2019 June

Design for disruption

Streamline processes or anticipate the disruption that is going to happen and design for it?

I was at a digital health event last night and one of the companies presented the new process that would be enabled by their technology. It was better but only modestly better. 

What it didn’t consider is an engaged healthcare consumer, patient or member. People everywhere in the world are trying to self diagnosis themselves with online information and studies. That trend is going to continue with the number of free apps, wearables and tests that are engaging people in their own health.

As an industry, we can’t put the genie back in the bottle. We need to anticipate what people are likely going to do and design for it.

Disruptive tech companies study how people use their technology and hook them by making their solution even easier to use. We need to take that mindset into process design and design for how people actually want to use the healthcare system.

Dated gatekeeper models are not going to work in the era of an engaged consumer, patient and member. People will circumvent processes that are long and difficult. It’s the work around that we all do in corporate America. So why would we expect anything different in a healthcare service?

A good plan

Five tips for physicians trying to push their initiatives through the healthcare systems.

I read a summary proposal prepared by a MD today that fell flat with the Hospital Administrator. It was missing the essential information needed to evaluate viability.

I provided some feedback and thought other MDs might benefit from some general feedback too.

1/ State the problem. What’s wrong with the status quo? Tell the story about how patient’s are being negatively impacted by the current treatment and/or service.

2/ Describe the future state. What would the new treatment and/or service look like, how would it be enabled and who would deliver it?

3/ Provide existing metrics and goals. Back up your plan with data for the relevant metrics.

4/ Resources. What needs to change to enable the new treatment or service? Can you train and redeploy resources or do you need more and/or different types of resources? How hard will it be to train, attract and/or hire the resources needed? How much will it cost? What other resources do you need?

5/ Commitments beyond approval. Who needs to buy into the plan and/or who could enable it because they have existing business relationships etc.? Are there partnerships that would be beneficial?

Improving Quality

I’m reading Stephen Pinney‘s book called How Hockey can Save the Healthcare System and highly recommend it. Why?

The section on Quality addresses one of the most important lessons for Administrators….don’t always trust your reports. Dr. Pinney highlights the problem in his example with the Pre-Operative Surgical Checklist.

According to the Administrator, the checklist was preformed consistently for two years without issue. The problem was that it wasn’t performed correctly. Significant errors resulted and were unreported.

One of the most important lessons that I have learned from working closely with Medical Directors is that they know the business. When they say something is wrong, something is likely wrong. Administrators need to dig into the details to get to the bottom of the issue rather than dismissing them.

Interestingly, Dr. Pinney and I have uncovered the same issue. Data is often missing and when data is missing – the reports are wrong. Administrators need to understand why the data is missing and take the steps needed to ensure it is consistently captured. It’s a matter of life and limb – literally.

According to Dr. Pinney, these types of quality and process improvements are key to systematizing medicine and achieving the third aim. However, it all starts with accurate data.