Healthcare
Embracing incremental change in solving the healthcare challenge
As I go from healthcare conference to conference and from event to event, the thing that always impresses me the most is how many different organizations there are – and how many people there are – that are focusing so much time and effort on the evolution of the healthcare system in the United States. There are literally thousands of different companies and groups who in some way, shape or form are trying to move the bar forward in the healthcare industry; trying to improve access, increase quality or decrease cost.
When one looks at how many different players are involved in the healthcare lifecycle (patients, family members of patients, providers, payers, employers, government agencies, vendors, standards development organizations, etc), it really hammers home the scope of the system. People keep talking about how much the system is broken, but when one looks at the scope of the broken system and the number of players involved, this challenge can seem more daunting than putting a man on the moon.
In order to avoid the analysis paralysis that can result from facing such a monumental task, as a society we need to beware of pursuing the approach where we try to get the one magic solution that will fix everything. It’s tempting to look to our leaders in government and industry and expect them to come up with the panacea for our woes, but if the financial crisis hasn’t taught us the error of this approach, nothing will. If we are going to improve the healthcare system, the fastest (and arguably the most effective) way to do it is incrementally and based upon a process of natural competitive selection. Like the process of evolution, if we simply allow the system to change at the microscopic level – enabling the various players to try out new things, judiciously measuring results, keeping those new characteristics that work and eliminating (and learning from) those that don’t – we can begin to move towards the healthcare model of the future. This is the model that the State of Massachusetts has embraced with their healthcare reform act, and the model that the European Center for Connected Health is following in Belfast. If we are unafraid to take bold, decisive action – and then critically scrutinize the results of those actions without fear of finding our own mistakes – then more effective healthcare paradigms WILL be found, and their success will be obvious to the rest of the market, who will (one should hope) follow the lead.
Entrenched forces that are not willing to change need to make a decision: lead, follow or get out of the way. The consequences of further delay are far too costly.
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Not only are delays costly, but the amount of capital investment being done for questionable returns is really becoming a primary deterrent to continued investment in HIT. But it all comes back to value and maximizing ROI. Too many projects trying to build things where the outcomes are impossible to measure up front. Incremental change allows us to build tools that are very lean and clearly address the issues at hand, tackling only problems where we know value is lacking today. Trying to boil the ocean leaves us with a few problems solved and a lot of money spent in places where the problem wasn’t fully understood or the need not adequately measured.