This year’s IHI Forum provided an opportunity to think deeply about the challenges and opportunities that lie ahead in healthcare. Key themes included implications of the Affordable Care Act, including the need to meet capacity and deliver quality care for an ever-growing patient population as well as the need to cut through all the noise in healthcare and focus on the right areas that will facilitate positive changes to our inundated healthcare system.
The forum was filled with industry gurus sharing their perspectives on the challenges and opportunities in healthcare. I found several of the discussions to be meaningful and wanted to share a few of my key takeaways:
1. Derek Feeley, Director General, Health & Social Care in the Scottish Government shared his experience leading his government through healthcare change. He noted every organization has the same five challenges as it relates to transformation and explained how fixing one issue alone is never enough. To make changes at a fundamental level, economic, demographic, epidemiological, population health and managing expectations all must be taken into consideration.
2. Dan Health, author, spoke about decision making. According to Health, decision making is not inherently easy for most senior executives, including healthcare professionals. With so many changes required in today’s environment, good decision making is critical. Health noted we need to provide senior leaders with the tools and techniques necessary to make informed, thoughtful and fact-based decisions in a timely manner. This resonated with me because Health’s level of reasoning can be related to the principles of Lean transformation. Health’s methodology is very similar to A3 thinking, mistake proofing and 3P. Health’s four stages of decision making includes:
3. Susan DeVore, President & CEO of Premier Healthcare Alliance, spoke on a number of macro topics, but one in particular stuck with me: the evolution of healthcare. DeVore spoke about two trends that will continue indefinitely: vertical integration and horizontal integration. On the vertical front we will continue to see mergers, acquisitions and partnerships. On the horizontal front we will see more mature managed care models and new services that round out the continuum of care for each respective patient population.
4. The best takeaway for me was during the panel discussion with former administrator of the Centers for Medicare & Medicaid Services, Don Berwick, M.D. Several people shared insights into how to best utilize various value equations to justify healthcare spending. They talked about the numerator as quality or value and the denominator as level of effort or cost, but Dr. Berwick challenged the group to dismiss that theory. His message is that cutting costs is essential to not only the healthcare economy, but the economy as a whole. Because there is no formula that will justify the value healthcare can provide, conversations about “bending the cost curve” are futile. Rather, the focus needs to be on cost cutting, and if we don’t drastically reduce cost immediately, the problem will be solved by more draconian means. I could not agree with Dr. Berwick more.
Mike Chamberlain is president of Simpler North America, and a key player in the formation of Simpler's healthcare practice, which has led more than 150 healthcare systems across the world in the application of Lean concepts and management.