Introducing #UHIH – Public Platform for Funding Health

The third and final hypothesis for my Gartner Maverick research project is:

A solution architecture is possible for a better system for funding health (The Universal Health Innovation Hub #UHIH) using the emerging technologies of digital business, distributed ledger, Internet of Things (IoT), and a common set of protocols between stakeholders.

This week, I will give a very high – level introduction to the UHIH. I do this now, somewhat out of order, for two reasons. First, because I think that without some notion of a proposed solution, hypothesis 1 (current systems for funding health are bad and will get worse) just sounds like more alarm-ism (and we don’t need any more of that) and hypothesis 2 (Smart Machines should have a prominent role in allocating healthcare resources) sounds like a fantasy. I’m hoping a brief description of the UHIH solution will bring a sense of purpose and practicality when I go back and fill in the first two hypotheses later this summer.

The second reason is to solicit your help. But I’ll get to that in a bit.

So here it is. The UHIH in brief.

What is the Universal Health Innovation Hub? The UHIH is a public platform for funding health.  

The UHIH is a public platform for funding health.

• It is public, because every instance is available to all potential global participants, and because transactions are continuously stored in a shared public record.
• It is a platform, because it connects participants according to their essential role in improving health, and exposes transactions to participants using globally defined protocols.

Who are the Participants in a UHIH and what are their roles?

1. 1. Humans: Humans want a healthy life. In our usual terms, this means patients, members, citizens and consumers. Humans cannot get the health they want on their own, so they participate in the UHIH to be connected with….
   2. Helpers:  Helpers deliver help to humans to improve health. In our usual language, these would not only include healthcare delivery organizations (HDOs) and pharmaceutical companies, but also social support services, app and device makers, environmental improvement services, community health workers, counselors, and educators. In other words: Any entity that offers products or services that improve health according to….
   3. Sages: Sages review scientific findings and real-world evidence to predict the ability of helpers to improve health. These entities evaluate published medical research, comparative effectiveness studies and real-world evidence to predict how much health improvement will accrue for a human when given specific help. Sages are compensated on a per-transaction basis when their predictions are utilized by the UHIH to execute a funding arrangement. In addition, for each executed transaction, the sage receives a certified token of his or her prediction, which becomes eligible for a supplemental pool of funds if and when that prediction is proved true, by evaluating the health outcome for the human. Sages enable the rational allocations made by….
   4. Funders: Funders provide funds to improve health. In our usual language, this would be “payers” or “purchasers.” This is the typical role of health insurers in private healthcare systems or ministries of health in public systems who act as fiscal intermediaries for the individuals and entities paying premiums or taxes. But UHIH allows for additional direct funding from any entity, such as a business, government agency, individual or nongovernmental organization, that has a financial or humanitarian interest in improving health and has access to funds to allocate to that end. This allows for dynamic funding arrangements to be made based on the relative value to a wide array of funders. Funders participate because they endorse the definition of health manifest in the UHIH by the founders.
   5. Founders: Founders programmatically define the health that humans want. In our current systems, legislators, policymakers, and clinical and business leaders review metrics such as survival rates over old standards of care; quality-of-life improvement, such as activities of daily living; and social impact assessments, to write medical policy. More-sophisticated approaches like quality-adjusted life years (or QALYs) are used to blend survival rates and quality of life. A definition of health is implied, but never clearly defined in the policies, business rules, handbooks and laws. Founders have the role of clearly defining health and assigning a specific value to a human’s state of health.

When we connect these participants, in these roles, to the UHIH using a common set of transaction protocols, we create a health funding marketplace in reverse, where the UHIH dynamically searches for the funding solutions that will deliver the most Health to Humans.

And that is the UHIH.

In a picture, for visual people:

And that brings me to my second reason for today’s blog: to solicit your help.

If you have made it this far in this blog, you are pre-screened for an openness to rethinking the status quo of healthcare finance and searching out new solutions (“we few, we happy few, we band of brothers [and sisters]”). This research has already profited from input generated from this blog. So I would greatly appreciate your input, which you can put in a comment on this page, email me (jeff.cribbs@gartner.com), tweet at me (@JCribbs_Gartner #UHIH), or put in your own blog. I will always try to give credit where it is due when this material is eventually published and presented (of course). At this point, I’m especially looking for answers to these questions:

1. Is this clear? Subsequent blogs will have contemporary examples to make it more specific, but purely at the conceptual level — does this make sense to you?
2. At this high level, do you see the opportunity of the UHIH to improve how we fund health?
3. What are the conceptual problems or oversights? (be assured, I have a long list of my own)
4. Do you know of individuals or groups whose work might intersect or contribute to the idea of the UHIH?

It’s hard to end a blog on this stuff — so much more to get into! But until next week… thanks for reading.

[note: for those of you joining in middle of this project, welcome!  If you want to get some oriented, here a little GPS of the project for you]

Intro to the project: A Grassroots, Digital Solution to Financing Global Population Health

In this research I will explore the following three hypotheses:

1. All current systems of financing healthcare on not equipped to match the pace of innovation in healthcare delivery, much less the broader demands of population health.
   • Economics: Busting the Binaries of Paying for Healthcare 
   • Evidence: The Evidence Problem in Paying for Health 
   • Coordination:
   • Compute:
   • Ethics:
2. Emerging capabilities in analytic modeling will, in the not-so-distant future, be better suited to making decisions about allocating scarce healthcare resources than all of the humans and institutions currently performing that role.
   • Getting to “Whoa” for Smart Machines in Paying for Health
3. An architecture is possible for a better system for funding health (working title: The Universal Health Innovation Hub #UHIH) using the emerging technologies of digital business, distributed ledger (“grassroots”), Internet of Things (IoT), and a common set of protocols between stakeholders.
   • Introducing #UHIH – A Public Platform for Funding Health [YOU ARE HERE]