Thought Leader: (Eco)systemic Change

Sep 01, 2005
By Pharmaceutical Executive Editors

Wolfgang Klietmann, MD
Dr. Wolfgang Klietmann is not an indecisive man. Nor is he willing to compromise his holistic view of healthcare by choosing to side with any one constituency. As a practicing researcher, lecturer, and faculty member at Harvard Medical School, Klietmann has developed overarching views—self-declared heretical thoughts—on how various players within the healthcare system interact.

For six years, Klietmann has been a member of Harvard Business School's Health Industry Alumni Association, and now serves as its vice president. He will co-chair the organization's sixth-annual alumni healthcare conference, "The State of Affairs in Healthcare," to be held in November.

Pharm Exec: In your writings and speaking engagements, there is a theme of change. Where do you see the biggest area of change in the healthcare system today?

Klietmann: I see change on several levels. One part, even looking here at Harvard Medical School, is the openness of medical schools to other forms of treatment and healing, such as studying the Chinese healthcare system, which is completely different from our Western system. Also, recognizing that a larger part of the population looks for alternative treatment methods, such as buying over-the-counter drugs. There certainly is a new openness seen in medical schools, to not disregard these forms of alternative medicine, but investigate them and try to integrate them into our evolving new form of healthcare.

And there are also other forms of changes, such as the political ones underway by the US government to push forward the new healthcare information network, with Dr. David Braylor pioneering this effort. The intention is to use this unique opportunity to improve quality and reduce cost at the same time, and diminish errors.

Do you think that initiative will actually go through?

I am convinced that it will go through. The government has decided to push it. I know that Dr. Braylor has asked the healthcare industry, especially the IT section, to come up with an open standard that would integrate all the different information networks. He even "threatened" that if the industry could not come up with a proposal, there might be a decree from the government to do so.

This initiative is expected to save up to 200 billion dollars annually, by streamlining the information flow, avoiding reduplication of medical testing, and reducing errors that may be fatal to patients—and also cost a lot of money.

What type of solution is expected from industry?

The goal is to digitize all healthcare information, including patient data, patient files, insurance data, X-ray images and—on the threshold—even microscopic pathology images.

The healthcare information will be available in an electronic format, able to be transported nationwide to all the different players in the system. This will avoid reduplications and streamline the flux.

Currently, we waste a tremendous amount of money by reduplicating services. On one side, we have the best medicine in the world in this country—our physicians, nurses, and hospitals. On the other side, we have a system that is antiquated, very bureaucratic, and very slow in processing data.

Ultimately, this slows down the efficiency of our healthcare delivery, because the system is inadequate for the very modern- and high-quality healthcare that was developed in this country.

Are there any other countries, maybe in Europe, that we can look to as examples?

At the moment, the country that could be used as a model is Switzerland. There, you have compulsory health insurance for everybody, and on top of it, you also have private health insurance. There are five universities with medical faculties and university hospitals.

There also are several hospital systems that are well integrated and deliver high quality care. They ensure that a good healthcare-delivery system exists for all patients, even in smaller towns and villages.

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