Wednesday, January 19, 2011

Bringing Systems Thinking to Healthcare

By David Rosenbaum

At last October's MIT System Design and Management (SDM) Conference on Systems Thinking for Contemporary Challenges, Senior Corporate Manager for Knowledge Management and Clinical Decision Support at Partners HealthCare Roberto A. Rocha spoke about how better to provide physicians with Clinical Decision Support (CDS) at a time when healthcare costs are soaring and, over the last 20 years, "the scientific literature has doubled." That mountain of information is impossible for any single physician to scale, which is why providing CDS is so critical to reducing errors and the costs they generate. But, as Rocha pointed out, the technological barriers to CDS adoption are significant, as are the human barriers, specifically the difficulty in getting patients to take their medicine as prescribed.

In his SDM thesis work, Chetan Jog is applying systems thinking to address both barriers - specifically, how to optimize CDS, encourage its use, and improve medication compliance. In order to do that, says Jog, one of the foundational applications of Health Informatics - the Electronic Health Record (EHR) - must be adopted far more broadly than it has been to date. (EHR adoption in the U.S. is around 18%-20% in contrast to 50% - 60% in Europe and 90% in Scandinavia.)

Jog, who grew up in Mumbai and Pune, India, received his M.S. in Computer and Systems Engineering from Rensselaer Polytechnic Institute in 2000. Prior to enrolling in SDM, he was a Product and Technology Strategist in the CTO's office at Nortel Networks from 2001-2008, where he focused on networks and cloud computing.

"There are tremendous opportunities to improve health outcomes for patients and streamline business processes for payers, providers and other stakeholders with the gold-mine of health data," says Jog. Any plan for transitioning to the broad use of electronic health records databases, he says, must include a "holistic system of education, incentives, and penalties." Indeed, it was Jog's bent for holistic thinking that originally brought him to SDM.

"Everything in the world is connected," Jog says, drawing on his computer networking background and also his interest in meditation and yoga. (He teaches at the Art of Living Foundation, and helped found the Art of Living Club at MIT in 2004.) "Good engineers have a common sense understanding of that connectedness and how to use it to optimize system architecture and design. At SDM, you learn the discipline and the principles in courses such as Professor Crawley's System Architecture course."

Jog was also drawn to SDM for the business education it offers. "Over almost a decade of working at big and small companies, I learned that even if there's a great idea, it means nothing without the right market conditions and customers who are ready for it," says Jog.

"At SDM," he continues, "I'm continuing to learn about my real potential. When I was just doing computer networks and software, I felt like I was not doing all I could do. But if I can help develop a system that leverages health analytics, it has business benefits - reducing treatment and process costs - and it could provide feedback for comparative outcomes that will provide best practices for providers.

"In other words," he concludes, "it could help people and transform lives."

No comments:

Post a Comment