There are many priorities in healthcare—heal patients, make appointments convenient, adopt proven technologies, and many others. Healthcare consumers want digital tools to help them manage their own health, but they also want a warm, empathetic touch from a caring human. Although these priorities might appear to be at odds with each other, I believe they can be complementary, and even synergistic, if we approach them the right way.
Let me give a quick example. We have TeleHealth Critical Care coverage (critical care experts monitoring and caring for patients remotely) for 30 hospitals, including all 22 of our own Intermountain hospitals, plus eight partner hospitals that have contracted with us to provide this service. This coverage has allowed us to keep more patients at home, in their communities, surrounded by family and trusted clinicians. We've been able to improve patient outcomes and keep costs and the length of hospital stays down. Managing intensive care over a distance using cameras, microphones and digitally transmitted vital signs and other data might seem cold, but it helps ensure patients receive high-quality care while sticking close to loved ones, which may be the most empathetic thing we can do for them.
As healthcare transforms to better accommodate patients’ needs, more care will be delivered outside of hospitals and clinics, including at patients’ homes. Self-dialysis, ventilation, and many other services can be delivered at home, either by the patient themselves, or by engaged and educated family members and local clinicians. Many patients are uploading vital stats and other information to their electronic medical records via Bluetooth or other wireless means. This is a great thing. It allows patients to stay in the most comfortable place for them, but still stay in close contact with their care team. It also allows caregivers other than physicians – including family members – to more fully participate in the care of the patient.
We believe that as digital healthcare gets better and better, we'll be able to keep many more patients out of our hospitals and clinics to heal in places where they feel more comfortable. Wait! Keep patients out of hospitals and clinics? For healthcare systems focused on operating hospitals at or near capacity that may seem like a counter-productive business strategy. But, for healthcare organizations like Intermountain that focus on helping people live the healthiest lives possible, it’s exactly the right thing to do. Patients will do better and heal faster. They'll be able to meet their life goals and keep the costs of care down. The question really becomes, where do you invest in digital health, and how do you bring it to patients?
Historically, goals for healthcare have been very much set in the biomedical model. Five-year survival rates for cancer, congestive heart failure exercise scores and treatment of heart disease, FEV1 pulmonary function testing around asthma, hemoglobin A1c for diabetes, numerical control of blood pressure, is your systolic below X, and so on.
All of these metrics are important and reflect years of research around disease treatment, but in a very personalized model of healthcare. However, these vital statistics are used to support what may be the most important questions we can ask: "What do you want as your life goals from a health standpoint? Do you want to make it to your daughter's graduation? Do you want to see your grandson get married? Do you want to be able to climb a flight of stairs? Would you like to be able to go fishing again? Do you want to be able to drive your own car?"
Intermountain started integrating these sorts of goals into our new electronic medical records beginning in 2017. For me, that's a revolution because we can actually start to work our technological solutions and our biomedical solutions to better serve what patients want for their own lives. This will lead to patients being more engaged in their care and more shared decision-making. We won’t waste a patient’s money doing things that don’t align with their wishes and goals. We’ll be helping them do what they want to do with their lives, and that’s a great thing.
A. Marc Harrison, M.D., is president and CEO of Intermountain Healthcare, the 22-hospital integrated health system based in Salt Lake City. He has had a distinguished career in pediatric critical care and as a health system physician leader. In his current role, he strives maintain focus on implementing best clinical and operational practices designed to advance its mission of helping people live the healthiest lives possible.
A specialist in pediatric critical care, Dr. Harrison held leadership positions at Cleveland Clinic prior to joining Intermountain in October 2016. He most recently served as chief of international business development for Cleveland Clinic, developing and implementing international strategy, and as CEO of Cleveland Clinic Abu Dhabi, where he oversaw the establishment of 12 institutes, five centers of excellence, and more than 30 medical and surgical specialties. Earlier roles included service as chief medical operations officer, involving oversight of a broad range of clinical operations worldwide for the system, and as chairman of Pediatric Critical Care.
Dr. Harrison earned an undergraduate degree at Haverford College and a medical degree at Dartmouth Medical School. He completed a residency and an internship in pediatric critical care through the University of Utah School of Medicine, working primarily in the critical care units of Intermountain’s Primary Children’s Hospital. Dr. Harrison later received a master’s in medical management from Carnegie Mellon University and completed additional study in management at Harvard Business School.
