By Carl Schramm, Chairman of the Board, Lumeon
As an investor in Amadeus, the British venture fund that made the first investment in Lumeon, I have long been intrigued by the company’s results managing variance in resource use and clinical outcomes. Now I am delighted to be joining the company as chairman of the board of directors.
While hundreds of companies have developed software solutions that promise to cut the cost of care in both outpatient and inpatient settings, Lumeon actually saves money for the provider while also improving the patient experience. Their care pathway management platform both makes it easier for patients to manage their care and supports providers to efficiently coordinate resources along the patient journey in a way that is aligned with improved clinical and financial outcomes.
Market-like forces are changing the care delivery equation
The principal reason that the U.S. healthcare system ranks poorly for outcomes and costs among developed nations is that it is managed on outdated organizational and reimbursement principles. These principles were instituted in 1965 when the federal government began paying for the care of low income and elderly patients, populations that now consume well over half of all healthcare resources in the U.S.
Patient-physician interactions and hospital stays are managed in fundamentally the same way as they were six decades ago. Hospitals, doctors, and drug companies have enormous political clout and — contrary to their rhetoric that seems to endorse reform — are largely content with the way things are presently structured.
Most American voters see through false promises of politicians promising better care for lower costs. They are also fearful of change; they want to remain with their doctors and suspect that government involvement in healthcare will mean intrusion and forced changes in their individual care.
Fortunately, recent shifts in federal reimbursement regulations and private insurance company payment methodologies are introducing market-like forces into the care delivery equation. Providers, hospitals, and doctors are now more often being reimbursed using performance-based payments – aligned with value and quality. Public policy is beginning to favor transparent pricing, which will cause individuals, government payment agencies, private insurance companies, and employers who share in the cost of insurance premiums to apply pressure on hospitals and doctors to deliver more and better care for less.
Information technology will be the next revolution in healthcare
The world has enjoyed huge benefits from U.S.-funded research and technological advances in medicine. For example, the surgical revolutions made possible by anesthesia and rapid advances in materials science, especially after WWII. The extraordinary biologics revolution that started with sulfa drugs and penicillin and has morphed into genetic editing and individualized DNA therapies. The diagnostics revolution that emerged from blood testing and is today evidenced in PET scanning and genetic coding. And, of course, the device revolution that allows people in their eighties to play tennis and ski once equipped with artificial joints.
Now, we have moved into a moment in which computers use machine learning and artificial intelligence to leverage data to make the practice of medicine better, more effective, and less expensive. Lumeon is at the epicenter of this revolution, helping to define it and make it happen.
Lumeon is extremely well-positioned to penetrate the U.S. market
In fact, it’s almost as if Lumeon anticipated this moment in U.S. healthcare. Its software allows hospitals to reduce variance in costs and clinical outcomes — exactly what hospitals and doctors need to manage the financial and clinical risks for which they are increasingly being held accountable. Its operational expertise deploying and scaling care pathways at enterprise level supports health systems as they mature to deliver these new models of care.
As chairman, my job is to support Lumeon’s management, especially CEO Robbie Hughes as he steers this young company to benefit the largest number of potential customers in the U.K., U.S., and other markets. I know the U.S. healthcare system intimately. I have built and scaled several companies in this space. With variety and depth of experience across healthcare finance, regulation, and insurance I have a solid vantage point from which to guide Lumeon in achieving its great potential.
I believe in the Lumeon team, the product and the team’s ability to deliver. I see the success the company has experienced working with U.K. providers and insurers as an important experience that has readied the company to enter the U.S. market. Lumeon has a very special vision: it exists to make hospital decision-making better in ways that benefit the patient and the payers. I’m very excited to help the company realize this vision in the U.S., where its products can make an enormous difference to providers as well as significantly improve patient care.