Pooling health care’s best ideas

By Jeffrey Kang

Globalization is inescapable. A soda sold in Georgia is available in any country in the world. A farmer in Iowa may travel to India for heart bypass surgery. Companies realize that growth in the next decade is more likely to be grounded in Asia than in America or Europe. The world has undeniably become a much smaller place, and it continues to shrink at an amazing rate.

Health care has failed to take full advantage of the benefits that globalization has wrought. Policy-makers, health care providers and everyone engaged in the current reform debate should recognize that health care, too, must take a global view, even as we prepare to overhaul our domestic system. The world’s health care stakeholders need to map an efficient route to identifying and implementing medical best practices from around the globe that can dramatically improve patient care and outcomes wherever someone lives.

The need for a formal international clearinghouse on best practices is especially evident now as the world braces for the re-emergence of the H1N1 swine flu virus. According to the World Health Organization, this new virus accounts for 71 percent of all flu viruses circulating globally, yet we continue to lack a clear-cut, universal and effective protocol for addressing this potentially fatal disease.

The Institute of Medicine estimates that there is an 18-year time lag between conception of a new medical practice and implementation of that practice. Between 10 and 17 years can elapse for even the most basic innovative practices to be shared and adopted by the international health community. In the 17 years it took to adopt best practices for infection control now used in hospitals worldwide, for example, countless people needlessly suffered during a course of nearly two decades.

Health professionals from Bangkok to Baltimore follow thousands of standard protocols in daily pursuit of improving the delivery of health care services and patient care. But today, the vast majority of our global health decisions are being made largely on an ad hoc basis. There is no formal connection among all points, no standard method of identifying all the new and emerging practices that save lives and money and no way to share them with the rest of the world.

This year a small step forward was taken by the creation of the nonpartisan Global Knowledge Exchange Network (GKEN), which allowed leaders from across the globe to come together to identify and promote the awareness and adoption of existing and emerging best practices and promising new health system models across industrialized nations.

GKEN favors the promotion of best practices that do not require legislation, international treaties or large sums of money. When adopted they can improve health on a global basis. Members are a collective brain trust who represent the best interests of the medical, business, government and consumer sectors around the world. The group met recently to focus on resolving the problems associated with chronic illness, which has reached worldwide proportions and accounts for 75 percent of health care spending.

There is more work to be done as we reach across oceans and borders, as well as our own backyards, in search of best health practices and a universal process to implement them. As we inch closer toward health care reform, the medical community — groups like the American Medical Association and the CDC, along with the World Health Organization — together with private industry have the chance to decide how to identify and use best practices. In so doing, we will be able to forge a global path to better health for all Americans and the world’s citizens.

Dr. Jeffrey Kang, a former chief clinical officer for the Centers for Medicare and Medicaid Services, is chief medical officer for CIGNA Corporation.