Making Health Care System More Efficient Subject Of Forum

By DANIELA ALTIMARI, altimari@courant.com

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HARTFORD -- A forum on health care Monday had a "best of times, worst of times" feel.

Some members of the panel convened by U.S. Rep. John Larson spoke of the tremendous explosion of knowledge and innovation that is dramatically remaking the health care system.

"We're in the most remarkable time in biology,'' said Ed Liu, president and CEO of The Jackson Laboratory, an independent research center with campuses in Bar Harbor, Me., Sacramento and Farmington. "It remarkable because the massive scale of advancement...and massive reduction of costs.''

Yet the delivery of health care currently accounts for more than 18 percent of the nation's gross domestic product, Larson noted. Making the system more efficient is crucial, he said. "More than $700 billion is wasted annually,'' he said.

For two hours, Larson, Liu and the rest of the panel pondered ways that technology and innovation can improve the delivery of medical care while addressing spiraling costs. The forum, held at the legislative office building in Hartford, included representatives from hospitals and the insurance industries, though there were no practicing physicians or officials from the pharmaceutical firms on the panel.

Rapid-fire advancements in research have given rise to a new approach in health care, known as personalized medicine. Embraced by The Jackson Laboratory, personalized medicine relies on genetic and molecular biology to pinpoint the causes of an individual's illness and develop targeted and personal therapies.

Liu compared the brisk speed of medical research to advances in electronics that began with bulky mainframe computers and ended with cellphones. "We've never seen anything like this in biology,'' he said.

As an example, Liu cited the advances in gene sequencing of the BRCA1 gene (mutation in this gene are linked to higher risks of both breast and ovarian cancer.) "Just 10 years ago, the cost of sequencing the BRCA1 gene was over $4,000,'' he said. "We can easily sequence 400 genes for about the same price and at much deeper coverage."

But technology and innovation has changed medicine in other ways as well. Jennifer Jackson, president and CEO of the Connecticut Hospital Association, said many of the state's hospitals have adopted an approach that seeks to create a culture of safety and accountability. The system, called "high reliability science," is similar to those used by nuclear power operators, air traffic controllers and other endeavors that entail significant risk.

"Health care is a complex, high-risk industry where mistakes can create devastating consequences for our patients,'' Jackson said. "We need to make very careful decisions about [the] effectiveness of treatments and that's where we're focusing but also [eliminating] waste and [making] sure we [provide] the right and most cost-effective treatment for each patient.''

Two representatives from the insurance industry—Joseph M. Zubretsky, senior executive vice president for national business at Aetna and Dick Salmon, national medical director for performance measurement and improvement at Cigna—also participated. The discussion was moderated by Bob Patricelli, chairman and CEO of Women's Health USA.