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Global Knowledge Exchange Network Overview Global Knowledge Exchange Network Overview

Global Knowledge Exchange Network Vision: The Global Exchange will become the recognized neutral venue Global Knowledge Exchange Network Vision: The Global Exchange will become the recognized neutral venue for evaluating and promoting better practices in achieving cost-effective health outcomes from across developed and developing nations. Mission: To improve health and the value of healthcare by comparing and contrasting key drivers and approaches to addressing healthcare costs and outcomes across developed and developing nations, with a goal of identifying and promoting successful, relevant, and replicable strategies. 2

GKEN and meeting the global health crisis § Globally developed and developing nations are GKEN and meeting the global health crisis § Globally developed and developing nations are faced with a health care crisis: rising healthcare costs threatening system sustainability, human resource shortages, increasingly frustrated consumers, and an absence of shared solutions and cross country communications. § GKEN believes the best way to meet these global health changes is: Better identification of new and emerging “better practices; ” Stronger cross border and cross cultural promotion and dissemination of better healthcare system practices utilizing traditional and non-traditional channels. 3

GKEN Areas of Focus § Workforce and Training, Governor, Colleen Conway-Welch § Individual’s Active GKEN Areas of Focus § Workforce and Training, Governor, Colleen Conway-Welch § Individual’s Active Participation in Health, Governor, La. Mar Mc. Ginnis § Health Promotion and Wellness, Governor, Beverly Malone § Chronic Illness, Governor, Murray Ross § Integration, Governor, Rick Norling § Metrics, Governor, Catharina Maulbecker-Armstrong § Efficiencies, Governor, Shane Solomon § Health Disparities, Governor, Dominick Stillfried 4

GKEN Guiding Principles § We will focus on emerging, better, and best practices with GKEN Guiding Principles § We will focus on emerging, better, and best practices with measurable outcomes. § GKEN is principally a communication initiative focused on promoting better healthcare practices among developed and developing nations. § Our ultimate goal is to promote better practices across all of the core components of health and healthcare § We believe that improving health systems will lead to population health improvements. § § We have a patient/consumer focus. We will build on current knowledge and look for effective emerging practices. 5

GKEN Guiding Principles (cont) § § We will help enable health systems to promote GKEN Guiding Principles (cont) § § We will help enable health systems to promote wellness. § § Our work will be unique and distinctive. We favor private policy/action (that which can be taken by organizations without governmental action) over direct influence of public policy Our work will be dynamic; that is, amenable to continuous refinement. 6

Developed and developing nations share many of the same Challenges: Facts on Chronic Disease Developed and developing nations share many of the same Challenges: Facts on Chronic Disease § Preventing chronic conditions is a key issue for developed and developing countries because of the growth and health complexity of the aging population, the high cost of treating and maintaining the quality of life for those with chronic conditions, and the challenges of treating chronic conditions in health care systems established to treat acute care conditions not chronic conditions. Approximately half of the burden of disease will be caused by chronic diseases, 13% by injuries and 39% by communicable diseases, maternal and perinatal conditions, and nutritional deficiencies combined. Some 45% of chronic disease deaths and 86% of the burden of chronic diseases occur in people under 70 years of age.

Shared Challenges (cont) Facts of Workforce and Training § Costs associated with HR (health Shared Challenges (cont) Facts of Workforce and Training § Costs associated with HR (health resources) issues form the single largest expense element in any health care system (as much as 60 -80 percent of total recurrent expenditures depending on the country) and are a key factor in reaching health care goals (related to quality, access and appropriateness of care) in each country. § The cost of addressing HR issues is only expected to increase across countries due to the complexity of health care needs of populations and training they need in order to address the emerging changes in the health care system including: § demographic and epidemiological issues (i. e. , the aging of nations with the number of older people soon surpassing the number of young people, lifestyle -related morbidity, overall increase in multiple, preventable chronic conditions in younger productive years, need for health care workers to coordinate both health and social services); § impact of new diagnosis and treatment technologies as well as the growing demands of better educated and informed citizens (i. e. , electronic medical records, telemedicine, and technical treatment improvements in the delivery of care); and § consequence of increased mobility and migration (i. e. , internal migration such as from public to private sector and rural to urban areas of the country as well as international migration),

Shared Challenges (cont) Facts on Health Promotion & Wellness § Almost half of all Shared Challenges (cont) Facts on Health Promotion & Wellness § Almost half of all premature deaths in developed countries are caused by unhealthy lifestyle choices with rates rapidly increasing in threshold and poor counties. Health promotion and wellness strategies aim to prevent many of these deaths and improve quality of life by encouraging people to exercise regularly, eat nutritious foods, avoid tobacco and excess alcohol, manage stress, enhance social networks and economic conditions, clarify lifestyle values, and achieve a sense of fulfillment in their pursuits.

The “Better Practices” Cycle of Adoption The Cycle from Identification to Adoption: § The The “Better Practices” Cycle of Adoption The Cycle from Identification to Adoption: § The challenge for all organizations committed to promoting better practices is the incredible lag time between when the “better practice” is identified and its actual adoption by the healthcare entity. § Once a better practice has been identified there is the further challenge of disseminating that information to the appropriate health venues and providers. This is a very difficult barrier when one looks at the geographic, cultural and social obstacles that impede the widespread dissemination of better practices. § The adoption of better practices has proven to be and even more challenging issue than the challenges of vetting or dissemination. Often, years go by before the “better practice” is accepted by the health system or provider despite scientific and research analysis that supports its efficacy.

GKEN Communicating the Findings: § GKEN recognizes the critical importance and value of disseminating GKEN Communicating the Findings: § GKEN recognizes the critical importance and value of disseminating “better and best practices” promoting robust interactive knowledge exchange through a variety of media, including printed materials, videos/DVD’s, seminars, symposiums, conferences, toolkits, and a highly user friendly public internet site. § The website will provide detailed information on new and emerging healthcare system better practices and promote costeffective healthcare improvements to a wide audience across developed and developing nations.

Infection Control Guidelines: A Case In-Point of the Challenges in Gaining the Acceptance of Infection Control Guidelines: A Case In-Point of the Challenges in Gaining the Acceptance of “Better Practices” § The Better Practice: This practice is designed to improve infection control in six specific areas and was released to the media on October 8 th. § The Gatekeepers: The American Hospital Association, the Joint Commission, the Centers for Disease Control and the leading international epidemiological societies. § Length of Time to Adoption: The acceptance of this better practice has taken years despite the fact that many of the guidelines were already in existence but there had been no universal adoption. In fact, one of the lead authors and a renowned epidemiologist found some of the guidelines had not been updated in years. Despite the critical importance of infection control practices there has never been a professional consensus on infection control. § The Challenge: One recent survey found that 87% of the hospitals did not consistently follow infection-control guidelines despite these findings being known to the healthcare community for a number of years. To quote one expert, “To often where we fail is not in the knowledge but the execution. ”

Join the growing GKEN network Catharina Maulbecker Armstrong , Associate Partner, Mc. Kinsey, Germany Join the growing GKEN network Catharina Maulbecker Armstrong , Associate Partner, Mc. Kinsey, Germany Cathy Baase, Global Director of Health Services, Dow Chemical, US Russ Bantham, President, Bantham Consulting, Former General Counsel to Ph. RMA, US Gordon Best, Director, OD Partnerships Network, UK David M. Cordani, President, CIGNA , US Marty Davis, Founder & President Applied Communications Institute, Former Dir. , Special Campaigns & Promotions, AARP, US Mike Farrar , Chief Executive, NHS Northwest, UK Pam Garside, Newhealth, Judge Business School, University of Cambridge, UK Ed Hanway, Chairman & CEO, CIGNA, US Johan Hjertqvist , President, Stockholm Network and Health Consumer Powerhouse, Sweden Maria Hofmarcher-Holzhacker , Institute of Advanced Studies France, Austria Delon Human, Pres. , Health Diplomats, Immediate Past Pres. World Medical Association, Switzerland Tommy Hutchinson, President I – Genius Pere Ibern, Professor, Universitat Pompeu Fabra, Spain Sherry Kaufield, Consultant, Joint Commission International Frances Kelleher, VP Market Intelligence, CIGNA Health. Care, US Wolf Kirsten, Founder and President of International Health Consulting Meng Kin LIM, Professor, National University of Singapore Beverly Malone, CEO, National League for Nursing, US La. Mar Mc. Ginnis, Clinical Prof. of Surgery, Emory Univ. ; Past Pres. , American Cancer Society, US 13

GKEN Network (cont. ) Chris Mc Swain, Director Global Benefits, Whirlpool Corp. , US GKEN Network (cont. ) Chris Mc Swain, Director Global Benefits, Whirlpool Corp. , US Jonathan Meakins, Nuffield Professor of Surgery, John Radcliffe Hospital, Oxford UK Surya N. Mohapatra, Chairman & Chief Executive Officer, Quest Diagnostics, Inc. US Russ Newman, Provost and Vice President for Academic Affairs, Alliant University, US Rick Norling, CEO, Premier Inc. , US Mike O’ Grady, Sr. Fellow, National Opinion Research Center, U. Chicago; Principal, O'Grady Health Policy, LLC, US Jim Parker, Former Chief of Staff to the president Wellpoint Stig Pramming, Executive Director of the Oxford Alliance Jerry Reeves, Principal, Health Innovations LLC & Chairman, World Doc, US Murray Ross, VP, Kaiser Foundation Health Plan; Director, Kaiser Institute for Health Policy, US Barbara Safriet, (former) Assoc. Dean for Academic Affairs & Lecturer on Law, Yale law School, US John Seffrin, CEO, American Cancer Society Michael Showalter, SVP, Health. Care Strategy & Marketing, CIGNA Health. Care, US Shane Solomon, Chief Executive, Hong Kong Hospital Authority, China Dominick von Stillfried, Managing Director of Zentralinstitut für die kassenärztliche Versorgung (ZI), Germany Karen Timmons, President and CEO, International Joint Commission, US Neil Trautwein, Vice President, Nat’l Retail Federation, US Janet Trautwein, CEO, Nat’l Assoc of Health Underwriters, US Mike Taylor, Principal, Towers Perrin Massimo Vergnano, President Sudler and Hennessey Europe Jo Webber , Deputy Policy Director, NHS Confederation, UK Colleen Conway-Welch, Professor & Dean, Vanderbilt University, School of Nursing, US 14