Will a system approach heal medicine?

This is an outstanding TED talk by Dr. Atul Gawande, physician and author of The Checklist Manifesto on how to heal medicine.

“The most expensive care is not necessarily the best care, and vice versa, the best care often turns out to be the least expensive; it has fewer complications and people get more efficient at what they do. What that means is there’s hope.”

Dr. Gawande talks about how the best healthcare is a systems, not a combination of components (like drugs, technologies and specialists). A system has inputs, outputs and processes. It has a focus on standard work and checklists. The following are what define his system approach:

  • The ability to recognize success and failure. A specialist doesn’t see the end result, but a system has an end-to-end view.
  • It can devise solutions. Forget more training or technology, solutions have standard work in process/checklists that make experts even better.
  • The ability to implement ideas by getting colleagues to go along even when it involves humility, discipline and teamwork.

Please take the time to watch and comment. Thanks.


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Categories: Continuous Improvement, Disciplines, Featured, Healthcare, Markets, Process Management

Author:Chris Taylor

Reimagining the way work is done through big data, analytics, and event processing. There's no end to what we can change and improve. I wear myself out...

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7 Comments on “Will a system approach heal medicine?”

  1. Ron Webb
    April 30, 2012 at 6:51 am #

    I think the most refreshing point of this presentation is that there is another physician that is talking about process and process tools.

  2. April 30, 2012 at 6:32 pm #

    EHRs (and HIT in general) must do a better job of representing and managing healthcare processes. They need the best elements from two different, but related, kinds of process-aware information systems: business process management (BPM) and adaptive case management (ACM). Represent process tasks to be accomplished with checklists. Automate routine processes with BPM. Facilitate non-routine processes with ACM. Luckily both kinds of process-aware technology are diffusing into healthcare.

  3. May 1, 2012 at 5:40 am #

    Thanks for sharing this. It’s great to see a physician leader articulate the need for standard processes in healthcare. Loved the pit crew analogy.

  4. May 1, 2012 at 10:04 am #

    Thanks for linking this video. I am a big fan of Atul Gawande. He brings a lot of good common sense to those trying to be successful. It is not about piling all the best parts together, but getting a system that works to apply the appropriate technology at the right time.

    I wrote up a review of his book “The Checklist Manifesto”:

    I am interested in seeing how these idea these ideas work into the methods and tools that we use to support knowledge workers in far beyond healthcare.

  5. May 1, 2012 at 12:17 pm #

    Excellent comments, Keith.

  6. Robert
    June 15, 2012 at 10:46 am #

    I’ve read many of Dr. Gwande’s books and articles. As a process improvement practitioner on the healthcare insurance side of the domain, I’m always listening intently when physicians or hospital administrators discuss process improvement.

    I enjoyed the talk by Dr. Gwandw and have but one criticism. In the opening I believe I heard him lay much of the problem of cost escalation at the feet of insurance companies and the government. Any process analyst in the vertical can tell you the primary sources of cost in the system are the physicians and hospitals themselves. For Dr. Gwande to say such a thing only demonstrates what many in this domain understand; systemic cost controls will only take root when physicians and hospitals take a hard look at themselves and begin to set aside their myopiac, deep rooted perspectives about first causes. Physician, heal thyself…please.

    • June 15, 2012 at 12:18 pm #

      I, like you, tend to think the real waste is in the physicians offices and the hospitals. I’ve witnessed what happens at places like Thedacare when attention is paid to cutting waste and improving quality.

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