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Walking the Talk of Patient-Centric Healthcare in Cuba

Former ONC National Coordinator Dr. David Blumenthal and the paper records of a neighborhood primary care facility in Havana, Cuba.

I spent most of last week in Havana, Cuba, with a 15-member delegation of healthcare executives led by former HHS Secretary and Governor Mike Leavitt. This mixture of vendor, consulting and provider executives came to see the Cuban healthcare delivery system up close.

Our meetings included visits to a neighborhood primary care office, a polyclinic (multi-specialty clinic covering multiple neighborhoods), a pediatric cardiac specialty hospital, a general hospital, biotech R&D facility, molecular medicine R&D facility, several government offices (Public Health and Foreign Trade) and others.

The American economic embargo, in place since 1960, has had a devastating effect on the people of Cuba. Coupled with the collapse of the Soviet Union in 1992, when Cuba lost 85% of its international trade, these people have been through a lot. But despite these factors, Cuba has an education/literacy rate equal to first world countries, an infant mortality rate lower than that in the US, and other measures of admirable health and well-being.

The lack of animosity toward Americans, despite our history toward Cuba, was most striking. Both everyday people as well as government officials see the US as a natural trading partner and look forward to the day of normalized relations and trade. When the day arrives with access to resources, capital and credit of the world markets, the Cuban people and the world markets will find significant business opportunity in many sectors, including healthcare.

In Cuba, they “walk the talk” when it comes to people-oriented care. It is truly a system that starts with primary care in the neighborhood, wellness, prevention and early intervention (hence the outstanding statistics in infant mortality and life expectancy).

Diagnostic technology is limited due to the embargo, and information systems and technology is almost non-existent. Yet, the Cubans are a resourceful people, borne out of necessity. While I am sure that we would find deficiencies in highly specialized care, we have much to learn from places like this when it comes to being truly person-centric.

Keywords: 
HIMSS; health IT; population health