U.S.-European partnerships improve care on both sides of the Atlantic
The U.S. healthcare system is often compared to European systems in unflattering terms, yet European systems are under growing pressure to increase their care quality and efficiency. Many are looking to the U.S. for innovative, proven solutions. There is much that we can learn
from each other, and newly formed collaborations are providing one vehicle for that learning.
At Intermountain Healthcare, my team and I are directly engaged in learning partnerships with a number of European countries. We are struck by the extent to which our very different systems are now grappling with the same pressures, and even moving toward each other structurally. It’s all the more striking since our systems are so different. Healthcare in the U.S. is based on free markets, while our European partners rely much more heavily on government controls. We share the goal of achieving the Triple Aim: better care for individuals, better health for populations and lower per capita costs. That is the basis for our collaboration.
We also share the pressures of rising costs, the need to cover more people, and growing public anxiety over who will get which services and who will pay the bill. Those pressures are driving our care delivery systems toward each other. The U.S. has moved in the direction of universal healthcare coverage, while in France, for example, some public hospitals are becoming private.
The European systems are especially strong in population health and wellness, a growing focus in the U.S., and American systems are strong in disease management. With the growing prevalence of chronic diseases, both strengths become increasingly important and intertwined.
That’s where the partnerships have emerged. The French healthcare system has created a collaboration with Intermountain’s Institute for Health Care Delivery Research for three purposes: first, to create a similar institute in France to study and promote best practices; second, to create a version of our Advanced Training Program in Health Care Delivery Improvement (ATP) and implement that program nationally; and third, to engage in joint learning opportunities—care delivery research— about “best care” strategies. We hope to study differences in care delivery patterns across our countries and learn from them, with the aim of improving both systems.
The French institute will in turn generate a European initiative focused on high value, similar to the High Value Healthcare Collaborative in the U.S. Intermountain was one of four founding organizations that created the HVHC, which involves some of the largest healthcare providers in the nation. Together, the groups in the collaborative study differences in current practices and outcomes, identify best practices, and jointly conduct analysis to find even better practices.
A separate collaboration has emerged with the Swedish health system, which has sent health officials (clinical and administrative) from every region of the country to benchmark Intermountain’s care-management successes. Sweden also sends healthcare leaders to attend the ATP and operates its own very successful “sister” ATP program in Sweden. Similarly, the Swiss healthcare system has sent numerous health officials to attend our program. Other successful “sister” programs operate in Canada, Great Britain, Australia and Argentina.
These collaborations provide an extraordinarily valuable opportunity to learn from each other. We bring different areas of expertise, then merge our learning.
Sweden, for example, has operated centralized disease-specific, researchoriented, patient registries for almost 20 years. Intermountain operates 58 similar registries, integrated into clinical workflows and designed for care delivery performance. Early studies comparing treatment of diabetes mellitus showed similar performance across six diabetes performance measures, while Intermountain did better in terms of the proportion of patients who did well across all six measures. This tracked back to data support systems integrated into primary-care practices.
The French, on the other hand, started focusing on population health 20 years ago and have much to teach us in the promotion of wellness and prevention of illness. Their insights will be vital, as American provider organizations determine how best to engage our communities in health promotion. At Intermountain, we envision future joint efforts in such areas as diabetes management, asthma management and mental-health treatment.
The rankings that compare the U.S. and European healthcare systems get widespread attention, but comparisons that enable those systems to share insights and learning are far more vital. Those comparisons are growing, and healthcare delivery on both continents will be better for it.
Dr. Brent James is chief quality officer at Intermountain Healthcare, based in Salt Lake City.