Have you ever wondered why the two continents in the Western Hemisphere came to be called “the Americas” and not something like “the Colombias”? We all know that Christopher Columbus, a Genoese seafarer, received the patronage of Ferdinand and Isabella of Spain, and in 1492 navigated his three boats into what are now known the West Indies, and supposedly “discovered” the Americas, though there are numerous asterisks to that famous story. To begin with, the hundreds of millions of indigenous peoples of North and South America didn’t need to be discovered by white Europeans to exist, of course. Then there is the fact that it is almost certain that Leif Erikson had landed in Newfoundland centuries earlier, and may have explored down the coast of North America as far as what is now New England; he just didn’t bother to notify the rulers of Spain or any other continental European power. And of course, Columbus, on his first voyage, believed that he had landed in the Indies, so he didn’t even immediately realize that he had “discovered” (again, contemporary scholars tend to resist using language such as “discovered America” to begin with, out of appropriate respect for indigenous peoples) the New World. So—lots of asterisks.
But, back to the question of nomenclature. Why do we call North and South America “the Americas”? And why do we call the United States, the United States of America? Who was this Amerigo Vespucci person, anyway?
As the Wikipedia article on Vespucci helpfully explains, “In April 1495, by the intrigues of Bishop Juan Rodríguez de Fonseca, the Crown of Castile broke their monopoly deal with Christopher Columbus and began handing out licenses to other navigators for the West Indies. Just around this time (1495–96), Vespucci,” who had been born and raised in Florence, “was engaged as the executor of Giannotto Berardi, an Italian merchant who had recently died in Seville. Vespucci organized the fulfillment of Berardi's outstanding contract with the Castilian crown to provide twelve vessels for the Indies. After these were delivered, Vespucci continued as a provision contractor for Indies expeditions, and is known to have secured beef supplies for at least one (if not two) of Columbus' voyages.”
Later, “At the invitation of king Manuel I of Portugal, Vespucci participated as observer in several voyages that explored the east coast of South America between 1499 and 1502. On the first of these voyages he was aboard the ship that discovered that South America extended much further south than previously thought. The expeditions became widely known in Europe after two accounts attributed to Vespucci were published between 1502 and 1504.” And, critically for Vespucci’s place in world history and geography, “In 1507, Martin Waldseemüller produced a world map on which he named the new continent America after the feminine Latin version of Vespucci's first name, which is Americus. In an accompanying book, Waldseemüller published one of the Vespucci accounts, which led to criticism that Vespucci was trying to upset Christopher Columbus' glory. However, the rediscovery in the 18th century of other letters by Vespucci has led to the view that the early published accounts, notably the Soderini Letter, could be fabrications, not by Vespucci, but by others.”
So, in a nutshell, that’s what happened. Though Christopher Columbus, the wily Genoese, was the first European to “plant a flag” in the western hemisphere, he got upstaged, in terms of nomenclature, when a German mapmaker chose to honor a Florentine explorer who had broadened Europeans’ understanding of the continents of the western hemisphere, with the distinction of having two continents named, in the European languages, for him instead (and let’s not forget that this was a period that predated Italian unification by three-and-a-half centuries; at that time, Genoa and Florence were intense rivals, as were all the city-states on the Italian peninsula). In other words, Vespucci was one of the first to demonstrate definitively that the lands explored by Columbus were the New World at not the East Indies, as Columbus had initially thought.
So this is how things happen in world history… One individual or team of individuals make achieve a certain breakthrough or blaze a new trail—but inevitably, others come along and modify that same breakthrough or that same path, in some way. Come to think of it, the current strategic landscape in U.S. healthcare reminds me a lot of the Europeans’ “Age of Exploration” (again, keeping in mind that all these Europeans “discovering” the Americas were “discovering” civilizations that had existed happily for centuries and millennia without having had to be “discovered” by the Europeans), in that we are very early in a journey towards a new healthcare system, and just emerging into and through the very earliest phases of healthcare system transformation.
And it’s all deeply complex. As I noted in one of our Top Ten Tech Trends cover story package in our March/April issue—the Trend that focused on hospitals, physician groups, and health systems taking on financial risk, both overall strategy and IT strategy are lagging behind policy and payment developments, as is typical in healthcare. As Bob Schwyn, a Columbus, Ohio-based director in The Chartis Group, a Chicago-based consulting firm, told me in our interview for that Trend article, “Starting at 50,000 feet, there’s a need for conceptual readiness, for understanding who you are as an entity, and what your relationships are in your defined market space,” in order to take on risk. “So if I’m in an organization in a market that’s starting to take on more and more risk,” Schwyn says, “the question becomes, how prepared am I as an organization to meet a growing level of risk in the value-based world? Do I have the operational infrastructure? The relationships I need to cover a population? How will I establish those relationships? Do I have the technology infrastructure to support that?” The reality, he says, is that “The IT industry right now is not where we need to be to support higher levels of risk.” The electronic health record (EHR) infrastructures have largely been created, he notes; the challenge now, he says, is building the first platforms for data analytics, care management, and so on, inevitably in an iterative fashion, given the demands coming from payers and the market environment.
So there is tremendous room for innovation here. And the good news is that teams of leaders in patient care organizations are forging ahead, and leveraging healthcare information technology and other tools and strategies in order to make real headway in laying the foundations for the new healthcare—a U.S. healthcare system that will provide higher-quality outcomes at reduced costs, along with improved patient, family, community, and clinician and staff satisfaction, and in a better-organized way, and with reduced unjustified variation. And who wouldn’t want to be a part of that?
Well, we editors of Healthcare Informatics have been finding for a long time that many healthcare leaders do indeed want to be a part of the transformation of U.S. healthcare. Indeed, we at Healthcare Informatics have spent a decade now honoring those at the forefront of healthcare IT innovation with our Innovator Awards signature issue. The Healthcare Informatics Innovator Awards Program recognizes leadership teams from patient care organizations—hospitals, medical groups, integrated health systems, and other healthcare organizations—that have effectively deployed information technology in order to improve clinical, administrative, financial, or organizational performance. The Program also distinguishes vendor solution providers that have helped their clients shine in enhancing clinician workflow, exchanging data, or cutting down costs.
So: are you and your colleagues creating innovation in your organizations? The innovation involved can be of any kind that has moved your organization forward, along clinical, operational, financial, or organizational lines; and that benefits your community in some concrete way. The ideal is to be able to share innovations that have involved the ingenious leveraging of data and information technology for these purposes. The program is open to submissions by all patient care organizations, including hospitals, medical groups, and integrated health systems, and collaboratives of patient care organizations; health information exchanges; and health plans. We do not accept submissions from vendor companies.
But if you and your colleagues at your patient care organization are doing things you know you can be proud of—we’d like to hear from you. Please let us know—and let the world know—by submitting today to our Innovator Awards Program.! The link to the program is here. And if you do submit an entry to our program, we want to wish you the best of luck—because you have a real chance of being recognized nationally for what you and your colleagues are doing. And who knows? Your team might someday end up being mini-Amerigo Vespuccis of the new healthcare—really, you never know.
