The Great Challenges tables in the Robert Wood Johnson Foundation partner space have been a hotbed of passionate discussion and lobbying for votes to encourage Delegates to nominate. With so many complex and — well, challenging — Challenges, it won’t be an easy choice.
As of early Thursday, the top three Challenges leading the polls so far were:
#22. Inventing Wellness Programs
#19. The Role of the Patient
#34. The Caregiver Crisis
“This is the only industry I’ve ever seen where strategy and quality don’t start by asking the ultimate stakeholder what they want,” said Dave deBronkart, better known as “e-Patient Dave,” advocate for challenge #19, the role of the patient. deBronkart said it’s a myth that if patients were given choices, they would choose everything and health care costs would rise. He told a rapt crowd of TEDMED Delegates about a Dutch infertility program that gave patients access to a wiki, told them to decide on health care priorities together, and promised to fund them. A number of the top picks were requests that didn’t cost a dime — more empathy, and a waiting room separate from the pregnant patients. “If the consumer is at the center of the health care universe, everything else makes more sense,” said deBronkart.
Challenges #1, achieving more innovation more affordably, and #12, faster adoption of best practices, both touched on similar themes — getting innovative health care practices or products to the people who need them, quickly and efficiently. On best practices, advocate Kedar Mate said, “We know they exist — they’re in the journals and they’re here at this conference. The challenge is getting people to use them. Research says it takes 17 years to go from journal publication to widespread use.” And that’s too slow, said Kedar, Country Director for the IHI South Africa Program, who likened it to having to wait until his new-born son’s 17th birthday for an innovation that could have helped him at birth.
Don Rucker, Vice President and Chief Medical Officer at Siemens and advocate for challenge #1, talked about another hurdle to getting innovations out into the world. “The FDA should be accountable not just on safety but also on availability of new treatments,” said Rucker.
Rucker wasn’t the only advocate talking about the role of government in the public’s health. Challenge #17, private rights versus public good, generated some interesting discussion. Topics included making the healthy choice the easy choice, and what to do next to make sure people take advantage of that choice, as well as defining when an unhealthy choice by one person makes for an unfair burden on the rest of society.
Making the healthy choice easier also came up as a solution from Michael Roizen, Chief Wellness Officer for the Cleveland Clinic and advocate for challenge #8, managing chronic disease. Cleveland Clinic revamped its vending machines for employees and offers financial incentives for healthy check-ups.
Making prevention popular and profitable, challenge #3, was another popular topic among Delegates and TEDMEDLive viewers alike. “We’re trying to take prevention and put it in your local shopping mall,” said Mary Jane Rotheram-Borus, PhD, Director of the UCLA Semel Institute Global Center for Children and Families and pioneer of the UCLA Family Commons program, funded by the Robert Wood Johnson Foundation. Rotheram-Borus is not an advocate, but a self-proclaimed big fan of prevention. The Family Commons program is training and equipping “mentor moms” to spread the word on prevention, and support other families in building a healthy life.