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Yesterday’s off-site trip to Johns Hopkins from the CSG/ERC annual meeting was impressive. We heard about out of the box thinking by a clinical scientist that led to a breakthrough in treating lung cancer – that very low, but longer term doses of chemotherapy drugs worked better than full doses in shrinking tumors and helped make future traditional chemotherapy far more effective. Traditional funders do not generally support out of the box ideas, preferring to stick with safe projects, but missing important innovations.

We also heard about an important ICU innovation that is re-engineering how multiple machines communicate with an EMR to save providers’ time, reduce measurement errors, and improve patient safety. Most machines in the ICU (in health care in general) do not communicate – they are made by different venders with no incentive to make them work together. One speaker compared this to Boeing who employ hundreds of independent venders to make parts that Boeing assembles into planes, but not requiring that the company that makes the landing gear ensure that the system can communicate with the dashboards the pilots see so they can know if the wheels are up or down. Hopkins has re-engineered their ICUs so that devices communicate hourly with the EMR and a dashboard lets providers know if care is appropriate. The system also includes a patient/family portal allowing them to see the quality of care, and to enter information important to them, including their goals for care.

The final speaker described Hopkins’ CMMI Innovation Award program which is identifying high utilizers of care in East Baltimore, a very low income, high health need community, and creating health neighborhoods on steroids to coordinate care, address social needs, and keep people healthy.