Recently, the Hope Street Group (http://www.hopestreetgroup.org) hosted a panel of industry leaders at the Kaiser Family Foundation in Washington, D.C., to introduce the new document, Using Open Innovation to Reinvent Primary Care (http://www.hopestreetgroup.org/docs/DOC-2346). This document represents months of work by dedicated stakeholders-clinicians, policymakers, researchers, economists, business professionals, entrepreneurs, insurance industry representatives, and health policy leaders. I feel very privileged to have been part of this venture; this was a long overdue role for me and an extraordinary lesson on the process of deliberative actions executed for the purpose of influencing policy decisions at the national level. All participants did not agree on all issues all the time; however, the common goals to fix the systems of care in the United States, increase access and efficiency, and improve health outcomes for individuals, sustained the momentum of the project and ended with consensus. There were no right or wrong responses when analyzing the case scenarios, and comments were thoughtful and stimulating, supported by varying levels of evidence.
A cultural shift
Optimistically, the project will gain the attention of legislators and other influencers, catapulting them into dialogues and eventually leading to policy decisions that will create lasting changes in the U.S. healthcare delivery system. Primary care would be used as the "transformative centerpiece" of change in the areas of workforce, practice, and payment reform.
The scarcity of primary care providers is alarming and projected to become even more serious if our methods of recruiting, educating, training, and using the health workforce do not change. Five recommendations were made based on the conceptual framework for the project. These include the following five principles: LEARN through research and development; CREATE the healthcare team of the future; SUBSTITUTE with alternatives; AMPLIFY our productivity; and MODIFY consumer behavior to decrease demand. The details of these five principles are designed to increase the capacity of the country's healthcare system so that we can provide accessible healthcare for the projected numbers of insured persons under the Affordable Care Act. A shift away from expensive, later-stage medical care to prevention, wellness, earlier detection, and treatment is necessary to maximize resources.
Strategies for a healthy nation
Interprofessional teams including nurses, physicians, and other healthcare workers are expected to collaborate more to deliver high-quality care. Recommendation 5 from the fifth principle, "MODIFY consumer behavior to decrease demand," is to empower consumers to take personal responsibility for improving their health through education, interactive tools, and incentives. Specific strategies include asking insurers to issue rebates for patients who seek preventive and chronic care services; using visuals such as graphs when reviewing outcomes with patients (a picture is worth a thousand words); taking advantage of available technology; adding an excise tax to unhealthy foods; and creating user-friendly, creative, interesting, and culturally relevant tools that allow patients to self-track individual outcomes. External and internal factors beyond an individual's control can influence health status, but our role as healthcare providers is to give patients the knowledge and tools to engage in meaningful behavior modification for factors contributing to poor health that are within the patient's control.
The Hope Street Group document comes on the heels of the final adoption of Healthy People 2020 (http://www.healthypeople.gov) goals and objectives, which are meant to guide national health promotion and disease prevention efforts. This fourth-generation iteration of Healthy People now offers a new and creative interactive website to disseminate information.
How well suited we NPs are to be an integral part of healthcare reform. Armed with Using Open Innovation to Reinvent Primary Care and Healthy People 2020, NPs are ready for action. Stay involved and take a seat at the table when policy decisions are at stake.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, FNAP
Editor-in-Chief [email protected]