Recently, Neil de Crescenzo, IBM's healthcare industry leader, spent the day at the University of Pittsburgh Medical Center (UPMC) wrapping up an agreement worth $402 million calling for IBM to reengineer the hospital's technology infrastructure. The eight-year project will build on UPMC's existing healthcare record strategy to create an on-demand environment that integrates patient information from all the hospital's facilities.
The agreement, one of several such deals IBM has made in the past few months, represents another milestone in a hugely ambitious project — building what de Crescenzo terms a national, on-demand, electronic healthcare ecosystem. "The on-demand approach has to do with operating your business on a horizontal basis to be able to connect the information and the processes that ultimately impact your customer or client," says de Crescenzo, who is heading up this effort for IBM.
In this instance, however, he is talking about operating the nation's entire healthcare industry on a horizontal basis. The challenge is to link all the country's hospitals, healthcare plans, pharmaceutical companies, public health surveillance networks, private medical practices, and consumers. "Improving healthcare through the flow of electronic medical information is a national priority," de Crescenzo notes, adding that doing so would shave an estimated 10 percent or more off the $1.7 trillion spent annually on healthcare in the U.S.
De Crescenzo, whose spouse happens to be an emergency physician working with the underserved, has been passionate about healthcare for several decades. "I originally started my career in finance and did a lot of work with some of the world-class healthcare organizations," he explains. "I really enjoyed the challenges in the field and went to work at some of the large hospital systems." Twelve years ago, Lou Gerstner hired him when the then–IBM CEO was bringing people with industry backgrounds into the company. It wasn't until a year and a half ago, however, that IBM's healthcare initiatives reached a critical tipping point. "President Bush invited business leaders to the White House to talk about how healthcare records could be improved through electronic records, and the team lead at the meeting was Sam Palmisano." Palmisano, of course, is IBM's chairman and CEO.
In the wake of the White House meeting, de Crescenzo and his team began thinking that a national healthcare network was within reach. "You can't run against a government headwind," he notes, "but when the headwind becomes a tailwind, you see an explosion of interest and activity."
De Crescenzo concedes that there isn't a model for an initiative of this magnitude, but IBM and an extensive list of collaborators that includes healthcare providers, insurers, and other industry players are putting enormous resources and funding behind the effort. IBM, for instance, just announced an agreement to buy Healthlink, the nation's largest healthcare consulting services firm. It also announced that it is building a test bed that will span IBM sites in San Jose, CA; Rochester, MN; and Haifa, Israel.
"We're going to actually drive and test the interoperability of some of the healthcare applications and services in order to get a jump start in understanding how to develop those interoperable networks that the federal government and other agencies are using," de Crescenzo explains.
For all these resources, however, the viability of a nationwide healthcare ecosystem is going to depend on the ability of disparate public and private sector interests to work together. That's been clear to de Crescenzo from the get-go. "One of the places where I worked was at the Leahy Clinic outside Boston," he says. "Like the Mayo and Cleveland clinics, Leahy uses a multispecialty, group-practice model wherein physicians and administrators of all types coalesce around the patient to try to improve treatment and diagnosis." As a microcosm, that's the approach de Crescenzo and his high-performance team are taking — except that the patient in this case is the entire U.S. healthcare system. — Laton McCartney
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