Many people say they want to revolutionize healthcare. But what does that mean? At Afia, when we say we want to revolutionize healthcare, we mean that we have a vision for healthcare that:

• Is affordable,
• Is integrated/coordinated,
• Is safe and consistent,
• Is efficient/streamlined,
• Treats the mind and the body with a focus on prevention
• Treats everyone

At Afia, we tie everything we do to making this future a reality. We think the path to this vision will require a coordinated effort between patients/consumers, providers, insurance companies, government, and service providers. While everyone must help to make this happen, here’s what we’re going to do:

• Make healthcare more affordable – On average, 16% of every healthcare dollar goes toward administrative costs. This should be more like 5% (Medicare manages on 2%!). We would like to see EMR systems where all services are tied directly to billing, and billing systems that are fully integrated with third-party payers.
• Make healthcare coordinated – Only 20% of doctors have electronic records systems in their offices. When a patient moves, they often need to start their health records over again. This approach is ridiculous! People have complete control over their banking from anywhere in the world, but if you get sick and you can’t physically make it to your doctor, you have to start over. Do you remember all of your allergies? No. Do you remember all of your medications? Probably not. Part of the answer to this one is fairly obvious – doctors need to move to electronic records, and they need to participate in RHIO’s, HIE’s, PHR’s, anything. It saves time, it saves money, and it can make a life and death difference.
• Make healthcare safer and more consistent – It’s a bit of a cliche, but have you ever seen some Dr’s handwriting? Do you know how long a doctor’s shift is, or how much they need to remember? Doctors are human. They make mistakes. They need some help. We need to start implementing clinical decision making tools – NOW. These tools will help make sure that, regardless of who your doctor is or how many hours she has been on-call, everyone sees the same information.
• Make healthcare more efficient – Recent studies have shown that doctors can spend as much time working with patients as they do just looking for information about patients in paper charts. Often times, the information they are looking for is nowhere to be found, resulting in redundant tests and additional time and money. Part of the answer here is once again simple. While an EMR can have a difficult learning curve, they are huge time savers in the long run. Every provider should move to an EMR!
• Treat the mind and the body and focus on prevention – Doctors should be adopting EMR’s that focus on Integrated Health and they should put the policies and procedures in place that will support an Integrated Health practice. Simply put, the EMR shouldn’t just capture allergies, surgeries, immunizations, etc. It should also capture the aspects of life that play an enormous role in our health – mood, stress, exercise, substance abuse, etc. Why do doctors spend so much time and money on heart transplant technology and so little time on telling people to get out and exercise or to take a break from work every once in a while? We need systems to support doctors in detecting warning signs, and systems for patients that help change unhealthy patterns.
• Give everyone a chance for quality care – Over 40 million people in the U.S.A. are without health insurance. For those folks who are not fortunate enough to have insurance, a large medical bill can be a financial disaster. Lack of health insurance prevents people from receiving preventative care, sending many people to the most expensive doctor’s office there is – the E.R. The way to change is to provide services to typically underserved populations. We need to expand the Medicaid and Medicare model (note: this doesn’t necessarily mean expand Medicaid and Medicare – they have their own issues – just the model where people can get affordable care). We require every driver to have auto insurance before they get on the road. Why is healthcare different? Insurance doesn’t need to be free, but it needs to be available. Until everyone is covered, we need to make sure that the existing support systems have all of the technology they can to provide the best care possible to as many people as possible.

In summary, there’s a lot of work to do. The good news is that there are answers to all of the issues. At Afia, we work every day to make a difference.

Chris Akerley, Afia Inc.

As we embark on this historic venture, I am asked many times if we feel this will be a success or if we are scared. The first one is easy – I truly believe afia will be a success. That said, of course I am scared! But, I refuse to let that stop me from pursuing my dream. This is the next logical step in my career and in the realization of my life vision.

As with any new venture, many unknowns and many obstacles will come upon us, and I am confident that Chris and I can handle them. I am very excited about the opportunity to branch out to other parts of the country and drastically improve healthcare everywhere we go. At the same time, I look forward to our continued commitment to work with the Washtenaw Community Health Organization, and to their continued success as a national leader in behavioral health services. We will also continue to work within the state of Michigan to help standardize electronic health records and cultivate our working relationships with the great people here.

I think there is a lot that technology can bring to the public mental health system. We are fortunate to live in a time when technology is the easy part. IT has evolved to a point where nearly everything we want to accomplish is technically feasible. The trade-off is that we have so many options, and we go about our work in so many different ways, that it is difficult for people to align on how technology should work. On top of that, technology is outpacing the speed at which we can change rules and regulations. People struggle to adopt the latest technology. The key to success with technology today is success with people. As a business owner and CEO, relationships are the most important aspect of my work. It is our ability to build and maintain relationships with our partners and our clients that will make us a great organization.

Here we come!

Jeremy Nelson, Afia Inc.