Duke summit kicks off new health innovation institute

Sep. 09, 2013 @ 08:15 PM

Duke University President Richard Brodhead on Monday challenged a summit on health-care innovation to think broadly.

“What do you do with a system that is a mixture of wonders and waste and service and unequal service?” Brodhead asked, opening the summit to launch a Duke initiative aimed at finding ways to cut costs and improve quality in health care. “It seems that (with) this convergence, systems need not tinkering. It needs the act of standing back and re-conceptualizing…”

The first-ever summit, at Duke’s Trent Semans Center for Health Education, was held as Duke is launching the Institute for Health Innovation. The initiative is designed to generate new ideas for using technology in health care, in delivering care, in training workers and in applying policy. Proposals coming out of it are to be piloted at the Duke University Health System.

The summit included discussion of efforts by hospitals and other providers to change the way doctors and other providers get paid, and also covered details about the federal health care overhaul.

Dr. Victor Dzau, chancellor for health affairs at Duke University and chief executive officer of the Duke University Health System, said in an interview that federal health care reform makes the initiative timely as people have to get ready for change.

In a presentation at Monday’s summit, Dr. Mark McClellan, director of a health-care-reform-focused center for Brookings Institution, an independent research institute based in Washington D.C., said there’s a “real opportunity” for change in health care.

Health care costs have been a growing part of the federal budget, McClellan said, and between the aging of the U.S. population and more participation in programs like Medicare, he said that’s on track to continue.

Instead of lawmakers reaching a “grand bargain” agreement to address the federal deficit and to rein in health care costs or raise new revenue, he said there’s been a push toward “squeezing down” other programs.

“We can continue to do that, but it is going to have (continued) consequences,” he said.

Among other proposals for health care system changes, McClellan outlined reforms in ways providers get paid, such as such in bundling payments for specialty intensive care and post-acute care services and creating accountable care organizations. Also called ACOs, providers in the organizations would get financial incentives to get better outcomes for patient populations.

In response to a question following one panel discussion, Uwe Reinhardt, a professor of political economy at Princeton University, said some have concerns that ACOs would just become “giant monopolies,” with providers in the organizations still receiving bundled payments, but “they’ll be big.”

Also at the event, Andrew Witty, chief executive of British pharmaceutical company GlaxoSmithKline, spoke about the company’s work to boost health care in developing countries.

The company, which has research and development operations in the Research Triangle Park, has set aside money for independent research into developing world diseases, and researchers’ access to company facilities to help them do their work.

It also made its compounds available that could help fight against tuberculosis bacteria, further adding to an effort from 2009 to make its malaria compounds public.

The company has also worked to boost transparency of its clinical trial data by allowing researchers to request access to anonymous patient-level data for clinical trial results.

The company faced scrutiny for marketing and clinical trial data practices for certain drugs. According to an announcement last year, the company agreed to a $3 billion settlement with the U.S. Justice Department and other states relating for the alleged illegal marketing and promotion of Paxil and Wellbutrin. The company also allegedly failed to report important clinical data about the drug Avandia.