In a recent post in The Health Care Blog, Archimedes Founder David Eddy, MD, makes a strong case for the new Global Cardiovascular Risk score (GCVR), because it will keep providers more focused on preventing disease and give them a more accurate and meaningful target to shoot for to keep patients healthy. This project, to test the merits of a new way to measure the health outcomes of patients with heart disease and diabetes, is an example of a truly disruptive innovation that could be a real game-changer for measuring quality. Read Dr. Eddy’s full post below.

-Nancy Barrand  

When the Robert Wood Johnson Foundation launched the Pioneer Portfolio, my colleagues and I asked ourselves what fields might produce the greatest potential game-changers for health and health care. Genomics was at the top of the list. The human genome had been mapped and fantastic discoveries had begun to blossom, but a true era of personalized medicine still seemed too far off.

So we set out to do what Pioneer does best. We explored and learned. We networked.  We asked a lot of questions.  And we began to hunt down ideas.

On March 12, PBS NewsHour did a feature story on one of the big ideas that came out of that process: the world’s largest, deepest, and most diverse “biobank.” It presented a good opportunity to share the backstory. 

“You need a logarithmic methodology to expand capacity to match the logarithmic increase in knowledge that is occurring worldwide.”

That’s how Dr. Sanjeev Arora described the force multiplication theory at the core of Project ECHO during last week’s launch of the ECHO model throughout the VA. It’s also a call to action for how we approach medical training and health care delivery.

Knowledge is power, yes, but in health care, knowledge is life-saving. Knowledge is more pain-free hours in the day. Knowledge is quality of life.

We need to think differently about how we share knowledge.

Let’s allow Dr. Arora to walk us through the math:

"More knowledge has been created in the last 100 years than was created in the last 5,000. And more knowledge will be created in the next 50 years than has ever occurred before. So what this leads to is a very complex issue—you have an explosion of best practices and how do you take these best practices to affect underserved populations that may be living all over the world? As a result of this knowledge explosion, what is happening is there is a shortage of highly specialized expertise all over the world, not just rural areas; even urban underserved areas experience this shortage."

Tonight in Washington, Scott Johnson, the CEO of the Myelin Repair Foundation (MRF), will be honored as the recipient of the prestigious Gordon and Llura Gund Leadership Award fromResearch!America. The Pioneer Portfolio congratulates Scott and the MRF on what has been truly pioneering and inspiring work.

Scott, an engineer by training, is a Silicon Valley entrepreneur who has lived with multiple sclerosis since 1976. His keen desire to improve treatment led him to start MRF in 2004. Though RWJF does not fund biomedical research nor focus on specific diseases, we saw MRF’s Accelerated Research Collaboration model as pioneering a new approach to biomedical research – one that had the potential to speed the process of discovery.

With the help of RWJF’s support, MRF piloted the Accelerated Research Collaboration model. The model re-engineers the painfully slow and siloed research enterprise into a collaborative venture to accelerate discovery and move more potential candidates into the pipeline for development of new treatments. From 2005 to 2008, MRF researchers produced 50 peer-reviewed articles, pinpointed 19 new pathways and therapeutic targets for myelin repair, identified 24 new tools for neurological disease research, and filed applications for nine patents, with eight additional applications in the works.

In the process, MRF’s work shifted the field of MS research to focus on myelin repair as the more promising avenue to slow progression of the disease and develop treatments. But as significantly, his fresh view of the biomedical research process – based on how it can and should work, not how it has been traditionally conducted – will shift the future.

The RWJF Pioneer Portfolio is proud to have supported such innovative and life-changing work, and we congratulate Scott Johnson on receiving this much-deserved honor.

Some good news came our way this week -- a story unfolding the way we hoped it would.

Freelancers Union, a Pioneer Portfolio grantee, will launch three Consumer Operated and Oriented Plans (CO-OPs)--nonprofit, consumer-governed insurance companies envisioned by the Affordable Care Act to expand health insurance choices for consumers and small businesses. This is made possible by $340 million in low-interest and no-interest federal loans announced Feb. 21 by the Centers for Medicare & Medicaid Services to start three of the first seven CO-OPs in New York, New Jersey and Oregon.

We’re delighted because Freelancers Union used a 2010 grant from Pioneer to shape its existing ground-breaking model for demand-side, consumer-driven health care into a proposal for the new world of CO-OPs.

It was a natural fit. Here’s the back story.

The existence of Freelancers Union is recognition that for the 30 percent of the workforce that earns its living as freelancers, contractors and temps – so-called independent or contingent workers – there are no employer-provided benefits, including health insurance. Many of these workers earn too much to qualify for public assistance and not enough to afford the health insurance available in the individual market, typically more costly than the group market plans offered by employers.

As a Foundation, we have been concerned for 30 years about Americans’ lack of access to affordable and stable health coverage, so a partnership took shape over the course of three grants.

We first partnered with Freelancers Union in 2007, when they were looking to start a health plan for the contingent work force, but with an important twist. They wanted the benefits to reflect input from the workers. Our first grant helped the organization conduct surveys and focus groups to shape the benefit design. It learned that its members wanted a product aligned to their holistic needs on top of catastrophic coverage.

With a second grant in 2008, we joined a consortium of funders that helped launch a for-profit subsidiary, Freelancers Insurance Co., with a line of products that combine catastrophic insurance coverage with special attention paid to mental health services as well as wellness, prevention and alternative therapies.

Then with a third grant in 2010 we sought to enable Freelancers Union to expand its group purchasing health-benefits program from New York into New Jersey and Georgia. We envisioned this work might produce a prototype for the CO-OPs, and it did. All CO-OPs won’t follow the Freelancers Union model, of course, but it certainly sets a standard.

The work of Freelancers Union reflects many of the core ideas that drive Pioneer Portfolio grant-making. It is transformative and disruptive. As large insurers back away from the individual market because of the tight profit margins, some fresh thinking is badly needed, like rolling individuals into groups even though they do not work together, and then listening to them carefully to design products that meet their needs.

That’s pioneering, and we’re proud to have played a part.

Follow @FreelancersU on Twitter.