Healthcare and Operational Transformation

I don’t believe, in a 10 year period of time, we are going to appreciably alter the process of actual clinical care.  That is to say, going to the doctor 10 years from now is not likely to be a different experience than it is today.  If we think back 25 years to our experiences with medical care, there has not been significant change… despite, the trends of patient centered care, HMO’s and a barrage of other well meaning clinical care trends.  I think there are a number of characteristics of “medical care” culture that make altering its behavioral and cultural paradigm very difficult.  It is ultimately a very fragmented professional body… many individual professionals and numerous practices without a technology to appreciably facilitate a change in clinical practice behavior.  The real estate profession was similarly locked into a specific behavioral trend for many decades until the internet forced a change in practical behavior.  The clinical lobbies and commercial enterprises invested in clinical practice not changing are considerable.  So how can change really be affected?

I believe it lies in the realm of the business operations of medical care.  The costs associated with operations, although inexorably attached to the process of clinical care, are not intimately embedded within clinical process.  Additionally, while it would not be reasonable to mandate a massive change in the process of clinical care, it would be reasonable to mandate an alteration in operational practice.  While there has not been a technology that has fundamentally altered clinical practice (more data can be shared and more experts can consult through better data access but without appreciable alteration to actual clinical process)… there are technologies available that can dramatically alter the process of operational management.

Research is now proving the investment in CPOE and clinical systems while a necessary investment for reasons of data preservation, sharing and utility, are not providing appreciable savings in either operational or clinical process.  Rosenblum’s blog on “Hospital Operating System” highlights such a solution.  I also work at StatCom with Jim. 

The system needs quantum change.  At the end of the day, I firmly believe there is a solution to the issues the healthcare debate is chasing.  Mandating changes in clinical practice or the cultural expectations for medical care of the US patient population is not the answer.  Quantum change is achievable through the operational transformation of the delivery of medical care.

Change the operational processes that surround the clinical activities of our healthcare professionals.  They already lead the world in care and innovation…  It is unreasonable to expect a quantum change in costs to be achieved through a clinical or cultural revolution in the short term.

Operational transformation… that’s the key.