The State of Access to the Under-served

Robert McCray, Chairman of the Alliance Healthcare Foundation board, began the day by providing an overview of the state of access to healthcare for the under-served. Given the current state of our economy, we can be sure that more money is not going to flow in from the government. Therefore, we must find creative methods at allocating our existing resources to reach members of our community in more efficient ways. Alliance is determined to find more efficient ways to streamline processes and reduce overhead in order to free up money for those in need. In our attempt to do this, the Foundation created the Innovation Initiative, a $1 million grant that is given to a project that is creative, collaborative and efficient in stretching resources to help those with the most need.

McCray also described some of the current challenges facing our over-burdened healthcare system, as well as some innovative solutions that are already being put into place. He spoke about the baby boomer population reaching retirement age, and noted that we soon won’t have enough physicians for the 65+ populations, which grows each day. More is spent per capita on healthcare today than ever before. McCray also noted issues of compliance. Two thirds of prescriptions aren’t followed as directed. This indicates a huge communication challenge whose solution must become a priority. To solve this challenge, we must find ways to connect effectively with every stakeholder. McCray noted the possibilities of increased communication and compliance through the six billion (and growing) mobile cell phone subscribers in the world. Health, McCray noted, is embraced as a focal point among young people all around the world, which means there are more opportunities for innovative thinking in terms of allocating our current resources and adapting new technology to benefit the health and health outcomes of all peoples.

McCray went on to provide a few examples of low-cost, innovative technologies that have the potential to greatly impact the delivery of healthcare:

• Clinical grade ECG on the back of mobile phones, costing less than $100.
• Itriage—mobile screening system that allows patients to know if they need to see their doctor of go to urgent care. This is a free system!

Years ago, healthcare devices were expensive and therefore only used by the well-insured or wealthy, but now as mobile phones and other devices are getting cheaper, the healthcare industry is finally reaping the benefits of the lowered costs to consumers.

From Alliance’s perspective, innovation does not necessarily mean technology. Innovation can come from a shift in workflow or education. The beautiful thing about the digital age is that information is now free, which empowers consumers to make more knowledgeable decisions in terms of healthcare and makes the healthcare world more transparent.

Nancy Sasaki described the evolution of the Innovation in Healthcare Conferences.

Nancy Sasaki, Executive Director of Alliance Healthcare Foundation, provided participants with a historical context for the gathering. Introduced in 2010, the first Alliance conference explored the connection between technology and innovation for moving the needle on access to healthcare. In 2011, conference attendees looked at social enterprise and creative structures and revenue streams to make nonprofits more sustainable and effective. In 2012, Alliance’s 3^rd annual conference focuses on community dialogue. In response to requests from our community that Alliance facilitate partnerships and cross-sector conversations, we have invited Professor Gary Mangiofico, an expert on community building and collaborations, to guide us through the interactive processes and structures of creating effective community dialogue, Sasaki noted.

Erica Whinston discussed Qualcomm’s Wireless Reach™ Initiative

Erica Whinston, Senior Manager of Government Affairs for Qualcomm Incorporated, leads a team who manage health care, education, public safety and environmental mobile technology projects.  Qualcomm’s Wireless Reach initiative supports programs and solutions that bring the benefits of connectivity to underserved communities worldwide.  The goal of Wireless Reach is to invest in sustainable projects that not only align with the Company’s business objectives, but also strengthen economic and social development in local communities. Ms. Whinston also directs the health care strategy for the team.  Qualcomm believes the use of mobile devices in health care has the potential to dramatically improve clinical outcomes while reducing costs.  To help drive the mobile health ecosystem forward, Wireless Reach™ is supporting a number of projects that are investigating the advantages of using mobile technology in health care.

By the end of 2012 there will be more cell phones than people in the world, but 29% of the world still lacks internet connectivity. There is still a digital divide which Qualcomm is working to overcome.

Currently, Qualcomm’s Wireless Reach™ initiative has 73 projects in 31 countries. Main focuses include empowering elderly and disabled through mobile technology.

In the Tijuana border region, 1.2 million people have diabetes. How can mobile technology be used to fix this problem? Out of this question came Dulce Wireless Tijuana, which provides patients with cell phones that allow them to access content such as their blood sugar level, blood glucose level, amount of exercise that they should be getting as well as dietary info. All of this info coupled together allows patient’s doctors to identify those with urgent need.

In Spain the Wireless Reach™ program has teamed up with the Spanish Red Cross in order to target elderly people who do not have their family around in order to help them remain independent. Qualcomm developed a system to allow elderly persons to take advantage of video calling without an expensive or complicated technology intervention. This project uses existing televisions as the medium through which individuals may video chat with Red Cross therapists and medical experts. Aside from giving these people instant access to medical experts, it also gives these elderly people a reason to shave, put on a clean shirt and look presentable when they otherwise may not feel the need to clean themselves up. This type of personal upkeep is also an important part of overall health.

A new Wireless Reach™ project must includes many components, says Whinston.

• Must meet a community need.
• Must involve partners including a local 3G operator and a nonprofit to manage and implement project.
• Must demonstrate how Qualcomm’s technology changes lives.
• Must create a win for all parties involved.
• Preference for ideas that will be scalable and self-sustainable after 2-3 years of funding.

To learn more about Qualcomm’s Wireless Reach™ initiatives, visit https://www.qualcomm.com/about/citizenship/wireless-reach.

Keynote Speaker: Professor Gary Mangiofico on “The Art of Building Community-Based Collaboration”

Professor Gary Mangiofico presented the day’s keynote speech. Professor Mangiofico is Associate Dean of Fully Employed and Executive Programs and a Practitioner Faculty of Organizational Theory and Management at Pepperdine University’s Graziadio School of Business and Management. As Associate Dean, he oversees the Executive MBA, Presidential and Key Executive MBA, M.S. in Organizational Development and Executive Education programs, as well as the Fully Employed MBA, Bachelor of Science in Management, and M.S. in Management and Leadership degree programs.

Professor Mangiofico noted that the interesting thing about community dialogue is that it’s like going back to the future in terms of trying to reach a level of bonding that has been lost in modern American society. We have become so mobile that people don’t know their neighbors nowadays, which makes it hard to create change. Ironically, technology can actually interfere with the community dialogue and much needed physical interaction. If we can blur the boundaries between organization and industries than we can have better collaboration to create change.

Community dialogue can help us map out whom else we need in the conversation, meaning it is important to have everyone contribute to the community dialogue. Most importantly we need to get rid of the bureaucracy and the rules of how we are supposed to do things. Sometimes it is crucial to challenge assumptions. What if we knew a different way? Historically, the most innovative revolutions have not come from logical/rational plans. For example, a manufacturing town in Spain was in serious economic decline. They hired outside consultants to help them solve their problem and the consultants advised them to continue focusing on their core competency, manufacturing. The town decided to be bold and instead commissioned the building of a unique museum structure filled with world famous art.  As a result, the town has become a large tourist hub and has increased travel to the whole northwestern Spain region.

Professor Mangiofico noted that the problem with government funding is that the government needs to have benchmarks to measure the worth and accountability of the beneficiary. Human interaction cannot be measured and it is this interaction where the most potential for impact exists. People need to be bold and committed to doing something different and have the dialogue of shifting the “me and mine” speech into the “we and ours.” Information alone is not enough because we are irrational beings. So rather than this being an informational issue, this is a relational issue because we need to be concerned enough to change what we know is not working. We need to be confident enough in the new theory of change.

Professor Mangiofico went on to tell that 80% of all mergers and acquisitions fail because those involved fail to consider the relational/cultural factors that cannot be quantified. “We create community dialogue when we bring in our authentic selves and share in the creation of positive narratives about who we are and what is possible for our relatedness,” Mangiofico said. Our interactions must become significant and personal. Being the smartest or most talented doesn’t mean that you will be remembered. People mostly remember those who they had a meaningful relationship with.

Creation of alternative method:

• Time—there is enough time
• Mystery is valued as an opportunity
• Reflection is valued
• Relationships as a means of measuring dialogue
• Belief that people will show up with generosity and goodwill.
• Commitment to common good
• We are relational animals by nature and relationships are the promise of intimacy

Creating community change:

• Every community/organizational change is preceded by a personal one
• We must take time with each other to encourage and develop trust because then the recommendations that we give each other will be considered valid
• We must commit acts of service to one another
• Most importantly we must feel a sense of mutually beneficial relationship for all of us
• Make people feel welcome and hospitable

Why is it so difficult to create collaborations for change? Mangiofico posited this is because everyone has their own perspective on the situation, based on our unique personal history. There is so much information that we are presented with in our environment so we use our mental models to sort through what we consider to be important for us. This bounded rationality means that we each take in different data and make sense of the world in entirely different ways. Most people actually distort the objective data to fit the current mental models.

So how can we shift our mental models? By realizing that who we are and how we believe matters, says Mangiofico. For example, do we look at people as unfinished works of progress or problems to be fixed? We need to focus on people being citizens, not patients, the power of social fabric, associational life as central, and our gifts and possibilities.

After the initial address, Professor Mangiofico broke conference attendees into small interactive workshop groups in which we were lead to share our talents and passions, create relationships based on common goals, view alternative perspectives, and find a space for connection and different methods of collaborating. Based on the creativity and positive energy flowing after each workshop, we could not help but imagine how powerful our community could be if each of us could perceive things this way.

Process and fundamentals of making collaborations;

• Take stock of the situation:
• Develop desire for change by acknowledging the benefits and negatives
• Use group members to elicit support
• Use informed community network
• Overcome objections to change
• Creating change in the community;
• Create a sense of urgency and call to action
• Put together a strong enough team
• Create an appropriate vision
• Communicate new vision broadly
• Empower stakeholders to act on vision
• Produce sufficient short term results to give their efforts credibility and to disseminate the critics
• People need a purpose, vision, or plan
• Fundamental way of thinking: what can this group do together that we cannot do alone?
• Conversation of ownership:
• Not waiting for someone else to make it happen
• What is the risk? Payoff?
• What story do you want to tell the world?
• We create the future by what we choose to pay attention to

To view Professor Mangiofico’s PowerPoint presentation, click here.

 Watch the 2012 Innovation in Healthcare Conference (Speaker Presentations)