Making Healthcare Better
I read an interesting article on Sunday, in The New York Times Magazine, Making Healthcare Better. The article discusses Dr. Brent James of Utah’s Intermountain Healthcare and the results that he and his team are producing with their patients. The Intermountain team has been improving healthcare and reducing costs by following treatment protocols and estimates indicate that the data-driven changes they’ve made at Intermountain have saved thousands of lives a year. In total, Intermountain has developed protocols for 50 clinical conditions, which accounts for more than half of their patients.
There are plenty in the medical field who are skeptical of Dr. James and his approach—and the balanced article includes them—but the results speak for themselves. In the end, what Dr. James and his team at Intermountain have done, is take a different approach to practicing medicine. They’ve looked at the way things were done, and effectively disrupted the intuitive approach to medicine. By providing protocols as a guideline, their doctors have saved thousands of lives.
Disruptive innovation—a theory of Clayton Christensen—discusses that the way to affect real change, is to disrupt the way things have been done. Disruptive innovation can have characteristics that traditional segments may not want (protocols vs. intuitive medicine). In fact, I founded Pharos Innovations and developed Tel-Assurance® based on Christensen’s notion of disruptive innovation.
According to Wikipedia, disruptive innovation “describes innovations that improve a product or service in ways that the market does not expect, typically by being lower priced or designed for a different set of consumers.” Intermountain made innovations in the way they treat patients, and have been able to save lives, but in the current healthcare system, that has been a money-losing proposition.
The article states: “In our current healthcare system, there is no virtuous cycle of innovation, success and expansion. When Intermountain standardized lung care for premature babies, it not only cut the number who went on a ventilator by more than 75 percent; it also reduced costs by hundreds of thousands of dollars a year. Perversely, Intermountain’s revenues were reduced by even more. Altogether, Intermountain lost $329,000. Thanks to the fee-for-service system, the hospital had been making money off substandard care. And by improving care—by reducing the number of babies on ventilators—it lost money.”
The good news is that there is clear indication that this is changing. Changes, such as bundling, the elimination of reimbursement for avoidable readmissions, accountable care organizations, the patient centered medical home, etc., are all gaining much favor and are likely to be included in some way in upcoming healthcare reform legislation. This will not only make it more profitable for organizations, such as Intermountain Healthcare and many others, to increase revenue through better care coordination but it will also encourage more organizations to invest in these necessary and beneficial initiatives.
If we are to truly reform healthcare, changes need to be made. Doctors and hospitals should be rewarded for keeping patients healthier and reducing costs. And this is where I feel a kindred spirit with the Intermountain team: results are what matter. Keeping patients healthier; reducing readmission rates; that’s actually reforming healthcare.
Excellent! “If we only did what we already know…” But what about the ultimate payers (employers and government)? Perhaps the government is too bent on “rationing” right now (not sure yet). But the employer ought to begin to wake up that with less emplyees; measuring total medical and indirect medical expenditures should cause a shft in focus from simple cost cuting to one of including quality of life functioning. This would create more partnering with providers to make accessing services easier (telehealth, retail clinics, etc.) but also communications to return the employee to work. In other words, no longer wait for the disability but use abscence management, risk assessments and other data to engage patient and provider team to prevent/reduce the disability time. Why, because actuaries know that over 50% of medical expenditures are due to the 10% of your workforce on disability.
Any tips or advice that can help is always appreciated.-Healthcare Help