Present: Chief Medical Officer, Deloitte, Federal Health Practice
Career highlights: Before joining the private sector in 2004 (first, at Oracle, BearingPoint, and finally, Deloitte in May 2009), Cowan had a 33-year career in the U.S. Navy. During Operation Restore Hope in Somalia, he served as the Joint Task Force (JTF) Surgeon. “I will forever be proud of the tens of thousands, if not more, lives that I was a party to save,” says Cowan, adding, “That’s my secret ticket when I go up to the pearly gates and St. Peter says, ‘Cowan, you’ve got kind of a spotty record here.’ I’ll play the Somalia card.”
Personal: Cowan is a life-long recreational sailboat sailor. “But I’m currently between boats,” says Cowan. “My last boat,” he adds, “was a Chesapeake Bay Skipjack — the signature oyster dredging sailboat of the bay.” When Cowan doesn’t have a boat to cruise the bay and the inland waterway, he “makes do” cruising the backroads of Northern Virginia and West Virginia on his BMW motorcycle.
- Remember you’re here to innovate. “Our government clients frequently look to us for innovation … I sometimes see reluctance by industry colleagues to step forward into that space,” says Cowan, adding, “There is a natural and very understandable desire to say, ‘What would you like me to do?’ However, there is an expectation on the part of government clients for industry to be able to peek over the horizon — I’m not sure we [industry] share that view with them as often as we could.”
- Keep in mind that web based-information technologies are the future. “Personal health records, patient portals, and electronic medical records — these are the wave of the future. The capabilities of care providers are extensive through information sharing. The internet offers unrivaled means to make that a reality.”
ExecutiveBiz: You’re in discussions with the military. Who’s next? The private sector?
Michael Cowan: There are opportunities with other federal agencies and offices, but I would also like to work in the private sector. However, more systemic and economic barriers exist there. My thinking at this point is that if we can really get the ball rolling and show that you can really move healthcare appropriately, safely, and effectively onto an internet-based IT system, then we can really revolutionize the ability to deliver primary care. That’s a field of dreams that many will follow.
ExecutiveBiz: Overall, how do you envision healthcare reform taking shape this year; what role do you see contractors playing in those efforts?
Michael Cowan: “Healthcare reform,” as we generally view it right now, is a little too much like a group of patients, employers, insurers, pharmacies, and providers having sat down at a great restaurant, after a six-course meal … rare and distinguished wine, Cognac, and cigars — and the check just came. They’re now furiously pushing it around the table hoping that someone else will pick it up. Fundamentally, the current discussion centered on reform is primarily for who pays the bill. However, I think that the most meaningful healthcare reform will be a reform of the way we deliver healthcare. It must be focused on a difference in what is done at the clinical level — and not predominantly in how we pay for it.
ExecutiveBiz: So, could your work with the military serve as a model for the private sector?
Michael Cowan: Yes, but the private sector will need to align economic incentives with best practices to achieve those benefits. Congress will play a role, and innovative payment alternatives will need to be implemented by the insurance industry. For example, insurers generally will not pay for telephone or e-mail consultations with patients. This then forces physicians to see patients for routine matters that could be handled safely and efficiently without a personal visit.
ExecutiveBiz: What technologies do you believe will be delivering solutions to healthcare challenges like these?
Michael Cowan: I think the most important innovation is the personal health record or PHR. And the game changers are the PHRs offered by Google and Microsoft — because they are free for everyone to use. As an example of their useful functionalities, Bumrungrad International Hospital — a popular medical tourism facility in Thailand — recently announced a partnership with Microsoft Vault to upload selected healthcare information into a PHR for the 50,000 patients that come through their system annually.
ExecutiveBiz: As you know, there’s been a lot of discussion about meaningful use. What’s your perspective on where the current definition is headed?
Michael Cowan: What I see in ONC (the Office of the National Coordinator for Health IT) is a forward-looking organization that has learned how to say, “Let’s start here, and if that’s the right thing, continue in that direction, and if not we will go back and recalibrate.” Too often, in government, we make a rule, cast it in concrete, and don’t deviate. However, I’m really very supportive of this idea of developing ground rules, and in my opinion, ONC has really proven itself a model organization for common sense and progress.
ExecutiveBiz: Beyond the halls of Deloitte, you also work in the field. You were in Somalia from 1992 to 1993 as a task force surgeon. Now you’re working on behalf of Haiti relief. What can you share about this humanitarian effort?
Michael Cowan: In the past, I was one of the authors and creators of the National Disaster Medical System (NDMS), and was in Somalia. Recently, I was invited to be an advisor to the Joint Task Force Surgeon in Haiti because the service wanted to utilize my experiences to help staff charitable organization personnel aboard Naval ships — the Hospital Ship Comfort and other platforms — and make these partnerships work to everybody’s benefit. I was charged with helping keep Navy-NGO relationships symmetrical so that everybody added and received best value. The Haiti relief operation, to me, is “good medicine in bad circumstances.” I feel deeply privileged and humbled to have been a part of this mission.
ExecutiveBiz: As for Deloitte, and your federal health practice, what’s next?
Michael Cowan: Health information technology in the federal space holds multiple opportunities: new generation health records; web-based augmentation of care delivery; patient empowerment; medical social networks. This is an exciting time to be in this business.