dispatches from the new world of work
TP's Healthcare Twenty-seven/December 2005
In preparation for a healthcare client conference call, I hastily jotted down this list of my more or less "beliefs" about healthcare (no particular order, not in order of importance—but main points are BOLD):
- Fully utilize Physician's Assistants to do routine work in a timely fashion. ("Doc in a Kiosk" at Wal*Mart is great!)
- Maximize Outpatient Services!
- Short hospital stays work!
- Support home care to the max. (E.g., "Declaration of Independents"—Beacon Hill/Boston)
- STOP THE 100K+ NEEDLESS DEATHS—much/most of the "quality stuff" is eminently fixable. (Don Berwick for President! AHA for Hall of Shame!) (Strong, vicious insurer incentives!!!)
- FLIP HC 177 DEGREES TO EMPHASIZE PREVENTION & WELLNESS. ("Steps" are being taken but not enough. Med schools: Awful! Insurers: Little better. Support for appropriate-proven alternative therapies is an important part.) (HUGE INCENTIVES FOR EFFECTIVE WELLNESS-PREVENTION PROGRAMS-MEASURABLE SUCCESSES.)
- "Boomers" will determine HC's (very different?) future. (They are from a different & demanding planet compared to yesterday's Oldsters.)
- "Focus on Women." (It's my generic—and correct—rallying cry, and it applies to HC in spades, women-as-patients-with different-woes-than-men; women-as-HC decision makers at the "consumer"—and commercial—level.)
- "Patient/Consumer-driven" may be a buzz phrase bandied about all to easily ... but it is true. (And changes the game.)
- Reduce incentives for unnecessary tests. (Malpractice caps would help, though the issue is complex. Insurers-HMOs doing so-so on this.)
- OUTCOME-BASED MEDICINE IS A MUST! (There is a long, long way to go!) (Measure until you're blue in the face!)
- Science-based medicine is a terrific idea!! (Many-most "therapies" unproven scientifically, uneven in application when proven.)
- Over the next 5-25 years, the Life Sciences Revolution will make the likes of the "info revolution" look like small beer. (Get ready.)
- Radical increase in "best practices" utilization—inculcate in Med school!
- Med school "revolution" imperative—outcome-based medicine, abiding emphasis on Wellness & Prevention, etc.
- Get info to Patients! (HIPAA mostly good.—"I wanna see my records!") (Detailed hospital-by-hospital, disease-by-disease, doc-by-doc success records a must—despite controversy.)
- Upgrade IS-IT in the entire system, starting with acute-care institutions. (Current grade: D-.) (Winners include: Indiana Heart Hospital; Inova Fairfax Heart Institute.)
- Healtheon WebMD-like (if it had worked) mega-, integrated-info network will-should emerge. (A healthcare Google+?)
- MOVE HEAVEN & EARTH TO IMPLEMENT ELECTRONIC MEDICAL RECORDS. NOW.
- By hook or by crook, something approximating basic universal care, starting with kids—50 state partial experiments is a help; some are quite far along. ("Market-based" as much as possible—but this is far from a "perfect market.")
- Deal with the enormous HMO "I want my doc" perception problem. (Fact: MARCUS WELBY, STATISTICALLY, AIN'T THAT GREAT A HEALER IN TODAY'S "HIGH SCIENCE" WORLD! Incidentally, same perception problem re Congress, schools. "My Congressman is great, Congress has 434 other crook-clowns." "My kids' school is good, the system is awful.") · Blitzkrieg of Patient/Customer/Citizen education (e.g., re "outcomes-based HC," "Get the most for your HC dollar"). (Corporate cuts should motivate this.) · "Healing-centric" care supported. (E.g., Planetree model—reduces future problems.) · Emphasize front-to-back "customer care" practices—cuts waaaaay down on malpractice claims among other things. · Specialization in acute care works wonders, regardless of howls! (E.g., Shouldice/hernia repair.) · Shorten the FDA approval process. (Tom, age 63, wants the good new stuff and will accept associated risk; so will most boomers-geezers.) · DON'T MESS AROUND WITH H5N1/AVIAN FLU! Tom Peters posted this today. SINCERELY YOURS
- RODRIGO GONZALEZ FENANDEZ, CONSULTAJURIDICA.BLOGSPOT.COM