Andy Grove offers quick fixes for health-care crisis

John Leschofs/VAS

Andy Grove delivers the eighth annual Thomas J. Fogarty, MD, Lecture before several hundred people.

Andy Grove, PhD, became a Silicon Valley legend by joining with a few engineers who left Fairchild Semiconductor to found Intel Corp. Then as its president, a decade later, he transformed the company from a memory-chip maker into the world's dominant producer of microprocessors.

Now Grove has turned his attention to the crisis in the U.S. health-care system, and once again he has embraced the idea that a seismic shift in technology could provide the answer to our woes.

On Nov. 2, before a standing-room-only crowd of faculty and students at the Arrillaga Alumni Center, Grove delivered the eighth annual Thomas J. Fogarty, MD, Lecture, using the talk to underscore the problems we face and some of the solutions. He vented his frustration with the exploding numbers of uninsured and under-insured Americans and the skyrocketing costs of caring for the aging population in nursing homes.

"I don't know about you, but talking about trillions of dollars makes me nervous," Grove said.

But such a large problem can be relieved, at least in part, with already available solutions. He advocates the use of the walk-in medical clinics popping up in megastores like Walgreens. And a key to making them work would be to harness the power of the Internet, Grove said.

Medical experts say that the lack of accessible electronic records causes duplication of care, unnecessary procedures and costly mistakes that accurate information could prevent. Although there's debate about how to create a record that would be accessible to a range of providers and still protect files, Grove presented a simple answer: Keep medical records on a Web-accessible word-processing file.

"It costs nothing because it's already in place," Grove said. "The technology already exists."

Latter-day Benjamin FranklinBorn to a middle-class Hungarian Jewish family, Grove, now 70, immigrated to New York in 1957. After receiving a bachelor's degree in chemical engineering from City College of New York in 1960, he moved to UC-Berkeley where he got his PhD in the same field in 1963.

After co-founding Intel in 1968, Grove became president, then CEO and finally chairman, before stepping down in 2005. He was Time magazine's Man of the Year in 1997, and lately he's been in the limelight with the publication of his biography by Harvard historian Richard S. Tedlow. In The Life and Times of an American, Tedlow makes a case for placing Grove alongside Benjamin Franklin as one of America's most notable entrepreneurs.

Grove turned his attention to the health-care industry in the mid-1990s after a bout with prostate cancer. Alarmed by the huge number of uninsured Americans who are often forced to use emergency rooms as their last option for primary care, he became a proponent of low-cost, walk-in clinics, the kind beginning to appear in the back of stores such as Wal-Mart and Walgreens.

But a key problem with this plan is the lack of a good medical records system, Grove said. His solution? Not the complicated, expensive medical record- keeping system that many companies and health-care providers are trying to develop, but something much simpler—the use of existing mass-produced technologies.

"Keep it simple, stupid," is the mantra behind Grove's prescription for today's health-care woes, which he's labeled "shift left" (no political implications to be inferred, he said). Instead of moving to ever more complicated and expensive methods of meeting needs and services, he recommends the system "shift left" to the simplest method.

Retail clinics are a simple solution, he said. They're hidden in "little nooks and crannies inside mega-stores" where they provide low-cost preventive services, inoculations and sometimes X-ray imaging. Treatment rooms are open seven days a week. Currently there are about 150 nationwide but that number will soon jump to about 1,000, he said.

"Right now all the uninsured can do is run to an emergency room that will take them—the medical care provider of last resort," Grove said. "The number of visits to the ER has increased by 25 million in the last 10 years. The problem is, they are not designed for primary care visits, and they're extremely expensive when used for this."

Meanwhile, U.S. industry continues to make cutbacks in health-care benefits at alarming rates, which will only exacerbate the problem, Grove said.

To demonstrate how these clinics would work, Grove orchestrated a skit on stage, which featured a patient receiving care at one of these clinics and then requesting that her medical information be uploaded into her Internet electronic health record.

Just "plunk it in there," Grove said, calling the repository a "shoe-box on the Net."

And it's free. Each patient keeps a secure Internet access key, and health-care providers, once they receive approval from the patient, can upload handwritten notes, X-rays and other medical results and documents onto the file.

Relief for nursing homesGrove went on to describe how he would apply this new "shift left" philosophy to the enormous economic strain on the health-care industry by the growing aging population. New technologies and new applications of existing technologies would help make possible more home care for the aging population, decreasing the need for expensive nursing home care. With the help of "dirt cheap" digitalized electronics, electronically monitored homes could provide much of the services that are currently being paid for at nursing homes.

Sensors, both wired and wireless, could be placed around the home, in beds, in pill boxes, keeping seniors always "plugged in." If anything out of the routine occurs these sensors attached to the Internet would trigger an emergency phone call.

"We have a huge problem and it's getting worse," Grove said. "I believe we can and we must use existing mass-produced technologies to cut costs."