The challenge here is not to impose a particular standard of care from the outside (the so-called death panels) but to change the public expectation from, on the one hand, doing everything imaginable to extend life to the last possible minute to, on the other hand, patient-centered care: giving the patient the care that he or she desires. This premise mandates that we develop processes to enable the execution of advance directives by the majority of the population and then store them electronically in a place where they are easily accessed by care providers at the time that they are needed.
The third priority is to reduce waste. It's a widely accepted fact that more than half of all spending on healthcare in the United States—about $1.3 trillion out of $2.6 trillion annually—is wasted: unnecessary, ill-advised or the result of systemic incompetence. The challenge is, therefore, to track and manage expenses and build a patient-centered system.
At Intermountain Healthcare, we've spent decades focusing on this challenge. We've learned that you can't improve what you can't measure. We now have advanced information technology that allows us to analyze every dollar spent in the system. We can chart the best treatment options for patients using information from other patients and team with doctors in our system to develop standardized approaches to common disease states. We analyze trends and, therefore, can quickly identify potentially life-threatening practices. We've learned to measure and evaluate, and, as a result, we've been in the forefront of high-quality lower-cost care.
The recent healthcare reform debate has focused on the federal government, and clearly improvements are still needed there. But the most impactful solutions to our national health and healthcare needs won't be found in Washington. They are in our own hometowns, our hospitals, our doctors' offices, our homes—in our own attitudes toward health and care. By exploring those solutions, we can improve our nation's health, reduce our reliance on healthcare, and provide care that is both accessible and affordable.