate wiki pages, so people reading a topic on the wiki can easily navigate to the associated blog posts. If a post does not have a corresponding page on the wiki, because it introduces a topic absent from the wiki, then the wiki should be expanded to include that topic.
• Contain links to specific pages in the wiki as is appropriate.

In some ways, this is like a blogs aggregator, except that each blog post is organized in the wiki by topic/category, not by the time period in which the posts happen to appear.

If certain topics in the wiki require deep continuous dialogue, lengthy posts, branches into sub-topics, voting capabilities, file exchange, etc., then a virtual forum can be set up for that purpose.

If any bloggers are interested, please contact me.

Steve

Welcome and Introduction

Hello and welcome to my blog -- "Curing Healthcare." Following is some background information about my company and me, which I offer as means of introduction.

Professionally, I’m a clinical psychologist, healthcare practitioner, researcher, and software inventor who serves as the President/CEO of National Health Data Systems, Inc. (NHDS), a privately held company founded in 1994.

In 1981, while a practicing psychologist, I began developing a healthcare information system to help me deliver the best possible care by better understanding my patients' problems, determine the best courses of action, evaluate outcomes (the results/consequences of such actions), and continually learn from experience.

By the mid 1980’s, I had developed the key components of the Psychological Services Index™ (PSI) System and began using it in my practice. I soon realized there was more I wanted to know. Not only did I want a way to learn about my patients’/clients’ mental health problems, but I also wanted to a way to know about any related physiological (bodily, medical, somatic) factors that were affecting them. To accomplish this, a team of colleagues and I set out to create the first information technology providing a comprehensive, in-depth, “biopsychosocial” view of patients’ conditions and treatments. This led to a 15-year journey of intensive, cross-discipline R&D (research and development). In the late 1990’s, we succeeded in developing a universal lifetime computerized patient record system with advanced decision support capabilities and a virtual forum supporting interdisciplinary collaboration. We named this software technology the Health Information Index™ (Hii™) System.

In the early 1990’s, as our country attempted to deal with the healthcare crisis of the 20th century, I realized that the efforts being proposed — managed care and capitation — would have to fail because these fiscal strategies didn’t focus on improving care effectiveness and safety. Neither did these strategies promote continuous quality improvement through the implementation of evidence-based practice guidelines, nor the use of information technology for knowledge-building and decision support. And they were fraught with dangers in which those who need healthcare most are the least likely to get it due to things like “cherry-picking,” in which insurers recruit the healthiest clients and avoid chronic patients with expensive health care needs and when providers focus on offering only the most profitable healthcare services while selectively choosing not to provide services that involve more risk, more medical attention or time, more expense those services that do not have a handsome return on investment; a problem that continues today. Another serious problem is that these strategies squeeze providers by paying them to treat as many patients as possible for lowest cost, without adequate focus on the quality of care delivered. We now see the results of such failed strategies in our current 21st century healthcare crisis.

In 1993, I attempted to reach our country’s leaders with a healthcare reform proposal centered on a “national health data system” and creation of an “electronic health information network” which, by the way, is eerily similar our government’s recent call for a “national health information network” (NHIN). The proposal laid out a strategic blueprint for a system supporting collaborative teams of practitioners and researchers across the country using advanced information technologies to build a storehouse of scientific healthcare data. These data would be analyzed, discussed, and transformed into evidence-based practice guidelines, which would be disseminated to all providers. The technology I’d been developing was a step toward realizing this vision. I received no response from the government, however. A year later, we founded our company and named it National Health Data Systems (NHDS).

At the same time, we had begun introducing the PSI System to the mental healthcare field in an attempt to recruit a large group of healthcare professionals to form a collaborative practitioner-researcher network. Our mission was to have this network help evaluate and evolve the technology, and to use it for building a large biopsychosocial knowledgebase. A key strategy of the network was to take a proactive approach with managed care companies by obtaining and using a wealth of scientific evidence and decision tools to support and justify clinical interventions. Unfortunately, the mental healthcare field was generally opposed to this approach and our attempts to establish the network failed. We then shifted our focus away from mental healthcare, per se, to opportunities in other healthcare fields, and beyond.

In 1997, I used the knowledge gained over the years to write a patent for the CP Split™ technology, which was granted a year later. The patent describes a uniquely flexible and efficient process for exchanging and presenting information, which is an ideal platform for supporting healthcare decision-making and knowledge-building in collaborative environments.

In 1998, we developed the Joint Commission on Accreditation of Healthcare Organizations’ IMSystem, which evaluates hospital performance, and NHDS became an approved vendor. That same year, we developed a clinical pathways system for Merck UK, in alliance with UK physicians, which helps diagnose and treat certain heart problems, as well as determine which interventions are most cost-effective. We later developed computerized practice guidelines, case management, and treatment planner tools — all of which also focus on quality improvement. Because of these developments, we were able to integrate the PSI system with biomedical applications, to generate the Hii System, with its universal life-time, electronic health record with built-in decision support.

Sadly, I came up against great resistance from the American healthcare system for the past two decades as I presented our ideas and technologies. Although supported by a small network of healthcare visionaries, we were generally scorned or simply ignored by the healthcare industry — not because of poor technology or faulty ideas, but because the American healthcare system simply wasn’t ready for this type of change. So, while we continued to develop innovative solutions, we were rendered powerless as our healthcare system continued to deteriorate and our company struggled to survive. Why didn’t I give up long ago? Many said I should … it was a losing battle … the system would never change!

What kept me motivated during all these years of disappointment and frustration is a personal life mission to do whatever I can to help improve the world’s health and well-being by enabling delivery of affordable, high-quality healthcare to all people in all nations. If our country focuses sincerely on the same mission, I believe many of the problems we face at home and abroad would begin to repair themselves, and we wouldn’t have to be ashamed of the world we’re leaving our children.

Thankfully, a window of opportunity, for which I’ve been waiting a quarter century, has opened in the spring of 2005 with our government’s initiative to build a national health information network and other strategies to improve healthcare quality and control expenditures. We are responding to this opportunity by presenting a solution evolving over the past 15 years — focusing on a wellness model and quality through knowledge strategy that benefits all healthcare stakeholders — which is aligned with our mission to help improve the world’s health and well-being.

I welcome your comments on this blog, and invite you to post any suggestions, critiques, and questions.

To your health,
Steve Beller

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