I posted the following comments on the Intel Health Care blog dealing with the topic Healthcare Reform: Too Big To Fail (Eric Dishman) and the need to seek new ways of approaching solutions here - my comments were published on Feb. 17, 2010.
Feb 17 | Paul B. Silverman said:
Let’s keep the discussion going here- good exchange of ideas.
We all know we have serious problems in our health care system and need some new thinking here. I am pleased to offer the following thoughts:
Most of our current health care debate starts with questions about what new applications can be developed using new technology, e.g., mobile apps, home telehealth, remote patient monitoring, WBAN’s, Zigbee, other wireless technologies and so on. But the real starting point should be what are primary and secondary business processes and key metrics that define our health care system. After this is defined, the secondary question is what is recommended process changes,what technology works best, what is cost benefit and ROI
The above is ‘Business Process Re-engineering 101’ – don’t be seduced by technology that is not driven by a strong business model that secures management support. We learned that lesson years ago with Electronic Data Interchange (EDI) and e-commerce promising to reduce cost for paper-based transactions. (I played a key role in C&L,, Booz Allen and also served as US CEO for a Netherlands based global management consulting company addressing these areas). Real savings came from changing business processes- many of the 100+ EDI technology companies that entered the market at that time missed the mark. I see many parallels with today’s health care technology market.
Consider hospital operating rooms which many do not know are a profit center within hospitals. Studies suggest these facilities today operate at less than 60 percent efficiency. Why? Changes or delays in patient admittance means facilities become available but this information is useless unless it can be managed, disseminated and acted upon to reschedule surgeries, identify the location of hospital assets and maximize use of resources. Imagine a hotel where a cancellation occurs and it takes hours to reschedule other customers to use the room. These problems occur in every sector today and are solved by robust, agile information systems driven by well proven business process re-engineering techniques. Think about the positive impact of a national initiative which offers incentives to modify processes for reducing total hospital costs by 5 percent, and this is a conservative target.
Many statistics confirm that other nations are doing a better job in efficiently delivering high quality health care services.
As one example, I look at Sweden’s ‘Sjunet’ e-health network supported by a secure national information infrastructure which also includes remote patient monitoring, early disease detection and even predictive analytics applications to assess long term disease patterns and treatment protocols. In early 2009, I was invited to participate in an Israeli hospital management venture which used Israeli logistics 'best practices' to optimize scheduling for all perioperative procedures to efficiently handle large patient volumes - these same new processes have excellent applications in US hospitals. Note the starting point here is advanced logistics, identifying process ‘hot spots’ ,quantifying benefits and then developing the technology solution. We have many lessons to learn looking at how others are effectively addressing national health care issues
In April 2009, the Senate Finance Committee addressed the EHR issue in their report ("Description of Policy Options: Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs') proposing to measure EHR use by physicians and hospitals with Medicare/Medicaid incentive and penalty payments. While maybe a good start, I found it disappointing this document has 48 pages and only 2 pages address 'Health IT' policy options. We need to pursue some bolder options here if we are to address the depth of problems and capitalize on global best practices.
I recently read a report that we have been pursuing the objective of implementing new clinical information systems for almost 40 years, and yet we still have, at the maximum, about 18 percent physician and clinician adoption. The message here is very clear – we need to do a much better job in defining processes, key performance metrics (KPIs) and benefits. Technology is a means to an end to achieve what should be our real objective - change health care business processes to improve operations, improve quality of service and reduce costs- driven by a strong national initiative, I believe that is the winning formula to dramatically improve our national health care system.
Paul B. Silverman
Executive Advisor
I can be reached at pbsgdc@gmail or via my blog at http://nextgenentrepreneurship.blogspot.com/
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