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Utah has a shortage of primary care physicians. This task force is teaming up with IBM to fix it

SALT LAKE CITY — The number of physicians, clinicians and nurses the state is turning out has always been estimated based on current need, which might have fueled the shortage of qualified providers Utah is up against.

"We're thinking about and asking people to expand programs on past data, when we know our needs in the future will be different," said Sen. Ann Millner, R-Ogden, who is working with the Utah Medical Education Council and the Utah Area Health Education Center to develop better policies on educating the future health care workforce.

Because the demographics within Utah vary greatly, so do the needs. The entire state could use more primary care physicians, and IBM, a global information technology giant, stepped in to help figure out how to get there.

University of Utah first-year medical students attend their lecture class in the Health Sciences Education Building on the University of Utah campus in Salt Lake City on Friday, Nov. 2, 2018.
University of Utah first-year medical students attend their lecture class in the Health Sciences Education Building on the University of Utah campus in Salt Lake City on Friday, Nov. 2, 2018.
Steve Griffin, Deseret News

A team from IBM Health Corps, a pro bono initiative of the company that focuses on tackling health disparities, spent three weeks in the Beehive State interviewing, collecting data and developing software that experts can use to drill down to more effective and efficient levels.

When it is complete, the workforce optimization tool they developed will help health care leaders, educators and lawmakers throughout the state to more correctly predict and fill health care needs in the future. The open source technology might even be used in other places, adapted to fit any state's needs.

"It will help us step back and rethink in ways that we are not accustomed to … to optimize the talents and the experience of the health care teams we assemble for the future, but even more importantly to do that in such that we're able to provide more accessible, more affordable, quality primary health care access to the residents of Utah, which is our first priority," Millner said during the unveiling of the IBM Health Corps model at the Utah State Capitol on Thursday.

Dr. Mike Magill, director of the Utah Area Health Education Center and former chairman of the University of Utah's department of family and preventive medicine, has been working to optimize available data for years.

He said much has changed in the way that health care is delivered.

"The vision of the future is very different than the old days," Magill said, recalling stories of his grandfather operating a medical practice and seeing patients at home.

Another problem is that medical education of any kind is expensive and, he said, "the pipeline can be long."

More than half of all health care costs go to personnel, and while the United States spends way beyond what other nations do on health care, the quality of that care isn't much different, said Anne Fischer, a health care analyst with IBM's Truven Health based in Detroit. And, a lot of it can be administered at the primary care level.

Fischer said primary care physicians have a unique opportunity to intervene with patients early on, reducing the incidence of disease and perhaps preventing long-term problems.

Yet, the number of primary care providers is dwindling.

Utah needs an average of 379 new physicians each year to keep up with population growth, aging, and physician retirement, according to a 2016 report by the Utah Medical Education Council. That's on top of rising health care costs and increased demand from a growing population.

The computing tool, the development of which is funded by a grant from IBM, helps fuel a "data-driven conversation" that is "necessary to get where we need to be," said Clark Ruttinger, director of workforce research at the Utah Medical Education Council. The council was created more than 20 years ago "out of a need to secure and stabilize the state's supply of health care clinicians," according to the organization's website.

The need to predict workforce needs was important then, and it is important now, but, Ruttinger said, "we're still using 20th-century methodologies to plan for the future."

"We are fully aware that supply counts, although easy to compile and compare, don't tell us anything about how healthy our population is," he said.

Utah is definitely underserved, Fischer said, as the state doesn't have nearly enough primary care providers — physicians who can address health care needs at their basic level — to provide for the population. The state also has a young and relatively healthy population, though spread between rural and urban settings that have different health care needs.

Perhaps the greatest disadvantage of a scarce primary care presence is growing concern for the mental health of many Utahns, as suicide rates in Utah fall well above the national average, Fischer said. A primary care provider could screen for problems and identify behavioral health issues earlier in a person's life and likely lead to better outcomes for many patients.

To help solve the issues Utah faces with its provider shortage, Fischer and six other IBM Health Corps enlistees helped to organize existing data and broaden its usability, paving a way for a sophisticated model to allow policymakers to make more accurate predictions for the future.

The framework they provided will continue to be worked to identify the most effective way of delivering health care, said Richard Hopkins, an IBM distinguished engineer from Yorkshire, in the United Kingdom. He said it wouldn't make sense to pay a specialist to give immunizations, just like it wouldn't be efficient to have a nurse perform brain surgery.

Those discrepancies make it difficult to know who and how many to train, and how to do it.

The tool, which will likely be fully functional within the next three years, could compare the current and ideal health care needs within counties and even towns, based on a number of statistical indicators. More data needs to be collected to make it most effective, the IBM Health Corps workers said.

The right input, said IBM data scientist Hannah Yang, will lead to the desired outcomes.

Of course, she said, there are limitations, too, given that not everyone utilizes health care or is insured, and data is not collected on people who are never patients.

The team completed its three-week mission in Utah on Friday, leaving the newly developed tool in the capable hands of the Utah Medical Education Council. Ruttinger said they will continue to fine-tune it and supply additional data to make it more useful in determining the future of health care in Utah.

"Utah is very innovative in the health care field," said Randy Gregory, senior design strategist for IBM Watson Health's life sciences division. "We're going to keep that going. You really have an opportunity to change health care."