First Year Summary

Our Inceptary journey began with two fervent beliefs: our approach to health in the US is badly broken, and solutions for reforming our system are unlikely to come from people who are entrenched in the current system or politicians. To test our beliefs and jumpstart our collective thinking, we posed 10 provocative questions and assertions about US healthcare and brought together a non-partisan group of individuals who had varied experiences with the current system, are future-oriented, but aren’t necessarily driving an agenda. Our objective was to engage these experts in constructive discourse to drive industry innovation and disruption through their participation in a social healthcare thinktank, that we called The Inceptary—a space where practical ideas are birthed and driven to fruition. Coming together bimonthly, we have deep, critical, dialectic, discussions, about possibilities from which we derive initiatives to pursue, to develop and test as a proof of concept for new levels of benefit.

After one year we have three active initiatives, have incorporated as a non-profit, have an experienced Board of Directors and have applied for our 501(c)(3) exemption. We have eleven active participants who span the globe from the US, Europe and Australia. We mentored a summer intern who conducted research and guided the redesign of our website.

The values of our group formed early and guide how we think about reform to extract greater value from the most expensive healthcare system in the world. These values include the primacy of community and the individuals within that community, the role of technology as an enabler, and the criticality of the imperative that cost savings from healthcare need to be ploughed back to benefit the community. The values were influenced and enriched by discussions of new neighborhood level determinants of health initiatives in The Netherlands. We were inspired by the “virtuous cycle” created by investing healthcare savings back into the community, and by the role that data and technology can play in integrating silos, engaging communities within their cultures, and understanding how health and quality of life can be improved as health access and economic opportunity dwindle—particularly in rural America.

Our three overlapping initiatives coming out of our rich discussions are:

  • Reimagining Rural Health
  • EHR 3.0 – Patient Centered Records
  • Hospital Anywhere

    Reimagining Rural Health has three characteristics that make it unique among other good efforts in community health.

    1. A bottom up approach to initially supplement, and eventually reinvigorate the declining top-down healthcare support. We start at the individual level and their connection to a

    2. A very broad inclusive view of heath determinants: job opportunities, home/living conditions, childhood care and education, as well as ecological factors. An increasing body of knowledge is finding these are responsible for decisions, behaviors, and limitations that result in the all too late admission to ERs and Hospitals for “repair” work.

    3. Finally, based on the success of shared savings approaches proven by ACOs in the US and community efforts in Europe, we will partner with health providers and payers, such that health cost reduction is rewarded through shared savings – with the bulk of it returning to the community to sustainably fund follow-on health determinant improvement efforts based on learnings.

    We are currently in discussion with communities in Texas and Indiana.

    EHR 3.0 – Patient Centered Records was inspired by the negative consequences of EHR implementations, and by the advancement of technologies. The reduction in patient-doctor time, coupled with clinician distraction while with patients, to enter data in the way the system requires it.

    A good intro can be found here: ( https://inceptary.org/news.html) in our comments on a Harvard Business Review article.

    Currently we are seeking funding from National Science Foundation to support design and pilot of this initiative.

    Hospital Anywhere was identified during our discussions while the New York Metro and New England area were in a Covid-19 crisis last spring. Leveraging a series of technologies, we’ve architected a possible approach to distributing hospital, even ICU care, focusing on the home, but perhaps anywhere as well.

    We see this as having value well beyond the Covid crisis, to accelerate patients out of hospitals and ICUs helping to both ease patient burdens of hospitalizations and use technology to bring medical care to the home – a 21st century approach expanding the impact of 1950s homevisiting doctor. IoT, digital health, 4G/5G, broadband, blockchain – all play a crucial role in pulling this together.

    We ended the meeting agreeing to continue the path we are on anchored in rich innovative discussions, and reinforcing our values around community, data, technology, and distributed healthcare.