The administrative complexity of the healthcare system in the United States is shocking, resulting in a system that is too expensive, too onerous, and is actually impeding the delivery of better care and lower costs. Resources are being expended to administer payment and administration ecosystems built on legacy IT systems that add very little value to stakeholders. IT interoperability between stakeholders has improved but rarely leads to timely and meaningful information sharing across the healthcare ecosystem. This is primarily due to information being used by businesses for competitive advantages in the marketplace, as opposed to the best interest of the patient. The solution lies in an interoperable system, built using distributed ledger technology, which creates trust and immutable auditability of events, and allows patients to be the custodian of their own health data, manage the sharing of such data with stakeholders of their choice, and enables them to become the economic benefactors of sharing their information with stakeholders.This will streamline information sharing between stakeholders, remove intermediaries, reduce costs, and result in higher quality healthcare delivery and better patient outcomes.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Dr. David Hanekom. Dr. Hanekom is the Chief Medical Officer and Regional President, North America of Solve.Care, a global healthcare company that redefines care coordination, improves access to care, empower consumers with information, reduces benefit administration costs, and helps reduce fraud and waste in healthcare around the world. Dr. David Hanekom MD, FACP, CMPE has almost 30 years of experience in medical and chronic disease management, having worked with and led clinically integrated networks (CIN) and multi-payer high-performing Accountable Care Organizations (ACO) across the United States. Dr. Hanekom has served as the CEO of Arizona Care Network (ACN), and as Chief Medical Officer with several industry-leading healthcare companies, such as SPH Analytics and Blue Cross Blue Shield of North Dakota
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
I have experienced the joy of caring for patients as a physician in a number of countries, including South Africa, the United Kingdom, Canada, and the United States. The needs of patients and those caring for them are universal; a supportive medical practice environment, a team of dedicated caregivers, and the necessary resources to help each patient achieve the best health possible. Acting in the best interest of each patient required me to engage with and navigate an unnecessarily complex healthcare administrative and technology environment, that often detracted from the joy of medicine and served as a barrier to achieving the best care for every patient. These experiences led me to begin a journey of walking in the shoes of major stakeholders, learning what works, and identifying what could be changed in order to transform people, processes, and tools in order to create a healthcare system that works better for all, that is less expensive, and that brings back the joy of caring for patients.
Can you share the most interesting story that happened to you since you joined Solve.Care?
I am struck by the energy and mission of the individuals working at Solve.Care.There is a focus on improving the world through empowering patients and care teams with information and technology to serve the best interest of every patient. The team members are committed and passionate about the change they are enabling in healthcare delivery and administration across the world. Solve.Care is the vehicle by which individuals can become part of a movement to simplify and improve healthcare delivery.
What makes Solve.Care stand out? Can you share a story?
At Solve.Care, we’ve created a culture to empower people. At our very core, we’re focused on improving the human condition, and we’re using technology as a tool to do that. Solve.Care also has a very strong belief that we are building a community of people that can benefit from what we do collectively in the long-term and change the world for the better.
From the very first time I worked with CEO Pradeep Goel, we decided the economic rewards from our success should be returned to the community and given back to society. We created the Solve.Care Academy, which offers a number of courses to arm young people with the necessary tools, skills, and education to be successful and potentially join our company. And we guarantee our products and services serve the needs of other people, not just us.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
Solve.Care has created an ecosystem, not a standalone app, to address the needs of people using not only the US healthcare system, but systems in countries across the globe. This ecosystem focuses on redefining care coordination; improving access to care; empowering consumers with information and control over their data; reducing benefit administration costs; and helping to reduce fraud and waste in healthcare.
We’re innovating the archaic payment and administration systems of healthcare and redirecting those resources to deliver higher quality care to communities. Solve.Care is creating value using digital payments and administrative simplification through our Care.Networks, redirecting those resources towards improving health outcomes for every patient. Our Platform helps direct money away from covering administrative costs and towards directly helping patients through preventative care, which leads to lower premiums and better benefits.
What are your “5 Things I Wish Someone Told Me Before I Started” and why.
The five things I wish someone had told me before I started in this industry are:
- The impact electronic medical records would have on the amount of time physicians would spend on documentation.
- The need for IT to support managing the healthcare needs of practice panels and populations in the era of value-based care.
- The need for robust point-of-care clinical decision support.
- The need to incorporate payer business intelligence into provider systems to track and manage the cost and utilization metrics across populations in an era of value-based care.
- The necessity for physicians to be leading the design and application of IT systems in applying technology tools in an clinical environment to ensure the tools meet the clinical and business needs of front-line clinical staff.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
- The US healthcare system is focused on disease care and procedures, which means we tackle the drivers of poor health and premature death in a reactive manner. We wait for things to happen and then we try and fix them, which is expensive and unsustainable. The health and wellness of the individual citizen should be our top priority and this is most often determined by work, education, access to food, community services, and roads. If we make investments in these areas, we won’t have to react to the catastrophic results. Other high income countries are much more focused on social determinants of health and invest in preventative health. Because they invest in the wellness of their populations, they spend less on dealing with the consequences.
- The US healthcare system also carries out too many procedures and services due to the perverse incentives in the payment system. As a result of this, many errors occur and more people are harmed. We have an aggressive intervention approach to dealing with diseases. Other countries that provide the same service don’t have as many delayed medical interventions, patients have fewer complications, costs are much lower, and people actually live longer.
- For example, the infant mortality rate in the US is highly variable and worse than any other high-income country. This means pregnant women and families are not getting the support or the services they need, including food, transport, education, that are available to pregnant women in other countries. As a result of this, we have more premature babies, more complications for the mother and child, and higher costs. Most high-income nations provide schooling, preschool, nutrition support, and maternal and paternal leave — all of which are critical when a child is born.
- Also, public policy in the United States neither supports wellness nor provides a comprehensive look at what drives healthcare outcomes. The US looks at healthcare too narrowly and operates a disease interventionist delivery system with no transparency or free market. Even within the Medicaid program, where the federal government negotiates on behalf of about 16 million beneficiaries, there are policy and legal restrictions that do not allow them to bargain for lower prices or do competitive shopping for alternate services.
You are a “healthcare insider”. Can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or an example for each.
- Empower patients with health information and personal clinical decision support in a manner that allows them to understand their health challenges, benchmark the care they receive against evidence-based professional guidelines, and seek out service providers that can help them achieve best outcomes at an affordable price. Our industry has become adept at data analytics and providing clinical decision support to healthcare providers, but have not done the same in providing the same information to the patient, who ultimately will bear the consequences, good or bad, of any and all healthcare decisions made by or on-behalf of the patient. I am convinced that empowering adults with personal curated information will allow for better decision making across the delivery ecosystem.
- The administrative complexity of the healthcare system in the United States is shocking, resulting in a system that is too expensive, too onerous, and is actually impeding the delivery of better care and lower costs. Resources are being expended to administer payment and administration ecosystems built on legacy IT systems that add very little value to stakeholders. IT interoperability between stakeholders has improved but rarely leads to timely and meaningful information sharing across the healthcare ecosystem. This is primarily due to information being used by businesses for competitive advantages in the marketplace, as opposed to the best interest of the patient. The solution lies in an interoperable system, built using distributed ledger technology, which creates trust and immutable auditability of events, and allows patients to be the custodian of their own health data, manage the sharing of such data with stakeholders of their choice, and enables them to become the economic benefactors of sharing their information with stakeholders.This will streamline information sharing between stakeholders, remove intermediaries, reduce costs, and result in higher quality healthcare delivery and better patient outcomes.
- Price and clinical outcomes must be transparent and accompanied by benchmarks. This will be important in empowering patients to become better healthcare consumers. The patient as customer of the payer, provider, and other role players in the healthcare ecosystem will allow for informed, comparative shopping, with the best value being more easily identifiable. This should drive market competition, based on value, which will benefit all as we strive to provide better care at a lower total cost.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
All healthcare stakeholders need to be fully transparent and make information available in an understandable manner to the public and patients. By doing this, we can empower patients to share their health information with meaningful contributors, which is critical to ensure they get meaningful support and improve their healthcare outcomes.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
As a healthcare leader, I always look to resources that will help me make decisions that are in the best interest of the patient and those that deliver care. I look to people who share those principles and those that do the maximum good with the resources they have. My favorite book is ‘Cry, the Beloved Country’ by Alan Paton as it has always had a profound impact on me. My hero is Nelson Mandela for the manner in which he brought people together and focused on the long term well-being of humanity. I’ve always admired his true belief in the power of individuals working together and being free to live their dreams.
How can our readers follow you on social media?
Main website: https://solve.care/
Thank you so much for these insights! This was so inspiring!