international network

Healthcare Reform

Lessons from Abroad for U.S. Healthcare

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international network

When Joaquin Blaya wanted to explore bringing the mobile health start-up he launched in Chile to the United States, he turned to his long-time support network for advice.

The Global Health Delivery Project (GHD) has provided a virtual community for healthcare experts trying to tackle obstacles in delivering quality care in developing countries since 2007. Now, the initiative run by Brigham and Women’s Hospital and Harvard Medical School has launched a U.S. network with the aim of improving care for underserved populations across the country.

Blaya, who has moderated discussions about healthcare innovation on the GHD network, sees the U.S. Communities Initiative as a good opportunity to apply some of the lessons learned abroad to a complex U.S. healthcare system that spends more per capita than any other country but lags other developed countries in quality of care.

“I think GHDonline will help in the U.S. to get communities together collaborating, but also bring the experience from other countries in the U.S.,” said Blaya, who is a research fellow at Harvard-affiliated Brigham and Women’s Hospital.

Blaya is also chief technology officer at eHealth Systems, which recently launched a mobile-based network called MiDoctor aimed at encouraging engagement among patients with chronic diseases by using automated phone calls and text-message reminders about medications and doctors appointments.

He is working to bring the service to the United States, with an initial focus on the Hispanic community. Adopting the system will take some “cultural tweaking,” he said, as well as adjustments to address regulations like privacy rules under the Health Insurance Portability and Accountability Act, or HIPAA.

So he sought advice from other experts on the U.S. virtual community, hearing about local services such as Trext, which enables automated text conversations.

Facilitating such connections is a key purpose of the U.S. network, which since launching in May has grown to 143 members from 41 countries, said Dr. Rebecca Weintraub, GHD executive director.

“We hope to see thriving virtual communities of practice for those working with underserved populations in the U.S., which allow for the rapid exchange of practical information for improving health care delivery,” Weintraub told HealthBiz Decoded.

World Bank President Jim Yong Kim, who helped found GHD while at Harvard, has highlighted improving the delivery of healthcare as a key component of the effort to end absolute poverty worldwide by 2030. Weintraub says she sees the “tide changing” in the years since GHD was launched, with the network helping to break down some of the “silos of information” and improving the delivery of healthcare.

While healthcare systems vary greatly from country to country, she and other experts involved in the project say the United States faces similar obstacles to delivery, especially for underserved populations. Some of the same solutions developed abroad can be adapted to the U.S. system, such as using mobile technology to engage patients.

“We strongly believe in the concept of `reverse innovation’ where solutions pioneered in the developing world find application in the United States,” said Dr. Kapil Parakh, a cardiologist at Johns Hopkins Medicine who is moderating the discussion on innovating healthcare delivery in the United States.

He compared the U.S. healthcare system to an IT network where anyone needing access to a computer has to travel to a mainframe — representing the hospitals — where all the power is located.

“We need to transition to a smartphone model where the majority of people’s health needs are met where they are,” said Parakh, who is also co-founder of Health for America, a non-profit that mobilizes recent college graduates to create community-based technology solutions for chronic disease.

Texting is also a key means of communication among underserved communities in the United States, he said, suggesting mobile tools that have proven successful abroad could be put into practice here.

The tendency for cellphone usage to be high in resource-poor settings is a key reason why Blaya believes MiDoctor could improve patient engagement among Hispanics in the United States, especially in addressing problems like diabetes.

While he hopes the U.S. Communities Initiative can help him understand the challenges in importing the service, Blaya said the main benefit of the network is as a forum for solving common problems faced in disparate environments.

“Having this experience makes it a lot easier to implement MiDoctor,” he said. “But my participation in the U.S. community was because I wanted to be more involved and see what was going on and help.”