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Proposal to build SoFLHealth, a South Florida Regional Health Improvement Platform.

I’ve put together a proposal for a regional health-enhancing system. You may find this of interest:


Your comments and suggestions for improvement will be greatly appreciated. Feel free to share. Regards.

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“..students of medical economics have long realized that what consumers demand when they purchase medical services are not these services per se but rather better health.”

This document outlines a vision for a care system that improves the health of all South Florida residents. The proposed platform will be based on consumer-owned IT tools (computers, mobile phones, etc.), a decentralized support infrastructure, and a close alignment of community resources with local families’ needs.

There are lots of conversations around “improving the healthcare system.” Unfortunately this industry is rife with mis-aligned incentives, starting with the root problem of a “fee-for-service” reimbursement model. Ill consumers are very profitable to healthcare providers, but not to consumers’ employers, their families, their communities, much less themselves.

The traditional framing of the issue (“let’s improve the healthcare system for all”) misses a crucial point: what SoFL residents really want is a care system that improves the health of all. Ample research evidence demonstrates that more healthcare does not automatically lead to better health.

At the end of the day, where would you rather live? In a city with the best children’s oncology hospital, or in a region where your children have the lowest possible odds of ever developing cancer?

How realistic is it to create a health-focused system? Quite realistic, as it turns out. This proposal is based on the reality that key SoFL stakeholders already have perfectly-aligned incentives to build a new health-enhancing delivery system:
* consumers are under ever-growing financial pressure to pay for healthcare expenses, while receiving less and less “good health” in the process
* payers are under tremendous pressure to contain their runaway healthcare costs, while requiring ever healthier workers to maintain the business’ productivity
* educational institutions (school boards; colleges; universities) need healthy students ready and able to absorb the knowledge being imparted
* communities need healthier employees who spend more money in their local area, and waste a lower percentage of their disposable income on healthcare
* economic development agencies realize that good individual, family, and community health are economic development issue: a healthy population makes for a healthy, vibrant economy.

Yes, we can make this transition, even in an industry as large as the healthcare industry currently is. Here is a historical perspective of how a huge industry in America was forced to transform its business model from “pay-when-it-fails” to a “pay-to-avoid-failure” model:

The US automotive industry went through a massive transformation starting in the late 70′s. The industry was used to building large, chrome-loaded vehicles that were very inefficient and failure-prone. There was an entire industry (repair shops, auto clubs, body shops) built around repairing the prone-to-fail American-made cars of that generation.
And along came imports (Japanese as well as German) with small, energy-efficient (for the time), and much more reliable vehicles. Imports were initially hampered by the fact that their dealer network (ie. repair shops) was not as widespread as the American manufacturers’. Until consumers realized that imports did not need to go to the repair shop as often as American-made cars. From that point on, American consumers demanded cars that don’t break down and that provide reliable transportation for years. Automotive companies then delivered on that demand.

Thus, our vision:

“SoFLHealth will build a consumer-centric, community-based, payer-driven, technology-enabled platform. This will help South Florida residents to maintain and improve their family’s health. We’ll develop new academic expertise and practical methodologies. And SoFLHealth will help to drive high-value economic activity in our region.”

* Consumer-centric:
The patient (or his caregiver) is usually responsible for the coordination of care across multiple settings (home care; out-patient; in-patient) and even multiple providers (primary care physician; specialist; hospital-based service providers; community-based services; etc.). SoFLHealth will empower the patient to take control of her health.

* Community-based:
We’re all in this together. A payer’s employee is somebody else’s customer and a local government’s taxpayer. A healthy individual is a productive employee, a valuable consumer, and a reliable source of local taxes and fees.

* Payer-driven:
In our market-driven system those with the “power of the purse” can effect change, and quickly. Payers need to use their healthcare dollars to push towards a health-enhancing system that produces healthier workers. Not just ever more expensive treatments for increasingly ill workers.

* Technology-enabled:
Consumers already handle their financial, business, school and personal life digitally. Why not their health? SoFLHealth will help consumers to leverage their existing technology arsenal (millions of broadband-enabled homes with PCs, printers, scanners, mobile phones, etc.). Most homes in SoFL already have more IT and telecom tools in place than the majority of physicians’ offices. SoFLHealth can build a “Health Improvement Network” from the edge (consumers) in (towards providers) at a faster pace than the current provider-centric Health IT approach.

* Platform:
An IT-heavy, de-centralized, consumer-controlled system that allows consumers to collect and manage their own health information from across all the healthcare providers they deal with. Note: SoFLHealth is the exact opposite of a RHIO: this is a consumer-centric, consumer-controlled model, and there will be no centralized storage of anything.

* Help South Florida residents:
The proposed platform will have a regional approach, from Homestead to North Palm Beach. People in our region live, work, play and pray up and down the tri-county area.

* Maintain and improve:
The current illness care system pays little attention to maintaining and improving an individual’s health because providers are  seldom compensated for avoiding illness. But consumers really want help to gain better health for themselves and their families.

* Family’s health:
The true unit of care in America is the family, not the individual. If a family member is ill the entire family suffers.

* Develop new academic expertise:
SoFLHealth will purposefully seek to provide a test-bed for new academic research, from security protocols to industry standards. And to develop new academic disciplines such as Health Engineering.

* Practical methodologies:
SoFLHealth proposes to look at the health improvement process as an Engineering challenge, and to develop “Evidence-Based Health” methodologies that leverage best-practices from other industries.

* Drive high-value economic activity:
Several cities have built themselves up as “cities of healing,” driving significant economic activity around their hospitals and centers of illness-care. Boston (Mass General); Rochester, MN (Mayo Clinic); and Pittsburgh (UPMC) come to mind. SoFLHealth represents an opportunity for SoFL to become a “region of health,” where we develop, implement, test, validate and then sell community-wide mechanisms that improve the local community’s health.

I welcome your suggestions to improve this proposal. Please contact me directly at +1 (954) 553-1984. Regards.

Jose C. Lacal, Chief Vision Officer
Open Personalized Health Informatics Corp.

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