Excerpt: As a health care reform package rumbles through Congress, how can we judge its potential to make things better? Here are four questions to ask.
1: Is the coverage problem separated from the problem of providing low cost, high quality care?
2: Are normal costs separated from catastrophic situations?
3: Can payers and patients identify the best sources of value and choose among them?
4: Do providers have incentives to provide the right care in the right way effectively and efficiently and are there penalties for poorly delivering value (a far different question than pay for performance based on subscribing to protocols).
If so, we have a chance for success. If not, more money will be wasted providing care that is inadequate, denying care to those who need it.
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Excerpt: What is hard about running a marathon? Not the 26.2 miles itself but the discipline over six months before. Train 4 to 5 times a week, intently pushing the boundaries of endurance, speed, and strength, and you’ll finish, and with a good time. Don’t and fortitude will be insufficient on race day.
So too with organizations needing to master high velocity competition, trying to generate unmatchable stretches of high speed innovation and invention. Tightly compress frequent learning cycles and you’ll get better, faster to do much more with much less. Delay, dawdle, and deliberate in lieu of doing dynamically, and you’ll feel like you’re working hard, but actually get nowhere. Read the rest of this entry »
Excerpt: The Obama administration proposes $10 billion/year for five years to encourage electronic medical record adoption. Can money be the main obstacle? The health care sector is $2.2 trillion, 1/2 of which is spent on hospital, clinic, and practices services. $10B is a drop in that bucket. The IT industry runs into the $100s of billions too. There must be some other obstacle for which money is not the solution. What do you think?
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The health care debate centers on the question: Provide more care to more people despite the cost or save money by not providing care? Both sides assume that better care requires more resources implying that we can’t learn how to better put resources to more efficient, effective use. Beth Israel Deaconess (Boston) has rejected the false premise that there is nothing else to be learned about delivering care, highlighting at this week’s Silverman Symposium staff led projects to improve access, patient and staff safety, efficiency, and effectiveness–100 in all.
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