Living Up to the Promise of Modern Medicine: Collaborating Across Boundaries

Living Up to the Promise of Modern Medicine: Collaborating Across Boundaries
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My father was diagnosed with diabetes when I was 6 years old, and it wasn't until years later that I formally learned about the disease in medical school. It soon became clear to me that most physicians never fully grasp what patients and family members do intuitively. Diabetes changes how you eat, how you feel, how you live. The traditional models that we have to treat and manage complex chronic disease -- doctor's visits, medications, and quiet counseling on diet and exercise -- get us part of the way there, but there is room to do more. The real experience of care for most patients and family members is disjointed and disappointing. At most, my father saw his physician for several hours throughout the year over a handful of visits.

Many of us have experienced the miracles of modern medicine and science mixed in with failures of communication and coordination. My family's experiences with care make me hopeful about accountable care and the role it can play in improving care delivery. In theory, accountable care organizations (ACOs) create the flexibility that healthcare delivery systems need to proactively manage population health. Rather than managing the complications of diseases like diabetes on the back end, ACOs will work collaboratively with patients and families to manage towards health and prevention. It is my hope, too, that ACOs will have the will and skill to personalize solutions to patients and their families such that the experience, quality, and value of care will be better.

Of course, there is a significant gap between accountable care in principle -- and in practice. And much of what we must guard against is squandering the opportunity to close this gap. We must have high standards for what we set to achieve, experiment without fear, measure, learn, and adapt. We have to return the focus to patients and their specific burden of disease and collaborate seamlessly to improve clinical outcomes and the value of care delivered to patients.

It is this last imperative that excites me most. In an era of accountable care, every player in the health care delivery system will have a role in reducing costs and improving health. Roles will change. Work will change. Boundaries will be blurred. Patients and families, physicians and nurses, health care delivery systems, pharmaceutical and device manufacturers, pharmacists, employers, insurers and technology companies will interact differently tomorrow than they do today. Those collaborations that focus on improving the experience and communications for patients and families will become leaders in bringing us the promise of modern medicine.

It is in this spirit that health care companies are reaching out to the broader community to crowdsource the very best solutions for managing the problems of people with chronic disease. I fully expect that these challenges will find some of their best ideas are inspired by patients and their families -- who have long operated with lists of what they'd like from health care if only the world was different.

I imagine a world in which my dad will be managed by a team of providers, nurses, pharmacists and other navigators. A world in which care is extended beyond the four walls of the provider's office or his room in the hospital where he'll have care connectivity with his team. Issues like adherence, medication reconciliation, clinical guidelines are addressed and enabled by health information technology. Remote sensing devices will allow my dad to stay connected and information liquidity will allow me to be part of the process. Health care leaders see the opportunity to bring us closer to this new world by crowdsourcing innovation from a community of entrepreneurs.

My father's life has been dramatically improved by medications borne of the best science has to offer. Now is the time that we must couple modern science with the promise of modern health care -- and for us to build a high performance health system to match.

Sachin H. Jain, MD, MBA (@sacjai) is Chief Medical Information and Innovation Officer at Merck; Attending Physician at the Boston VA Medical Center; Lecturer in Health Care Policy at Harvard Medical School; and Co-Editor-in-Chief of Health Care: The Journal of Delivery Science and Innovation.

The Merck | Heritage Provider Network Innovation Challenge is currently underway. It's a first-of-a-kind collaboration between a pharmaceutical company and an Accountable Care Organization, created to help crowdsource the very best solutions for managing the problems of people with chronic disease. Semi-finalists will present at a live Demo Day in New York City on January 23. Learn more about the teams by visiting The Merck | Heritage Provider Network Innovation Challenge.

This blog series is produced in partnership with Health Data Challenges, creators of The Health Data Challenge Series, a formal initiative of the Health Data Consortium, powered by Luminary Labs. The platform seeks to foster the use of data to drive innovation that will ultimately transform health and healthcare through high-stakes innovation challenges. Learn more at

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