Going Upstream - Iora Health

Happy almost spring, although many of you are still being hit with snow and ice!  

I want to continue the theme I began 2 months ago where I discuss “upstreamists”, those who are “going upstream” to find the cause of problems in our healthcare system, and then working directly to create change. Last month I profiled Health Leads, a nonprofit organization that is providing information and connection for low-income patients, as well as providing access to many wrap-around services that affect health and wellbeing, such as having adequate food, transportation, and heat in the winter.

Yesterday I had a very stimulating conversation with a young physician who had just finished medical school in the UK.  He felt drawn to medicine by his desire to help others, like most doctors, but he did not gravitate to a particular specialty.   Instead, he’s been traveling around the US talking to upstreamists in order to tap into their experiences. His network includes those that create technological tools that try to fix some discreet dysfunctional piece of healthcare, rather than affecting the whole system. All of the projects he told me about were lovely little gems. But there is a problem with creating beautiful gems.

When you have something that is rotten underneath, applying beautiful gems to it does not cure the problem; it remains rotten. We need to look deeper to figure out what we can do to impact our healthcare system, from the inside out.

Dr. Rushika Fernandopulle of Harvard University, is doing just that with Iora Health.  I’ve been following him for a number of years.  Here is what Iora Health says about itself:

We’re changing health care from the ground up.
We believe better health care starts with better primary care. Our simple yet radically different approach to restoring humanity to health care is three-fold: Team-based care that puts the patient first, a payment system based on care, not billing codes and technology built around people, not process. ……….
 Our care team, which includes a dedicated advocate for each patient, works together to treat the whole person. We see people when they’re sick, but also when they’re well, so that we can keep them healthy. Here, the environment is caring and patients have a voice. It’s our job to give them everything they need to live happier and healthier lives.
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Here is a fabulous and inspiring talk by Dr. Fernandopulle, who discusses how and why we need to change the healthcare system. ​

Here is a short version, but I really urge you to watch the longer one—its way more inspiring.

And a freebie thrown in: The Hot Spotters is the seminal article on change in the healthcare system, by Dr. Atul Gawande, published in the New Yorker. This is a must read in my opinion, to know where the “rot” is.   It would not be an exaggeration to say that this article changed my life.