Have you ever wondered where passionate health advocates derive their dedication? Often, they’re inspired by personal experiences.

Determined to improve global health, Donato Tramuto is not only passionate, he’s filled with boundless energy and visionary insights, immersed in numerous, impactful initiatives. Of special note, he founded Health e-Villages, a not-for-profit that provides mobile medical diagnostic and treatment information for healthcare professionals in the world’s most underserved areas. He’s also CEO of Healthways, a publicly-traded healthcare company focused on targeted population health for those 50 and over. 

What drives Tramuto? In a candid interview, he described a series of events that might deplete the average person but, in his case, led to impressive achievements.

Photo credit: tedxnashville.com

Photo credit: tedxnashville.com

At age seven, he lost a significant portion of his hearing, which also impacted his ability to speak. Several years and five surgeries later, his hearing was partially restored but, at the same time, his sister-in-law died in childbirth at age 27 due to a medication error. His brother also died in a car accident.

“All those things really engulfed me for a period of time,” he explained, directing him to a path of exploration. At first, he entered the Roman Catholic seminary but, during his stay, discovered an interest in healthcare. He learned everything he could on the subject and, by the 1990s, had become an innovator, bringing technology and data together by launching, as a co-founder, his first company, Protocare, Inc. (now Constella Health Strategies).

He then had a realization: when you’ve aggregated data, as Protocare did, you need a platform to deliver that data. So he spent several years developing Physicians Interactive Holdings.

Tramuto took his realization a step further, noting “it wasn’t about innovation, it was about integration.” In other words, “there had already been enough innovation going on; what I needed to do was to integrate it.” Physicians Interactive was launched in 2008 with this goal in mind. Now known as Aptus Health, the company is advancing health engagement to transform healthcare models.

Even as Tramuto enjoyed these professional successes, he continued to face personal challenges. In 1995 he required another surgery but this operation did not have a successful outcome. He lived for two years with chronic otitis media, preventing the use of hearing aids. After finally locating a doctor who could solve the debilitating issue, he chose not to sue his original provider, but rather to encourage collaboration between the two physicians. This motivated him to promote social media as a powerful agent of connection and education.

“And then, of course, in 2001, my world literally came to a screeching halt.” On September 11 of that infamous year, Tramuto was scheduled to take Flight 175—the second plane to hit the World Trade Center. A last-minute decision to change his flight saved his life, but he lost two close friends together with their three-year old son. He established the Tramuto Foundation in their memory, which aims “to make resources available to individuals and communities in need through collaborative partnerships.”

He’s “devoted the last 15 years of my life to philanthropic initiatives, which is not only the launch of my private foundation, but the launch of Health e-Villages…an international organization providing healthcare technology to the disadvantaged and to emerging countries.”

During our talk, Tramuto returned again and again to the notion integration, as opposed to innovation, is key. “There are more than 100,000 health care apps out there right now,” he said. “Less than 10% are fully utilized, and it’s because innovators develop for who they know and what they know and integrators get right into the mindset of who’s going to use the product.”

He mentioned Health e-Villages’ work in emerging countries as an example. “It’s not going in there and innovating something new, it’s basically taking what we have and integrating it with other apps and other programs.”

Lwala, a small community in East Africa, was plagued in 2012 with an exceptionally high infant mortality rate—100 deaths per 1000 births. Bringing in doctors and nurses was not a realistic solution. Health e-Villages decided the villagers could be trained to use a medical app (“just because you’re poor doesn’t mean you’re not smart”). Eighty-five villagers were told “how to turn the tablet on, and how to use the medical app for pregnancy-related conditions.”

Tramuto noted with pride, “Today we have lowered infant mortality from 100 deaths per 1000 births…to 30. Seventy more babies are alive today because we integrated what we had. We had trust in the people, who are in fact as smart as we are. They’d just never been given the chance.”

His passion was palpable. “In our lifetime, one billion people will go to their graves prematurely because they never had access to a healthcare worker.” He went on, “Some people will say, well, just educate more physicians. But in Ethiopia, a country of 100 million people, the physician per population ratio is one per 48,000. You can’t educate enough physicians in our lifetime to take care of that problem.”

He believes “the go-forward resolution is to integrate the technology that is there, to rely on technology that can be used by local villagers to empower individuals.” Case-in-point: India, a population of 1.2 billion people; 45% don’t have toilets, but 65% have mobile phones.

Even in the United States, we have the technology, but we have to work together. “I think the number one problem in healthcare is not cost nor quality. I think it’s trust.” He said the more we can “increase our collaborative integration, the more we will get done.”

We need to focus on outcomes, which are “more than just cost, and more than just quality…you have to look at the consumer as being educated, and not look at the consumer in terms of trying to make their decision for them.” He also doesn’t think consumers should be told, “get engaged.” People get engaged when they’re sick. “You have to recognize they want to be empowered.” Negative incentives do not encourage empowerment. Consumers have to “feel they are a part of the solution.” Involvement in wellness and prevention early on will improve not only outcomes but overall well-being.

This involves a cultural shift. Currently, “we’re caught between the challenge of managing chronic diseases to meet…the responsibilities that companies have in terms of their public trading status” and moving toward well-being. For Tramuto, healthcare should currently be viewed as a “turnaround” demanding both transformative and transactional leadership. He explained it’s important to demonstrate transformative leadership that is not all about transactions—a shift that will take time. “You’ve got to get the content right, you’ve got to get the culture right, you’ve got to get the people to believe in you, and then you’ve got to implement the strategy.”

Consumers are better educated than ever before, partially thanks to their smartphones. Knowing this, pharmaceutical companies, as but one example, need to better explain their intentions. “We are not focused on whether or not you’re going to take the drug. We’re focused on making the right decisions for the right patient in the right environment for the right outcome.”  

He believes the tide is changing, moving toward patient empowerment, although not overnight. “We’ve got to quit thinking that we can make the decisions for the patient. The patient is a consumer and the consumer is well-educated.” He knows this will take time, but smartphones and currently available technologies are “our greatest movement.” Tramuto said, “If, in Africa, we can train villagers on how to turn a tablet on…to make decisions about a pregnant woman, then I think here…we can move the needle a lot quicker, by putting our egos aside and collaborating.”

All who have had the opportunity to collaborate with Donato Tramuto are no doubt in awe and energized by his amazing work. We’re looking forward to his ongoing humanitarian efforts (with help from digital health technology!).

He ended our discussion with this inspiring quote from Horace Mann, “Be ashamed to die until you have won some victory for humanity.”



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