To Modernize the Hospital - It Has to Get Medieval
Given the close relationship between technology and medicine, you would think that the hospital is a
relatively recent institution, but its history actually stretches back into classical civilization. Of course,
during these early incarnations (up through medieval Europe), the hospital wasn’t really a place where a
lot of medicine was being administered, as they didn’t really have much. What they did accomplish
instead was community outreach. Hospitals often worked in conjunction or under the auspices of the
church and therefore aimed to care for and educate the unwashed masses as well as clothe and feed all
people. Compared to what a hospital looks like today, they are quite different. But I am here to
advocate for a return to this ancient purpose. To redesign the very modern, very complex, and very
expensive issues facing healthcare and the US economy, we need to reorient the hospital to look outside
its sliding doors at the community around it. The hospital needs to get medieval.
One of the biggest drains on the American economy comes from the impact of chronic disease. Chronic
diseases such as diabetes, cancer and heart disease are responsible for 7 out of every 10 deaths in the
US, and account for 75% of healthcare spending. Every year, 69 million US workers miss work or die
early due to illness, a loss of productivity that amounts to roughly $260 billion. Now, some of this needs
to be addressed by federal, state and local policy, which some Innovative advocacy groups, like
PHAdvocates are working to resolve. Decades-old organizations like The Rippel Foundation are now
using innovative data solutions to tackle regional problems, but administrators should see the writing on
the wall. The more their hospital can offer in the way of free or affordable screenings for the most
preventable diseases, the less their medical professionals will be inundated later on by truly sick
patients. This isn’t charity, this is bottom line common sense.
St. Anthony’s of London, founded in the early 14th century, became London’s first free grammar school
by the 15th century. St. Anthony’s wasn’t a prestigious boarding school, but a hospital. While there is no
record of their understanding of preventative policy, this initiative clearly has that motive in mind. The
more your community knows, the more likely it is to take care of itself. The modern hospital is full of
extremely smart and gifted professionals who have spent years educating themselves and minutes
educating their patients, often by simply handing them a pamphlet or showing them a short video.
St. Leonard’s in York, also founded in the 14
th century, instituted outreach programs to neighboring
institutions, like the leper colony. It is important to frame the hospital not as a single building or set of
buildings on a campus. A hospital should be a source of ideation on healing that can be carried out to
the far corners of the world, or, at the very least, the neighborhood. Today, paramedicine programs are
being implemented in some forward-thinking regions and delivering amazing results. Taking the
treatment to the streets not only creates a more connected chain of communication between patient
and provider, but it saves money, lots of it.
Imagine the hospital of the future. It’s doctors and nurses see fewer patients each day, but spend longer
with each one. This increase in time forges a deeper trust (also a proven factor in faster recoveries), and
ensures the patient has every tool necessary to make sure they don’t have to go back to the hospital for
a very long time. In between patients, these medical professionals are meeting with paramedics to go
over program notes and feedback, inputting the data into analysis metrics to find out how they can be
more effective in future rounds. A few days each month, the doctors and nurses go out into the
community themselves, delivering talks at schools, offices and public forums to update people on
preventative measures they can take to stay healthy.
The thing is, this doesn’t cost that much, especially when you consider how much the alternative is
saddling the system with. People today are obviously a whole lot healthier than their medieval
counterparts, but their relationship to their care providers is actually less healthy, especially in
underserved neighborhoods. The more we can bring this bit of history back into the community and
current healthcare delivery systems, the better our future will be.
Joe Wilkins, FACHE
jdw@jwhealth.org
www.jwhealth.org
Atlantic Health's Aha! Moment: One of NJ's largest healthcare providers turns to its employees for new product ideas
By Vince Calio, November 13, 2017 at 3:00 AM
From left, Jefferson Isibor, lead pharmacist, Overlook Medical Center, Brian Gragnolati, president and CEO, Atlantic Health System, Heather Gucwa, pharmacy manager at Overlook Medical Center, Alan Lieber, president of Overlook Medical Center, and Joe Wilkins, SVP and chief transformation officer,
Atlantic Health System, with the ISSI Box (Insulin Safety Secure Initiative). -
(AARON HOUSTON)
Innovation should come from within, according to Atlantic Health System.
The Morristown-based care provider introduced the first product from its Atlantic Health Advancements (AHa!) program, an internal idea incubator that encourages its 16,000 employees to develop new ideas and products that improve and lower the cost of healthcare.
Aha!’s initial product, fittingly launched at the start of November, which is Diabetes Awareness Month, is the Insulin Safety Secure Initiative (ISSI) Box. This is a storage system for excess insulin and helps separate the various types of insulin to avoid confusion and waste. The new product, similar in appearance to a pill box, was developed by a pharmacist and a nurse at Atlantic Health’s Overlook Medical Center in Union County.
The idea for the ISSI Box came about because the inventors realized that they were accidentally wasting insulin for diabetes patients because there wasn’t a clear process for labeling and storing excess insulin between shifts, resulting in the need to continually open new insulin vials.
A three-month study that was supported and funded by Atlantic Health, found that the new product could save the hospital $100,000 per year. The box will be launched and available through Health Care Logistics, Inc. in the coming months, and featured at the American Society of Health-System Pharmacists Clinical Meeting and Exhibition in Orlando next month.
The ISSI Box is just the beginning, said Joe Wilkins, Atlantic Health’s chief transformation officer.
Here is a close-up of the new ISSI Box (Insulin Safety Secure Initiative) insulin delivery device for nurses and pharmacists. - (AARON HOUSTON)
“We have over 16,000 employees and 3,700 physicians that want to be more engaged and creative and be a party to finding solutions,” he told NJBIZ. “So with the AHa! Program, we help facilitate that. The ideas are coming from the physicians who see patients every day, and nurses that care for patients every day.”
Dr. Eric Whitman, medical director of Atlantic Health System Cancer Care, told NJBIZ in an email that the next products that will come out of the AHa! Program is an intraoperative nerve mapping device for multiple types surgical procedures and a new type of surgical retractor.
“I believe that AHa! will ultimately improve the efficiency of healthcare by encouraging and fostering the innovative creativity of our physicians and other medical staff,” Whitman said.
Atlantic said the program will give its employees access to best-in-class engineering and prototyping support, and will integrate four independent innovation management processes—recording and evolving ideas, training and supplying idea generators with the tools needed to convert ideas into products, use of innovation-on-demand methodologies, and education on needs and demand—into one streamlined system.
Atlantic Health has also created a panel of experts from Atlantic Health System, universities, government lab and private enterprises who will evaluate each product idea for further development.
Wilkins said that initially, Atlantic Health and the successful inventors will split any royalties resulting from the new products, while Atlantic Health will own the intellectual property rights. Atlantic Health will use its share to continue its mission of building healthy communities, he said.
“We have an intellectual property policy established today, so we now have the ability and infrastructure to protect the intellectual property rights of the inventor, as well as the organization that supports the inventor,” said Wilkins.
He said Atlantic Health will determine in the coming months how much capital it will invest in the program, and the split in royalties between the healthcare group and inventors will be more clearly determined as the program develops.
“There are going to be rewards and incentives for everyone that’s engaged in this work,” stated Wilkins, but it will take time to work through the details.
Employees from all of Atlantic Health’s 350 sites of care and six hospitals will able to participate in idea and product generation.
“The incubation lab is pretty much virtual,” said Wilkins. “We do have a ton of different facilities, so this all will happen within the day to day work of our team members. We have a website that we can capture all of the ideas and proceed with the innovation process. The excitement among our employees is well beyond our expectations.”
Atlantic Health System is one of the largest integrated healthcare providers in New Jersey. In August, its CEO, Brian Gragnolati was appointed to take over as chairman of the American Hospital Association in 2019.