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Project MISO: Mixing Up Old Ideas to Deliver
Healthcare into Medically Underserved Areas (MUAs)
By: Chief Incognito
Feedback and comments to: chief@buddyspace.net.Rev.2016.0417
Whats Wrong with This Picture?
You need to be
under this line
(@$500/mo.)!
Whats Interesting about This Picture?
This is not
a pipe dream!
This is not
pie-in-the-sky!
Whats Alarming about This Picture?
Worrisome trend, a
train-wreck coming!
This is not
castle in the air!
Why the Disparity Between U.S. & Them?
Poster child again but
nothing good this time!
Look here
 and here!
Case Study: How Did Singapore Do It?
Talking about
U.S.? Get us
outta here!
Case Study: How Did Singapore Do It?
You inspiredme to
thinkdifferent...
I took care of
my people
Honestly, What Choices are There for U.S.?
 for under $6k per year?
But Seriously, Where Did All Those
Healthcare Spending Actually End Up?
80% of the Benefit
@ 20% of the Cost =>
Biggest Impact for MUAs
U.S. Healthcare Economics 101:
Capitation Model vs. Fee for Service (FFS)
TypeofCare
Payment Model
Disease
Management
Primary
Care
Capitation FFS
The Challenge: Timely Access + Affordable Quality
Disease
Management
Primary
Care
Pay-For-Performance + Single-Payer
(A Patient-First Capitation Model)
Healthcares Iron Triangle: Access + Quality + Cost
(But Which Comes First...? This Time Its Access!)
Most easily
overlooked, especially
for Medically
Underserved Areas.
What good is healthcare if you cant get to it when youre sick?
Healthcare In A Moving Box: Operate A Fleet of
Mobile Clinics (aka Clinics On Wheels) for MUAs!
Mo betterwheels!
Have wheels,will travel.
E.g., How to Provide Care for Patients with Diabetes?
E.g., How to Provide Standard Lab Tests, Complete
Physical Exams, Physiotherapy or Homeopathy?
Brokenbones?
E.g., How to Provide Accessible Pediatric Care?
E.g., How to Bring Vision and Dental Services to Kids?
Do you see
whatI see?
E.g., How to Provide Care to Women:
Mammography, Pregnancy Testing and Ultrasound?
E.g., How to Provide Imaging Services (MRI) On-The-Go?
E.g., How to Provide Mobile PET or CT Scan Services?
(The Trucks are Really Getting Big Now!)
Healthcare In A Box: Operate a Satellite-Linked
Network of Portable Clinics (aka Clinics In A Can)
Satellite Communication Link
Healthcare In A Box: Self-Sustainable Portable
Clinics Inside MUAs Where Sunshine is Plentiful!
I just need
water
Standard Shipping Containers
(Modular and Portable)
Doctors Without Borders: Go Where the Patients Are!
Its simple really: go where the patients are. It seems
obvious, but at the time it was a revolutionary concept
because borders got in the way. Its no coincidence that
we called it M辿decins Sans Fronti竪res 
 Bernard Kouchner (MSF Founder)
I had this
great idea
back in 1971...
Dont ask whereI got
my medical degree
Imyour doctor!
Mo better
talent next!
Mobile Care Coordination: Mobility Improves Outcome!
Timing is everything.
One Last Thing: How Does Everything Fit Together?
(Hint: Another Old Idea of System Backplane)
Standardized Communication Protocols + Plug-and-Play Modular Design.
Introducing MISO: A Healthcare Information
Backplane That Ties Everything Together!
MSI
Management Service
Infrastructure (MSI)
Management Service
Organization (MSO)
MSO
for MUAs
Plug-and-Play EHR
Global New Talent Source
Tele-Medicine
Comm. Link
Mobile &
Portable
Clinics
Small Steps: Delivering Behavioral Health Services
(BHS-On-Wheels) Around IHS Heathcare Centers
Creating A New Patient-First Organization (PFO)
By Combining the Best Features of PPO and HMO
Feedback and comments to: chief@buddyspace.net.
Timely Access via
real-time logistics
of Wheels + Talent.
Bestin class?
Japan?Taiwan?
Singapore?
Affordable
Quality via single
payer only paying
for performance.

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Project MISO

  • 1. Project MISO: Mixing Up Old Ideas to Deliver Healthcare into Medically Underserved Areas (MUAs) By: Chief Incognito Feedback and comments to: chief@buddyspace.net.Rev.2016.0417
  • 2. Whats Wrong with This Picture? You need to be under this line (@$500/mo.)!
  • 3. Whats Interesting about This Picture? This is not a pipe dream! This is not pie-in-the-sky!
  • 4. Whats Alarming about This Picture? Worrisome trend, a train-wreck coming! This is not castle in the air!
  • 5. Why the Disparity Between U.S. & Them? Poster child again but nothing good this time! Look here and here!
  • 6. Case Study: How Did Singapore Do It? Talking about U.S.? Get us outta here!
  • 7. Case Study: How Did Singapore Do It? You inspiredme to thinkdifferent... I took care of my people
  • 8. Honestly, What Choices are There for U.S.? for under $6k per year?
  • 9. But Seriously, Where Did All Those Healthcare Spending Actually End Up? 80% of the Benefit @ 20% of the Cost => Biggest Impact for MUAs
  • 10. U.S. Healthcare Economics 101: Capitation Model vs. Fee for Service (FFS) TypeofCare Payment Model Disease Management Primary Care Capitation FFS
  • 11. The Challenge: Timely Access + Affordable Quality Disease Management Primary Care Pay-For-Performance + Single-Payer (A Patient-First Capitation Model)
  • 12. Healthcares Iron Triangle: Access + Quality + Cost (But Which Comes First...? This Time Its Access!) Most easily overlooked, especially for Medically Underserved Areas. What good is healthcare if you cant get to it when youre sick?
  • 13. Healthcare In A Moving Box: Operate A Fleet of Mobile Clinics (aka Clinics On Wheels) for MUAs! Mo betterwheels! Have wheels,will travel.
  • 14. E.g., How to Provide Care for Patients with Diabetes?
  • 15. E.g., How to Provide Standard Lab Tests, Complete Physical Exams, Physiotherapy or Homeopathy? Brokenbones?
  • 16. E.g., How to Provide Accessible Pediatric Care?
  • 17. E.g., How to Bring Vision and Dental Services to Kids? Do you see whatI see?
  • 18. E.g., How to Provide Care to Women: Mammography, Pregnancy Testing and Ultrasound?
  • 19. E.g., How to Provide Imaging Services (MRI) On-The-Go?
  • 20. E.g., How to Provide Mobile PET or CT Scan Services? (The Trucks are Really Getting Big Now!)
  • 21. Healthcare In A Box: Operate a Satellite-Linked Network of Portable Clinics (aka Clinics In A Can) Satellite Communication Link
  • 22. Healthcare In A Box: Self-Sustainable Portable Clinics Inside MUAs Where Sunshine is Plentiful! I just need water Standard Shipping Containers (Modular and Portable)
  • 23. Doctors Without Borders: Go Where the Patients Are! Its simple really: go where the patients are. It seems obvious, but at the time it was a revolutionary concept because borders got in the way. Its no coincidence that we called it M辿decins Sans Fronti竪res Bernard Kouchner (MSF Founder) I had this great idea back in 1971... Dont ask whereI got my medical degree Imyour doctor! Mo better talent next!
  • 24. Mobile Care Coordination: Mobility Improves Outcome! Timing is everything.
  • 25. One Last Thing: How Does Everything Fit Together? (Hint: Another Old Idea of System Backplane) Standardized Communication Protocols + Plug-and-Play Modular Design.
  • 26. Introducing MISO: A Healthcare Information Backplane That Ties Everything Together! MSI Management Service Infrastructure (MSI) Management Service Organization (MSO) MSO for MUAs Plug-and-Play EHR Global New Talent Source Tele-Medicine Comm. Link Mobile & Portable Clinics
  • 27. Small Steps: Delivering Behavioral Health Services (BHS-On-Wheels) Around IHS Heathcare Centers
  • 28. Creating A New Patient-First Organization (PFO) By Combining the Best Features of PPO and HMO Feedback and comments to: chief@buddyspace.net. Timely Access via real-time logistics of Wheels + Talent. Bestin class? Japan?Taiwan? Singapore? Affordable Quality via single payer only paying for performance.