Guest Opinion: Health innovation region’s hallmark

Spokane has always been a vibrant center for new ideas about medicine, and it is a city that has often been at the forefront of the currents and cross-currents of change that periodically sweep through the health care industry.

I experienced this firsthand in the late 1990s when I came to Spokane to help run Group Health’s Eastern Washington operations. Back then, we were just beginning to understand how to use information technology to improve medical care. It was exciting to be part of a regionwide effort in which all of the major health care organizations in the area worked together to create a groundbreaking information system that made it dramatically easier to access patient information. We also collaborated on a number of community health initiatives and shared the cost of expensive services like a regional airlift hospital. These efforts helped make Spokane a national leader in health care quality and efficiency.

Today, Spokane is a good place to witness the impact that health care reform is having on hospitals and medical groups. The last year has seen a wave of mergers here, with hospitals and care delivery systems acquiring doctors’ practices at a pace we haven’t seen for many decades. This trend is a logical reaction to the volatility that health care organizations face as we prepare for an uncertain future and respond to state and federal policy initiatives that encourage greater integration and coordination of care. But it’s unclear whether the changes we are seeing in Spokane are the kind that will lead to better quality and value or higher prices.

What is clear is that change is necessary and inevitable. The current approach to medicine in this country is unsustainable: Costs are too high, quality is too uneven, and too many people don’t have access to the care they need.

In part, change will be driven by policy decisions that are made in Washington, D.C. That’s why there is so much focus on the U.S. Supreme Court ruling on the Affordable Care Act that could come any day now.

But as important as public policy is, solutions to our national health care crisis will ultimately come from local health care organizations that are working to find better ways to work with patients to deliver care in the communities that they serve. That’s because the most important decisions about medical care aren’t always made in Washington, D.C. Just as important are choices that individuals make about their health every day, whether it’s in the doctor’s office or at the dining room table.

Washington state is widely recognized as a leader in this quest to find local solutions that lead to better lifelong health for patients. In Spokane, for example, Group Health and Providence Health Care are working together to create an integrated care system based on shared information about clinical results, coordinated treatment and patient-centered innovations that improve outcomes and lower costs.

Efforts like these are in their early stages, but we’ve already learned a lot about what it takes to build better health care systems.

We know, for example, that when primary care emphasizes strong relationships among patients, primary care doctors and teams of specialists, it leads to fewer emergency room visits, lower hospitalization rates and a decrease in the cost of care. Helping people manage chronic conditions more effectively reduces complications and improves quality of life. When patients work with their doctors to make evidence-based choices about elective surgeries, it can reduce the rate of expensive invasive procedures by 25 percent.

The challenge is to apply successful approaches like these at a national level. This is why what happens at the state and federal levels is so important. Health policy that supports local innovation and rewards local health care providers that work together to raise quality rather than costs is needed to accelerate the transformation of our health care system.

But what ultimately determines whether we live healthier lives is what happens in the communities where we live. A lot has changed in the 15 years I have lived in Spokane. The spirit of cooperation that was so evident in the late 1990s has been dampened somewhat by the recent competition to buy doctor groups. But the focus on excellence and quality is undiminished. As policymakers in Washington, D.C., continue to argue over the future of health care in America, here in Washington state, we have an opportunity – and a responsibility – to continue to strive to improve quality and lower cost.