Dreamforce: 'Unusual thinkers' needed for healthcare reform

Dreamforce: 'Unusual thinkers' needed for healthcare reform

Summary: One of the tracks today at Dreamforce in San Francisco had nothing to do with cloud computing, mobile apps, or new developer platforms. It did however, cover an important and controversial topic that impacts everyone, which is healthcare.


One of the tracks today at Dreamforce in San Francisco had nothing to do with cloud computing, mobile apps, or new developer platforms. It did however, cover an important and controversial topic that impacts everyone, which is healthcare.

The visionaries invited to speak at Unusual Thinkers: The UCSF Track included 7 doctors and researchers who covered sugar, obesity, aging, sports medicine, stress, and more. Among them was Mark R. Laret, CEO of UCSF Medical Center, which includes UCSF Benioff Children's Hospital.

Laret is a 30-year veteran of healthcare management, has advised congress on health policy, and is helping to develop the new UCSF Benioff Children's Hospital at the UCSF Mission Bay campus. Salesforce.com CEO Marc Benioff and his wife donated $100 million to UCSF Children's Hospital to help fund the construction of a new cutting-edge facility that will open in 2014.

Laret kicked off the opening talk with a brief history of healthcare in the US, noting that we are now at a inflection point like no other in the industry, and it's IT-driven.

In the 60s the big changes were the introductions of Medicare and the Medicaid program. The 70s saw a jump in the private health insurance industry and costs started to head through the roof. "GM puts more into healthcare costs than steel in for their cars", he said. Managed care arrived in the 80s and consumers did not like it, and in the 90s we saw an economic boom, but nothing much happened. Finally, in the first decade of the new millennium, we see the introduction of a diversity of health plans, many with large deductibles and limitations. Now, one out of very six dollars spent by the government goes to healthcare, and a starting nurse at UCSF earns $110K per year.

"We need people outside of the industry to be involved and think through how to bring healthcare to the industry," he said.  Information technology has been so successful because it has harbored many interesting people, and those kinds of paradigm shifting thinkers are needed in healthcare.  One example is Nobel Prize winner Stanley Prusiner who proved that mad cow disease is caused by a protein, an idea initially rejected by the medical community.

Laret asked, "Is healthcare is supposed to be a public good or a business or what?" Hospitals and doctors are the people you are working with when a child is born, when cancer is diagnosed, and when there is death. So it can't be relegated to an impersonal process.

He went on to list more problems with the current system. For instance, those who live in rural areas do not get enough treatment, while those in urban may actually get too much. Then there's the decades old system of how you go about seeing a doctor. You first need to find a doctor and then make an appointment which is time consuming and uses a lot of energy just to get a brief moment with an intellectual mind.

"We need the Ruby on Rails for healthcare...disruptive innovation. We need innovative thinkers to challenge the status quo, people outside our industry to weigh in, and leverage technology in new ways. Healthcare needs to power of "AND." As in provide more care AND do it cheaper. Highly personalized care AND less labor. And so on."

Laret then raised tough questions and issues in the areas of science, policy and people:


- How do we apply what we already know more broadly to benefit people worldwide?

There's the science of discovery that you often hear about, but how about the science of integration and applications?  Over 90,000 people die in hospitals each year in hospitals due to lack of hand washing by providers. Improving hand hygiene alone could go such a long way.

- How do we leverage data in new ways to improve care and lower costs?

One example is Genomic Health, which is focused on the development and commercialization of genomic-based clinical diagnostic tests for cancer.

- How do we accelerate the time from discovery to adoption?

It took 48 years for James Lind's discovery that citrus fruits cured scurvy to be finally implemented by the US Navy.  Now the time from general discovery to general adoption in the industry is 17 years. If the grand vision of computing intelligence over the decades comes to be, the time can be reduced to near-real time.


- We are not entirely sure to what is important to us. Is it providing care? - Currently, we got to get enough insured patients to come through to cover the costs of low income patients. The whole healthcare reform puts more people into Medicare and Medicaid. - Is healthcare a right? Should everyone get everything? - Will have a national debate about what healthcare people should get vs. what they can afford? - If we insure all people, we will think through how we ration healthcare?


- Healthcare is incredibly labor intensive industry - One of the challenges is communication, how do we improve it among multiple caregivers, patients, and families? The #1 reason errors happen in hospital is due to communication errors. - UCSF is exploring ways for people to communicate online, like using Chatter. - How do we reconcile increasing demand and dropping capacity? - We have to distinguish the sickness system from the wellness system - We need to take this to another level. The only way to solve this long-term (man power) with more technology and innovation, For instance, Andy Grove suggested to put monitors under carpets to track seniors in their homes.

The Goal

- An optimally health society in every way - Built on success but never be captive of the past - Collaborate in new ways to leverage the considerable assets of our healthcare system

He concluded by saying that to get there we need more unusual thinkers.

Topics: Health, CXO, Legal, IT Employment

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  • Two words to slash health care costs about 90%...

    Logan's Run
    • RE: Dreamforce: 'Unusual thinkers' needed for healthcare reform

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  • RE: Dreamforce: 'Unusual thinkers' needed for healthcare reform

    One problem is that people have accepted a myth that every illness is deserving of aggressive expensive treatment.

    Some illnesses go away by themselves, some illnesses have the same outcome whether we treat them or not, and some illnesses have treatments that may improve outcomes, but are so expensive as to be marginal in value. We need to accept that tough decisions need to be made on these area.

    Another major problem, we need to stop making the global pharmaceutical industry richer at the expense of patients. Drugs are given too much cover in the form of patents especially in the US with its ridiculous duration of patents. Innovation is not driven by patents or money. The most beneficial drugs ever invented were not held close to the chest of some corporation (opiates as anaesthetics, penicillin antibiotic, insulin) but were intentionally disseminated as cheaply as possible for the public good. Actual researchers (the professors, not the companies they work for) make modest salaries, and never see a percentage of their work. And yet they are the ones actually doing the work of innovation.

    Reduce the patent duration. Allow generics into the market sooner. Create a truly independent monitoring agency with enough manpower (and end the nonsense of "voluntary self regulation").

    End the practice of having drug company salesmen visit individual doctors directly. Replace it with a new model.

    Create a collegial system where doctors have easy access to the research and test results behind new (and old) drugs.

    Promote sharing of ideas between research labs even in different private companies to allow synergistic thinking.

    These are just a few ideas that would definitely reduce health care costs. Of course none of them will be used, because they would actually work, and big pharm won't like them.
  • Not American MBA's needed with UK experience!

    so why have they not hired management consultants from the UK to shape the future in the US...the same old loop of thought in the us needs to be short circuited with inputs from outside?

    Clearly this is about industry change and political change to focus in a new direction...so hirer my company as an international consultant?
    The Management consultant
  • health insurance

    I have posted this already here before You guys should stop complaining because, one the health care we have now isnt as good as it was supposed to be. also the law has just been signed so give it some time. so if u want to say u have the right to choose tell that to ur congress men or state official. If you do not have insurance and need one You can find full medical coverage at the lowest price check http://ow.ly/3akSX .If you have health insurance and do not care about cost just be happy about it and believe me you are not going to loose anything!
  • It's really simple . . .

    It's really simple . . .

    We don't have enough supply to meet demand. Playing around with politics and who will pay for it and how we deal with insurance blah blah blah blah blah blah blah will not fix it.

    It's really quite simple: We need more doctors and other health care professionals. We need to overhaul our lousy school system that is struggling to produce them.

    . . . and if anything, the system is just plain too complex. Our "solution" was to pass a bill that, well, made it even more complex and just adds more overhead. We need to bring the KISS principle into health care. I dare say we need to rewrite the system from scratch with a clean slate. Design it with maximum effectiveness and minimal overhead.

    But nooo, the people who are trying to "overhaul" health care are politicians, with a vested interest in towing the party line.

    The Democrats are right: We need something that anybody can use.

    The Republicans are right: We need minimal overhead.

    Are these really contradictory principles? Nah, they're not. But you'll pay dearly if you dare to agree with the opposing party on anything these days.
  • RE: Dreamforce: 'Unusual thinkers' needed for healthcare reform

    Health care reform, or any other attempts to cut medical costs or improve the system, can go only so far, if health insurance companies don't pay their bills for the medical care they are supposed to insure. Physicians are put in the position of having to increase fees or reduce care, if many of their bills go unpaid by carriers, forcing doctors to find the money or savings elsewhere. That's why offshore medical billing services can help, not hurt, the U.S. economy and the U.S. health care system. Offshore collection services in India, for example, efficiently take on the carriers and make them pay the legitimate claims that they so often try to avoid paying. That's health care reform you can believe in!

    James P. John
    Medical Billing Manager
  • looks like it's all Policy to me

    All this breaking out things into science and whatever seems pointless. Everything that he's asking for is basically under the Policy category. Without the will to say, "These are the new guidelines, this is what is and isn't allowed." then all the innovation in the world is pointless. HMOs took over because they were allowed to and encouraged to, not because of any inventiveness on their part. Swindling is not innovative, it's as old as life itself.
  • RE: Dreamforce: 'Unusual thinkers' needed for healthcare reform

    LOL....The Insurance Companies WROTE the Health Care Reform Package.
  • RE: Dreamforce: 'Unusual thinkers' needed for healthcare reform

    Highest-paid UC execs demand millions in benefits
  • RE: Dreamforce: 'Unusual thinkers' needed for healthcare reform

    My personal opinion is that there is no place in a civilized society for a "health care industry". Fix that mind set and some of the medical care problems might be solved. I came to that conclusion years ago when I read on a financial page that the emerging AIDS epidemic was a great opportunity to make big profits
    General Ludd