On the ground in Cuba: A look at a healthcare system driven by prevention

You will be hearing a lot about Cuba after the death of Fidel Castro. I am certainly not an expert on Cuba, but I learned a lot about the country and its people recently on an eight-day Road Scholar tour. I was particularly interested in learning about their healthcare system.

“I wanted to see and experience Cuba before it drastically changes with American influence and investment”. That was the sentiment from many of our fellow travelers.

The trip was called “People and Society: Cienfuegos to Havana”. It included day trips to Trinidad and Santa Clara plus a stop at the Bay of Pigs on our way to Havana. Everywhere we went, we experienced the cultural arts first hand – music and dance from young grade school age students to seniors well into their eighties. We heard a chamber orchestra and saw a contemporary dance show.

We heard lectures on history, politics and religion as well as how Cuban millennials view the future. We learned how negatively the U.S. embargo has impacted the people of Cuba – and how they want the embargo fully lifted, but with future U.S. investments and development managed.

We had a chance to sit and talk for an hour with a young man who works in a telecom job in healthcare. I asked about electronic health records and he said they are in the process of implementing a system they have developed.

When I got home and caught up on my email, I learned that a 15-member delegation of healthcare executives visited Cuba while we were there. That delegation was led by former HHS Secretary and Gov. Mike Leavitt, and included David Blumenthal, MD, a former National Coordinator at ONC and Stephen Lieber, HIMSS president and CEO.

Lieber wrote an insightful blog on the experience. The delegation was a mix of vendor, consulting and provider executives who had gone to see the Cuban healthcare delivery system up close.

On our Road Scholar trip, we learned about the healthcare system more broadly from our tour guide. There is clearly an emphasis on prevention and as Lieber says, it is truly a patient-centric approach.

There are multiple levels to the delivery system. At the base level where the emphasis is on prevention is the family physician and nurse who are assigned to a group of families. They know them well as they live in the same community. The doctor and nurse maintain the health records for those in their care. They have office hours in the morning and in the afternoon visit seniors in their homes.

The next level up are public clinics that provide specialists, lab services, and small wards for surgery or rehab services. The next level are hospitals and at the highest level are institutes and research centers.

Healthcare is free at all levels for all patients.

More than 50 percent of physicians are women. Our tour guide noted that more than 50 percent of all professionals are women. Most likely it’s a sign of the education system and a focus on developing equally both men and women in all sectors.

As noted in a Forbes article from two years ago, “Cuba’s Surprisingly Cost Effective Healthcare,” outcomes are impressive. Life expectancy is almost identical with the U.S. Infant mortality in Cuba is lower than the U.S.

Everyone we spoke to was friendly and gracious.They asked us to go back to the U.S. and tell people that Cuba is neither a socialist heaven nor a communist hell. They want the U.S. embargo lifted and to see continued efforts to normalize relations between our countries. I hope that more Americans can visit Cuba in the months ahead and understand the people and their hopes for the future. And that our leaders will continue to improve relations between our two countries.

Suggested reading on health care in Cuba:

Walking the Talk of Patient-Centric Healthcare in Cuba  

Prevention Better than Cure in Cuban Healthcare System

Cuba’s Surprisingly Cost-Effective Healthcare 

Cuba’s Health Care System: A Model for the World  

A Different Model – Medical Care in Cuba  

This post was first published on Sue Schade's Health IT Connect blog.

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