Amidst the loud Apple-IBM and Google-Novartis partnership announcements, a much quieter announcement was made which carries equally large implications for the healthcare industry.
On July 22, President Obama signed the Workforce Innovation Opportunity Act (WIOA) into law. The WIOA is a bipartisan bill that passed both the Senate and House with large majorities and includes moving three programs from the Department of Education to the Administration on Community Living (ACL) including:
1) National Institute on the Disability and Independent Living Rehabilitation Research (NIDRR)
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Andrey Ostrovsky, MD Website Physician and social entrepreneur. Creating disruptive technology to better health for vulnerable populations. Specializes in applying Lean Startup Thinking and Design Thinking to discovering social and commercial value of innovations in healthcare. Andrey blog's at www.disrupthealthcare.org. He is the CEO and Co-Founder of Care at Hand, Inc (www.careathand.com). He practices as […]
2) Independent Living programs
3) Assistive Technology Act programs
A core function of ACL is and will continue to be the administration of Older Americans Act (OOA) funding for Area Agencies on Aging (AAAs). Area Agencies on Aging are an essential piece of the post-acute care fabric because they coordinate community-based resources such as home care, Meals on Wheels, and mental health services for frail elderly individuals living at home. Without ACL-supported AAAs, care coordination for this vulnerable population would unravel, and the $30 billion readmission problem would worsen.
Before WIOA, ACL was already developing innovative functions to bolster its support of AAAs, including the provision of technical assistance to AAAs to build their capacity for sustainable growth. With the reimbursement changes introduced by Obamacare, hospitals and payers are increasingly looking to less expensive and more comprehensive transitions services being offered by AAAs.
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A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Part of the value of the ACL technical assistance is the introduction of evidence-based practice (EBP) into the language and culture of AAAs. The common lexicon is helping AAAs and their partner hospitals and payers have a dialogue about building business relationships.
However, there is a limitation to introducing EBP to AAAs without concurrent introduction of quality improvement (QI) capability. That limitation stems from the heterogeneity of healthcare microsystems and the frequent need to adapt EBP to cater to the unique strengths of the AAAs and needs of the local population. Without QI, adaptation of EBP is a blind process of delivery redesign and can actually harm patients more than help them.
With the acquisition of NIDRR, a major research institute, ACL may now be able to expand its capacity to perform and teach quality improvement to AAAs. The infusion of QI into the existing culture of EBP at ACL may help AAAs to more effectively translate evidence into practice.
Furthermore, the NIDRR acquisition will empower ACL with an internal capacity to conduct research which will hopefully shorten the timeframe to identify emerging evidence-based practices, such as introduction of mobile technology into AAA services and new models of care delivery.
Like most developments in community-based care, the signing of WIOA will be overshadowed in the mainstream media by more “sexy” hospital closure, payer rate hike, and technology-acquisition announcements. But under the radar, vulnerable elderly populations may soon start to see major improvements in the services and culture of their local AAAs.
Physician and social entrepreneur. Creating disruptive technology to better health for vulnerable populations. Specializes in applying Lean Startup Thinking and Design Thinking to discovering social and commercial value of innovations in healthcare.
Andrey blog's at www.disrupthealthcare.org. He is the CEO and Co-Founder of Care at Hand, Inc (www.careathand.com). He practices as a pediatrician at Boston Children's Hospital and Boston Medical Center.
