My buddy Brad has suggested that I occasionally post something with a little “heft” to it. So, inasmuch as I’m working on a book project to help people become better prepared for the future of healthcare, I thought I’d point out the need for people to be better prepared for the future. Comments, please.
I collected articles and newspaper clipping about the world of healthcare providers. Here’s a sample and thoughts that try to go beyond the simple facts of the story and address the issues of being prepared.
· “Medicare Won’t Pay Hospitals for Errors,” chicagotribune.com, February 18, 2008. The lay person reads this and says “Darned right!” Healthcare professionals think about the reality of dealing with human bodies and the near impossibility of taking these incidents to zero. A person who takes the time to think about the future wonders about the unintended consequences of this action.
One of the truisms of systems thinking is that all solutions inevitably create a new set of problems. Furthermore, these problems usually show up later and in different places. People prepared for the future have to consider the system of which they are a part and how that system reacts (predictably) to bending and breakpoint forces.
· “Innovation in health care: An interview with the CEO of the Cleveland Clinic,” McKinsey Quarterly, March, 2008. The article explores an interview with Toby Cosgrove, MD, the CEO of the renowned Cleveland Clinic. In the article Dr. Cosgrove explains the three seismic shifts he sees in health care. The first is prevention; the second is the drive for value for dollars spent; and the third is that healthcare providers are being judged on the patient’s total experience, not just the clinical outcome. In order to address the third shift, he hired a chief experience officer “whose entire responsibility is to look at the hospital experience from the eyes of the patient and to translate that message back to the caregivers.”
Some hospitals have a tax status of “for profit;” others a status of “not-for profit.” But all hospitals are a business that competes for patients. Healthcare providers prepared for the future will consider their “value promise.” Why should patients come to your organization? Transparency of the total experience will only increase in the coming years, especially with the generation who “Googles” everything.
· “Health Care that Puts a Computer on the Team,” The New York Times, December 27, 2008. The article describes the Marshfield Clinic an early adopter of health information technology and how it is a forerunner of medicine’s “digital future.” Much of the article goes onto explain the advantages of electronic medical records and how the Obama administration sees them as necessary. However, midway in the article it shifts to an examination of “predictive medicine” and the impact that it could have on the health of the population and the reduction of health care costs.
We’ve been down this technology road before and should know to think about the second and third order effects of a new technology. Leaders who are prepared for the future often have a great sense of the past. The invention of radio did more than replace local singing groups – it enabled changes that ranged from national advertising to Blitzkrieg warfare. Electronic medical records will do more than replace paper records; and predictive medicine is only one of the more obvious effects. Be prepared for the future by learning how to “look across time” and really learn from history.
· “How to Revive Health-Care Innovation,” Harvard Business School Working Knowledge, March 9, 2009. Clayton Christensen is a respected innovation guru and he has recently set his sights on evaluating the world of health care. He states that business model innovation, one of the three enablers of industry disruption, was common in health care until about thirty years ago. If he’s right, and we think he is, the current ranks of managers and executives are only beginning to feel the pressures of industry-wide disruptive innovation.
Leaders can prepare for the future of changes in their industry by analyzing the changes that other industries have experienced before them. Health care leaders like to remind us that “they don’t make widgets.” True; but human nature is pretty consistent, irrespective of the nature of the work to be accomplished. Do you want to prepare for the future health care innovation? It might not be a bad idea to analyze the reactions of people in industries ranging from automotive to consumer electronics to newspapers. Patterns emerge that might be helpful.
· “Scalpel, suture and tweet: Surgery in 140 characters,” Chicago Tribune, April 8, 2009. The article explains how a spokesperson for a hospital in a Chicago suburb tracked the progress of an operation and sent “tweets” to a group of “followers.” Why? Because the hospital is experimenting with social networking as a marketing tool. Think this is silly? Questions came in from as far away as Switzerland.
Like it or not, different groups want different styles of communication. In a broader, more connected world, prepared leaders will have to flex to the needs of their stakeholders. Great thinkers always consider multiple points of view and what you see may not be comfortable. Like it or not.
· “Virtual colonoscopy at center of policy debate,” Los Angeles Times, April 18, 2009. This article presented the pros and cons of paying for virtual colonoscopies and whether or not they are effective and saving money. Toward the end of the article the author explains that some studies have shown it to be pretty good but others “have suggested that it is not as good as detecting some smaller polyps.”
Ask yourself another question: “Is this as good as it will get?” Remember your first “car phone” or bag phone? How fast did they progress? Preparing for the future requires the ability to develop “impact maps” of current technologies and mentally play-out paths of progress. Die hard technologies generally assume the impact of a new technology sooner than it actually happens. But many of us get “surprised” by how fast technology progresses. Learning to assess varying “winds of change” is essential to thinking about the future. And technology is one of the winds affecting health care.
· “Health care options focus on paying hospitals and doctors for quality, not quantity,” StarTribune.com, April 28, 2009. This was an AP article that gave an overview of the announcement of the Senate Finance Committee as they prepared to go into closed door discussions. In the announcement they quoted Senator Max Baucus, the Finance Chairman: “The key to healthcare reform is delivery system reform – reimbursing providers on the basis of quality, not volume.” Here are our questions: How would a liberal interpret that sentence? What about a conservative? What about the CEO of a hospital? Without solid critical thinking skills that sentence is wide open to interpretation.
Now is not the time for uninformed opinions. Now is the time to think about the future and preparing for the future requires solid critical thinking skills. A key skill is the ability to ask GREAT questions. What assumptions are being used? What’s the scope of the “delivery system?” How does he define “reform?” He’s presented the problem in terms of a solution. What’s the real problem and what are the root causes of the problem? And on, and on. Preparing for the future requires an understanding of today and that requires more than opinions.
· “A doctor in your pocket,” The Economist, April 18, 2009. The article explains how cell phones are being used in sub-Saharan Africa and part of Asia. The applications are simple, such as self-reporting and getting messages from a health care provider. However, the power of the story comes at the end when the article mentions the cell phones as part of a “global surveillance system” that can be used for prediction.
We have no data from the future. However, we have been blessed with imaginations. Unfortunately, many adults have disconnected their imagination in search of “the numbers.” Being prepared for the future requires a fertile imagination and adults need to rebuild what they had aplenty as children. Not only can it be done, it has to be done.
Healthcare will account for over 15% of GDP in the coming years. What do you think they need to do to be prepared?