Table of contents


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Introduction & Executive Summary


Introduction

Vision of a better future

Executive summary



Defining the Problem


The Current Situation -- Answers the questions: What is the healthcare crisis? What's the problem with healthcare today?

The Knowledge Gap -- Explains why the healthcare community is drowning in oceans of information, yet doesn't know the best ways to prevent health problems and treat them cost-effectively.



Examining Three Proposed Solutions


Three Potential Solutions: Use with Caution!

Discusses the pros and cons of three possible solutions to the healthcare crisis currently being discussed: (1) High Deductible Health Plan with Health Savings Accounts, (2) Disease Management with Pay for Performance, and (3) Rationing.



Introducing a New Solution


This section presents the unique, multi-faceted, Wellness-Plus Solution™.{1} It is based on the Patient Lifecycle Wellness™ model and Quality though Knowledge™ strategy. The Wellness-Plus Solution solution helps overcomes the shortcomings of all other proposed solutions, and presents a wise strategy for ever-increasing and sustainable improvements throughout the healthcare system.

Overview and Benefits


Wellness-Plus Solution Tactics


This part discusses the solution's 20 tactics:

  • Tactic - Collaborate
    • Regional Health Information Organizations
    • Practitioner-Researcher Networks and Other Professional Organizations
    • Non-Profit Multi-Stakeholder Organizations for Healthcare Improvement
    • Consumer Watchdog and Advocacy Groups

  • Tactic - Deliver Biopsychosocial Healthcare
    • Behavioral Health Problems Account for a Substantial Portion of Primary Care Costs
    • Psychological Problems Cause or Contribute to Physical Illnesses
    • Psychological Treatment Remedies and Reduces Many Physical Problems
    • Behavioral Healthcare Improves Productivity and Quality of Life


Barriers and Drivers to Implementing the Wellness-Plus Solution


This section examines the problems and solutions to executing the Wellness-Plus Solution's tactics:
  • Problems with Current Practice Guidelines and How to Solve Them
    • Problem: Many of Today's Guidelines are Immature or Invalid
    • Solution: Develop and Validate Evolving Guidelines
    • Problem: Current Diagnostic Codes are Inadequate
    • Solution: Develop More Precise Diagnostic Codes
    • Problem: Lack of Adequate Continuity of Care
    • Solution: Continuity of Care Coordination
    • Problem: Implementation Delay
    • Solution: Speed Guideline Development and Dissemination
    • Problem: Guidelines Do Not Consider the Mind-Body Connection
    • Solution: Consider the Mind-Body Connection
    • Problem: Guidelines Do Not Address Patient Preferences
    • Solution: Shared Decision-Making Supported by Patient Decision Aids
    • Problem: Cookbook Guidelines are Too Rigid
    • Solution: Avoid Cookbook Guidelines
    • Problem: Guidelines May Conflict with Each Other
    • Solution: Reduce Guideline Conflicts
    • Problem: Patient Resistance
    • Solution: Involve Patients in Decisions, Consider Their Preferences, and Give Incentives for Compliance

  • Problems with Todays HIT Systems and How to Solve Them
    • Problem: Immature, Insecure, Expensive Technologies
    • Solution: Rational Incentive Programs, Patient Life-Cycle Wellness System, and Core-Competence IT Vendors
    • Problem: Addressing the Needs of Smaller Providers
    • Solution: Offer Affordable and Useable Technologies for Smaller Providers

  • Problems Relating to Provider Motivation and How to Solve Them
    • Problem: Poor Financial Compensation to Providers
    • Solution: Use Effective Financial Incentives
    • Problem: Unsupportive Organizational Culture and Lack of Leadership
    • Solution: Focus on Learning Organizations with Leadership for Change
    • Problem: Unwillingness to Change, Lack of Self-Confidence, Skepticism, and Insufficient Time and Resources
    • Solution: Support by Clinician Champions
    • Solution: Increase Clinician Confidence
    • Solution: Gradual Implementation with Ample Support and Workflow Accommodation
    • Solution: Have Adequate Time and Resources
    • Solution: Recognize Competitive Value




Conclusion & Epilogue


Conclusion
Epilogue



Appendix


Northeast PA Task Force Recommendations

Economic_Forum_hearing_Rep_K_Boback

IEEE GHTC

House Ways and Means Content


Wellness Model Technology Blueprint


This section presents the PHIN Consortium's technical blueprint of a comprehensive health information technology (HIT) system -- the PHIN HIT™ Interoperability Model -- that is able to drive the Wellness-Plus Solution. It also discusses a simulation of scenarios in which a "Wellness Model" is compared to the typical non-wellness models in use today, and presents some surprising results.
  • Filling the HIT Gap -- Describes how the PHIN HIT Interoperability Model, which is the foundation of the Patient Life-Cycle Wellness (PLCW) system, bridges the HIT Gap.

  • Yellow Brick Road Map -- Presents a path to policies and technologies for transforming the healthcare system




From the Authors


Stephen E. Beller, Ph.D.
Sabatini J. Monatesti



Wellness Wiki Book


You can now buy the Wellness Wiki as a softcover book or pdf download.
Click to purchase "Understanding & Curing American Healthcare: A Wise Way to Better Outcomes and Lower Costs".




{1} Trademarking the terms Wellness-Plus Solution™, Patient Lifecycle Wellness™ model, and Quality though Knowledge™ strategy is to ensure that their use is consistent with the information presented in this Wellness wiki and the corresponding "Understanding and Curing American Healthcare" white paper.