The American College of Occupational and Environmental Medicine (ACOEM) opened its 98th annual meeting with a keynote speech by Paul Grundy, MD, Global Director of Healthcare Transformation at IBM, urging adoption of a new system of patient care in the United States that moves away from focusing on the management of health care "episodes" and more toward long-term management of population health and integrated delivery of health services.
Grundy, who is also President of the Patient-Centered Primary Care Collaborative, said physicians who practice occupational and environmental medicine (OEM) can play a significant role in moving the United States towards this new model.
Grundy spoke during ACOEM's opening session, which welcomed more than 1,000 occupational health professionals to Orlando for several days of educational sessions and discussion forums.
According to Grundy, the movement in the United States away from "buying" an episode of care has already begun, with many of the nation's largest employers, who purchase a significant portion of health care services, requiring care providers to be more focused on keeping their populations healthy through a more preventive approach.
Dr. Grundy urged more widespread adoption of the Patient Centered Medical Home concept, which he has helped pioneer and which is formally endorsed by several leading American medical specialty organizations. The concept calls for more team-based care, patient empowerment and greater emphasis on preventive health strategies.
The Patient Centered Medical Home, according to Dr. Grundy, has delivered impressive results where it has been implemented - including in some cases reductions of more than 30 percent in hospital stays and emergency room use and significant reductions in the need for medications and in overall costs.
Dr. Grundy said the three main factors that are driving the movement toward the Patient Centered Medical Home are unsustainable cost increases in health care delivery, the growing availability of data, and "a vast change in the way we communicate." He noted that In Denmark, more than 80 percent of health-care encounters and transactions are electronically based and that a "vastly different method of communicating is coming online and it's coming fast," driven by younger generations of patients and physicians.
But he noted that the United States is currently behind the curve in these trends, particularly in terms of the use of data and more team-based models in health care delivery. "It's going to take a massive shift in how we handle data in order for us to join the rest of the world in how we deliver care," he said.
Occupational and environmental medicine (OEM) physicians are uniquely qualified to help move the nation toward the Patient Centered Medical Home concept because they have expertise in managing the health of populations - particularly those who care for employees of large organizations. Through heath risk assessments, preventive health strategies and wellness programming, they are able to focus on preventing disease and disability and help individuals manage their health over time.
By embracing the Patient Centered Medical Home, Dr. Grundy said, OEM physicians can also help raise the productivity of the workforce, adding value to the concept beyond reduction in costs and improved health outcomes
Dr. Grundy said that for the concept to continue to grow, the practice-delivery mode in the United States will need to evolve faster toward team-based care and that payment and benefit-design models will need to shift, with physicians being rewarded for keeping patients healthy.
The concepts of the Patient Centered Medical Home also of great benefit employers, he said, who can help accelerate their adoption by requiring them of health providers they contract with. "As buyers of care, we need to think about demanding change," he said.
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