THE BLOG
10/02/2013 06:00 pm ET Updated Dec 02, 2013

Cities as Laboratories, Discovering America's Healthcare Solutions

American history is full of famous tinkerers -- Henry Ford, The Wright Brothers, Thomas Edison -- people who started with an idea and processed through trial and error until they arrived at a solution.

What would happen if we applied that same type of curiosity -- that innovative laboratory mindset -- to our current healthcare system. Could we make a dent in the $2.8 trillion dollar health care bill we're expected this year? If we were more willing to apply an approach that starts small -- in a local hospital or community -- where success becomes the impetus for scaling-up, and productive failure the incentive to try something new, could we create a health care system that delivered better value with improved outcomes at a competitive cost?

Take the Cleveland Clinic. In 2010, they took head on the task of lowering equipment and supply costs by engaging doctors in an on-going dialogue about how to maintain the highest level of patient care while being budget conscious. These discussions resulted in a change in how doctors approached their use of supplies, and more than $155 million dollars in savings over a three year period.

And there's Oklahoma City Mayor Mick Cornett, who helped transform this city from one of the country's fattest to one of its fittest. Motivated by his own weight loss, Cornett put his city on a "diet," setting a collective weight-loss goal of a million pounds. To accomplish this, Cornett launched thiscityisgoingonadiet.com as a hub for diet and exercise information and worked to redesign the city, making it more walkable. In January 2012, Oklahoma City reached the million-pound mark. In addition to losing weight, residents have also joined forces with business to fund $917 million worth of public improvements aimed at advancing community health, fitness, and quality of life.

We also have the Clinton Health Matters Initiative (CHMI), which uses an evidence-based, community-driven system to reduce health care costs. Still in the early stages, CHMI created an action plan for the Coachella Valley, which is home to some of the nation's poorest citizens. Among other challenges, CHMI observed a shortage of physicians; CHMI then set a goal for 2018, to increase the number of health care providers by 20 percent and work with local residency programs to encourage 50 percent of graduates to practice medicine in the region.

In Cincinnati, we've seen a similar success story unfold. A partnership of civic leaders, health care providers, businesses and area employers, including GE, banded together with a vision to achieve better quality, better health, and lower health care costs. Through a "living lab" pilot approach, we tried a number of different programs to figure out what works and what doesn't.

The community in Cincinnati needed to improve primary care. By working with local stakeholders, we helped Cincinnati go from no primary care medical homes to over a 100. And this targeted approach is working. At the end of 2012, we observed in our own data a 3.5 percent drop in ER visits and 14 percent fewer admissions since 2008.

The real triumph in these examples, the one with repercussions for the entire American health care system, is not what was changed but rather how change happened. Given health care's inherently local nature -- where services are almost always delivered at a hospital or provider near your home -- the city as laboratory approach is both germane and promising. And it is the kind of collaborative solution that is needed across the country in order to meet the individual needs of each community.

These examples represent a promising start. But ultimately, the most profound discovery may be the realization that our greatest hope for improving American health care lies not in an elusive silver-bullet, but in the innovation that comes from unexpected places, like the ingenuity that's unleashed when colleagues, communities and companies join together around a common local challenge.

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