senior holding hand of healthcare worker

Moving healthcare into the home is helping shift the balance of power from healthcare systems to patients, former Centers for Medicare and Medicaid Services Administrator Donald Berwick, M.D., said Monday. That is a positive development, he noted.

Donald Berwick, M.D., IHI president emeritus and senior fellow

“If you don’t think healthcare is about power, you haven’t been paying attention,” Berwick said during the keynote address of the second day of the National Hospice and Palliative Care Organization’s (NHPCO’s) virtual 2021 Leadership & Advocacy Conference.

Berwick, now president emeritus and senior fellow at the Institute for Healthcare Improvement (IHI), told NHPCO members that one upside of the pandemic has been the amount of care patients are receiving through telehealth and other methods of at-home care.

Berwick singled out healthcare providers who are empowering patients by helping them self-administer therapies at home. For example, Parkland Memorial Hospital in Dallas, Texas, is helping some patients learn to self-administer intravenous antibiotics at home. The practice has reduced hospital admissions among those patients 47% over the past few years and saved roughly $40 million, he said. 

Oversized healthcare system

During the webinar, Berwick, who served as CMS administrator from July 2010 through the end of 2011, painted a picture of a bloated healthcare system, comprising about 18% of the United States’ economy.

“Countries with better healthcare systems are operating at 10% to 11% of their economies,” Berwick said.

IHI is calling for a redesign of the U.S. healthcare system, making it more efficient and patient-focused. That includes customizing care to individual patients, promoting well-being, embracing technology and creating joy in the workforce. 

Workforce design flaw

Berwick says the pandemic has highlighted numerous problems in healthcare staffing, including worker burnout and turnover.

“Not protecting the workforce, not giving them an opportunity for healing and support is a major error in design,” Berwick said.

Berwick also called on healthcare providers to be more collaborative with patients, families and the communities they serve.