What’s the Fix for Healthcare?

Blog by Colin Hung

This week we are helping our friend and HCLDR community member – Burt Rosen @burtrosen as he prepares for the What’s The Fix conference (hashtag – #WTFix) on Wednesday June 14th. Burt describes #WTFix as:

A free, one-day online and in-person conference dedicated to those working from the outside in to change health care for the better – for everyone!

You can still register to attend the event virtually here (no cost). #WTFix features several members of the HCLDR community as speakers:

There is no doubt that healthcare around the world is less-than-optimal. In his Forbes article, athenahealth CEO Jonathan Bush neatly defines the elements of US healthcare that, in his opinion, are broken:

Healthcare has been broken for some time. It’s been broken by misaligned incentives, by endemic inefficiencies and redundancies, by thousands of well-intentioned regulations and guidelines that have stifled market dynamics, and by our complacency with the status quo. It’s time for a reckoning. It’s time to unbreak healthcare.

It is easy to get a headache thinking about all the challenges facing our healthcare systems – no matter what country you live in. Everyone’s healthcare is broken in some fashion. But if you think hard for a moment, is there one healthcare problem that rises to the top? If you could wave the proverbial magic wand, what is the one thing would you fix in healthcare first?

My first fix would be to eliminate useless non-healthcare costs. This includes money spent on:

  • Lawyers to prosecute/defend malpractice suits
  • Pharmaceutical advertising and promotion
  • Enforcing regulations that have no clinical benefit
  • Marble floors in the lobby

The first bullet requires a little explanation. I believe that people and organizations that provide care should be held accountable. If they fail due to negligence, lack of oversight, criminal malfeasance, etc. there should be consequences. However, in the US especially, launching a lawsuit when you have unexpected or undesirable outcomes has become a cottage industry. The dollar value of settlements of medical lawsuits is such that less-than-scrupulous people see it as potential lottery win and you can’t win the lottery without entering.

The cost to prosecute and defend these lawsuits is enormous – and not just in legal fees. The prevalence of these cases translates into higher malpractice insurance premiums for medical professionals which in turn translates into higher costs to patients. Organizations also have to account for the likelihood of lawsuits and thus have to reserve funds for that eventuality – funds that could otherwise have been funneled into care programs. .

Unfortunately one of the solutions to this problem is tort reform – which for the legal community would be chopping off one of their most lucrative sources of revenue. So the likelihood of reform is very low…and thus the need for the magic wand.

In his article, Bush outlines four fixes to healthcare that he would like to see:

  1. Encourage disruption
  2. Build a connected continuum (interoperability)
  3. Align incentives to focus on outcomes
  4. Restore humanity to the moment of care

These are similar to the areas of focus in the Quadruple Aim of healthcare – a modification of the Institute for Healthcare Improvement’s Triple Aim initiative:

  1. Better Outcomes
  2. Lower Costs
  3. Improved Patient Experience
  4. Improved Clinician Experience

In lieu of the magic wand, what can we do to help fix healthcare? One thing that we can all do is raise our collective voices. We can advocate for our loved ones while they are in the healthcare system. We can tell our healthcare stories publicly so that others can be inspired to tell theirs. If we raise enough voices we can chip away at the problems within healthcare.

Social media is obviously one of the easiest and best ways to share stories and raise your voice. When I met Burt Rosen at the HITMC17 conference earlier this year he mentioned to me that social media was one of the main sources of inspiration for #WTFix. It certainly was through social media that Burt recruited the great lineup of speakers. But is social media the only channel available? Are there other ways that our collective voices can be heard? Is there another medium that is available to share patient stories?

Please join us on Tuesday, June 13th at 8:30pm Eastern (for your local time click here) as we discuss the following topics:

  • T1 What aspect of healthcare is most broken/What would you fix first? Why?
  • T2 What solution, technology or process do you feel holds the most promise for fixing healthcare?
  • T3 Is there an effective alternative to social media, for patient advocacy? Or has SoMe supplanted all other channels?
  • T4 Patient stories are powerful, how could their impact be increased without saturating the space?

References

“Fixing health care from the inside, today”, Spear SJ, Harvard Business Review, September 2005, https://hbr.org/2005/09/fixing-health-care-from-the-inside-today, accessed 10 June 2017

“Want to help fix health care? First you have to care about costs”, Chris Trimble, KevinMD.com, 11 January 2016, http://www.kevinmd.com/blog/2016/01/want-help-fix-health-care-first-care-costs.html, accessed 10 June 2017

“Four Ways to Heal our Broken Healthcare System”, Jonathan Bush, Forbes, 14 June 2016, https://www.forbes.com/sites/realspin/2016/06/14/four-ways-heal-healthcare-system/#2259654e7748, accessed 10 June 2017

“From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider”, Thomas Bodenheimer and Christine Sinsky, Annals of Family Medicine, November 2014, http://www.annfammed.org/content/12/6/573.full, accessed 11 June 2017

“It’s time for both parties to get serious on fixing health care”, Michael Bloomberg, New York Post, 27 March 2017, http://nypost.com/2017/03/27/its-time-for-both-parties-to-get-serious-on-fixing-health-care/, accessed 10 June 2017

“How to Fix Health Care in a Populist Movement”, Doug Badger, Politico, 10 January 2017, http://www.politico.com/agenda/story/2017/01/how-to-fix-health-care-in-a-populist-moment-000265, accessed 10 June 2017

“How to fix US health care”, Martin Varsavsky, Huffington Post, 6 January 2017, http://www.huffingtonpost.com/martin-varsavsky/how-to-fix-us-health-care_b_13995886.html, accessed 10 June 2017

“Fixing a Broken System”, Adi Ignatius, Harvard Business Review, July 2016, https://hbr.org/2016/07/fixing-a-broken-system, accessed 10 June 2017

“5 scary facts about America’s broken health care system”, Larry Getlen, New York Post, http://nypost.com/2017/05/06/5-scary-facts-about-americas-broken-health-care-system/, accessed 10 June 2017

“More proof our health care system is broken: Opinion”, Nadia Alam, Toronto Star, 7 February 2017, https://www.thestar.com/opinion/commentary/2017/02/07/more-proof-our-health-care-system-is-broken-opinion.html, accessed 10 June 2017

Image Credit

Shattered – Thomas Hawk https://flic.kr/p/btQrqV

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