Health care on global scale: Four takeaways from Davos

By Robert C. Garrett, Hackensack Meridian Health
Davos, Switzerland | Feb 5, 2020 at 12:36 pm
Op-Ed

My latest trip to Davos, Switzerland, to participate in the World Economic Forum was a major win — for our network, our patients and health care in New Jersey. This international incubator delivers real tangibles for health networks right here in the Garden State when it comes to cultivating new partnerships, investing in advanced technology and improving behavioral health care and expanding community-based care.

I left energized and optimistic about our mission to transform health care, by delivering high-quality care that is also affordable, convenient and patient-friendly. Here are four lessons I’d like to share:

Behavioral health: This is just as important to the global community as it is to providers in New Jersey. I am so encouraged about this, because it’s high time we treat mental health and addiction the same as diabetes, heart disease and cancer — as a chronic illness that deserves the full spectrum of care, highly coordinated treatment and novel therapies. There are human and economic reasons to do so. Nations around the globe are working hard to change the trajectory in these diseases of despair — including high rates of depression, suicide and substance abuse.

We must end the stigma and provide better access, more coordinated care and innovative treatment. One in five people is diagnosed with a behavioral health issue in the U.S. Meanwhile, across the globe, depression treatment consumes 12% of health care dollars.

Just last month, New Jersey Attorney General Gurbir S. Grewal announced that fatal overdoes were down for the first time in five years. However, I agree with Attorney General Grewal that the 3% decline — while positive — doesn’t indicate we’ve turned the corner. We’re still looking at more than 3,100 lives lost in New Jersey last year, and we are collectively committed to preventing more deaths and getting more people into treatment.

Last year, our network opened the first urgent care with behavioral health services in New Jersey to help people get treatment faster and to divert them from more complicated, expensive emergency care. This is one of several successes in our 2019 merger with Carrier Clinic, the state’s leading behavioral health provider. So far, we’ve treated hundreds of patients since our September opening and the cost is up to 70% less than an ED visit. We plan to scale this pilot throughout our 17-hospital network.

This year, we are on target to open the Retreat at Ramapo Valley, a comprehensive addiction treatment center in Mahwah, to provide high-quality, coordinated care to improve outcomes and give people hope. I believe we need to offer New Jersey residents more options to recover right here, near loved ones and their support systems.

Research and technology: Investing in research and technology will help us deliver tomorrow’s cures today and advance care delivery to improve lives and reduce costs.

Once again, we are facing a global pandemic, this time with the novel coronavirus. Researchers at our Center for Discovery and Innovation are at work to develop a rapid test, a vital leap forward that would help patients, providers and ultimately better control spread of the disease. Dr. David S. Perlin, chief scientific officer and senior vice president of the CDI, has a long history and hands-on experience in previous virus outbreaks, including SARS.

Additionally, experts at CDI are committed to reducing hospital-acquired infections, which kill 100,000 patients a year in the U.S. — and unnecessarily drive up health care costs. Our experts obtained a $33 million National Institutes of Health grant last year — a record for our network — to help in this endeavor to save lives.

Without such incubators, health networks cannot expedite new discoveries at the pace that is required to transform health care. The CDI and similar enterprises work to break down the silos that exists in academic, research and clinical practice that unintentionally slow down the process of discovery.

Additionally, we are at the cusp of radical transformation of the treatment of behavioral health because of technology that allows us to take a more proactive, preventive strategy — just as we do with many other chronic illnesses.

Here’s a really exciting development: Beyond the wearables like Fitbits, there are other devices that are providing detailed snapshots of health and wellness regarding behavioral health care. For example, let’s consider a person with a history of depression and anxiety. Even before he awakes, data from his neuro-endocrine system reveals a spike in cortisol, which can signal a major depressive episode. So, a virtual appointment with a therapist is scheduled in his busy day to reduce his stress — even before he wakes up. This emerging technology will one day be routine.

Our Bear’s Den is a panel of experts in health care, finance, patent law and network leadership that vets ideas and companies to improve care delivery. We have funded breakthroughs in better management of medication and reducing hospital-acquired infections.

We are currently evaluating new technology that looks at elements of speech as key indicators of different behavioral and clinical conditions, just like we map a gene to identify biological markers for disease. It will help us take some of the guesswork out of treatment, ultimately, and get people on the path to recovery faster.

Population health: We must continue to invest and improve our population health strategies. This is a big trend in health care, because demographics make it a necessity. A few staggering facts that require a new approach not only in New Jersey, but around the globe: The treatment of diabetes in the U.S. alone costs more than $237 billion — and now accounts for 1 in 4 health care dollars spent in our country. Depression treatment consumes 12% of global health care dollars.

Growing evidence tells us that the social determinants of health, such as housing, education and access to fresh food, are at least as important as medical services in producing good health outcomes. Additionally, financing for health is moving from fee-for-service models to those that reward providers for improving outcomes. In other words, there are major incentives globally to focus more on prevention, earlier intervention and better care coordination.

We are all evaluating bold strategies including: delivering fresh food to chronically ill patients; supporting housing needs of people of these same patients and hiring more care managers to make sure people who consume the most health care dollars are on track with medications, appointments and a care plan.

And, ultimately, we must teach physicians to approach medicine differently. We are doing precisely that at the Hackensack Meridian School of Medicine at Seton Hall University. Our innovative curriculum includes sending teams of students to work with underserved communities to address all spheres of health — relationships that endure for their entire education.

Here’s a great example of success: One pair of students worked with a woman with diabetes who lives in Hackensack. They helped her stay on track, and she lost 14 pounds, enough to reduce some of her medication.

Transformational partnerships: Davos provides all of us with the opportunity to develop partnerships to advance our goals to transform health care. Partnerships deliver value for patients, employers and payers, with innovative approaches that give consumers what they want — high-quality, convenient and affordable health care. We have so many success stories and the key to all of them is ensuring we partner for sound strategic reasons. Our merger with Carrier Clinic, New Jersey’s most respected behavioral health provider, is expanding access in every sphere of care: inpatient, outpatient and addiction treatment.

Our strategic and clinical partnership with St. Joseph’s Health in Paterson will also transform cancer care in much of Passaic County. Together, we will enhance care options and bring more specialists into the area. Additionally, a new outpatient center is planned for Totowa to enhance options for cancer patients.

This trip was so valuable because it affirmed that much of our approach in New Jersey is on the right path and we remain committed to delivering high-quality, affordable and convenient care to all of the communities we are privileged to serve.

Robert C. Garrett is CEO of Hackensack Meridian Health, New Jersey’s largest and most comprehensive health network, with 17 hospitals and more than 500 patient care locations.

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