Executives Ponder Future Healthcare through a New Lens

On Thursday and Friday of last week, I had the pleasure to attend the HIMSS Leaders & Innovators event in Florida.  Designed as an executive retreat for senior health leaders in the provider setting, we engaged in highly thought-provoking discussions about what it means to truly transform our health system. 

If a hospital’s financial viability is dependent upon daily census, and knowing that payment reform is happening all around us, how can a senior leader literally transform the business of a hospital? 

A very similar question faces executives in ambulatory settings – if the current business model is based upon billing for as many patients as is possible in a single day, how in the world can that business be transformed into patient-centered care?

We focused on the power that IT can bring to the discussion.  Using analytics to understand the dynamics of the business, engaging on an entirely new level with patients and consumers using e-communications, the innovations pouring out of the mobile space – the possibilities are exciting.  And, scary. 

Say, for example, you’re a physician.  As a demographic, physicians tend to be leaders, and our existing system’s approach has the physician in the center.  Now, there’s all kinds of chatter about putting the patient in the center of the care scenario, using decision support systems, and making clinicians accountable for the care they provide. 

Using the current paradigms of how care is provided and paid for, those conceptual ideas can be difficult to absorb.  After all, these are the same patients who don’t take their medications as prescribed, and the same doctors who never asked for a “support system” to make a decision.

What it takes is an entirely different way of looking at things. 

At the Leaders & Innovators event, Mark Bertolini, Chair, CEO and President of Aetna, provided his vision that “convenience is the new quality.”  He clearly articulated his reasoning, and actively engaged with the leaders in the audience in a lively give-and-take.  I was struck by Larry Holly, MD, CEO, of SETMA – a Davies Award-winning ambulatory group in Texas.  Dr. Holly, who has transformed his practice into a patient-centered medical home, wrestled with Mr. Bertolini’s assertion, and questioned him closely during the exchange.  Afterall, the clinician’s role is not to humor a patient – it’s to work with the patient to restore him/her to health. 

Dr. Holly’s assessment is as follows:  “As SETMA became a PC-MH, we came to see that coordination translates into: (1) convenience for the patient, which (2) results in increased patient satisfaction, which contributes to (3) the patient having confidence that the healthcare provider cares personally, which (4) increases the trust the patient has in the provider, all of which (5) increases compliance [adherence] in obtaining healthcare services recommended, which (6) promotes cost savings in travel, time and expense of care, which (7) results in patient safety and quality of care. 

It was only through this analysis that we accepted convenience as a worthy goal of quality care as opposed to it only being a means of humoring patients. This process fulfilled SETMA’s goal of ceasing to be the constable, attempting to impose healthcare on our patients; and, to our functionally becoming the consultant, the collaborator, the colleague to our patients, empowering them to achieve the health they have determined to have.”

It is these types of illuminating conversations that helped all of us to look at the delivery and payment of care through a new lens. 

HIMSS, as the transformative leader through the best use of IT, took an important step last week.  By engaging directly with executive leadership of health-related organizations, we can open all our minds, unleash our creativity, and engage in valuable intellectual debate. 

I welcome your thoughts and encourage you to respond to this blog entry. 

What transformational ideas do you have up your sleeve?