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Page 767 – Stanford Medicine X

Designing the health care "system" intelligently from the ground up - for patients, then providers, then industry

Marc Braman drbraman@drbraman.com


What we call a system is not actually a health care "system". It is a conglomeration of competing, fractured, conflicting elements, most of which do not have the patient's best interest as priority.

For all the innovation occurring in channels such as Medicine X, substantial innovation cannot occur due to the current "system" not having vested interest in true innovation benefitting patients, and/or mountains of bureaucracy and regulations that overwhelm us with paperwork instead of patient care.

What is needed is the creation of an entirely new platform for health care based on open, universal standards designed and controlled by patients and patient advocates. The reins of power and the management of function must be directed for the benefit of the consumer of health care.

We do not need to reinvent the wheel, but rather take a page from the playbook of the tech industry. In the old days, every electronic device manufacturer had their own proprietary connector that made life miserable and completely dysfunctional for technology use and interoperability. The USB Consortium was formed to create universal standards that worked for all. This is what is needed in health care for true innovation and progress to be possible.

We need to actually design an true working "system" for health care. Patients must be the hub. All components and players must justify their existence and function relative to patient benefit. Providers need to work closely with patients as the next concentric ring outward to guide the application of health care to patient benefit. The third outward sector is patient benefit industry, and the fourth outward sector is regular commercial industry.

Thorough, systematic work is needed to engage the right stakeholders in the right dynamic. Government engagement, cooperation, and facilitated process will be highly important. Appropriate funding and funding structures will be key.
It is time to put real health care system design into the hands of those able and willing to make health care all that it can and should be. It is time that we collectively buckle down, realize the work that really needs to be done, roll up our sleeves and build the design studio and factories for "our" health care "system" -- of course, together.
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