Ultimately, says Khozin, the goal is for Hello Health to go nationwide, and hopefully impact proposals for reform. “The heath-care system cannot be fixed the way it is,” Khozin says. “Top-down mandates won’t work. The best kind of reform is grass-roots.”

The above segment is an excerpt from a recent New York Post article where I talk about Hello Health and clearly show my affinity for grassroots-driven transformation in healthcare.

I firmly believe that bottom-up innovation can be the most viable way of addressing many of the deficits of our healthcare system such as limited access to care and inefficiencies in care delivery.  I should point out, however, that there is certainly a need for top-down reform, which has the potential to spark innovation and lay the groundwork for more efficient practices. For example, tort reform to discourage predatory lawsuits against physicians is of crucial importance in reducing healthcare costs. The constant and ubiquitous fear of lawsuits drive physicians to order unnecessary tests and procedures that may trigger a trail of more expensive tests and procedures, all to meet the legal needs of documenting the physician’s thought process. Complications do sometimes arise as a result of these rather paranoid acts of self-defense. This practice is appropriately called defensive medicine and has made the act of doing too many unnecessary things an absolute legal necessity for physicians. Meaningful tort reform is the only solution and that comes from the top.

There are other examples of top-down initiatives that can have a positive and meaningful impact such as payment reform to reward physicians for the use of technology (e.g. email communication with patients) and delivering preventive care.

Filed under: Health Policy, Hello Health