Accountable healthcare: Can ya get there from here?

Today is Day 1 of the WCBF Annual Lean Six Sigma and Process Excellence in Healthcare Summit.  This isn’t a new organization nor is Lean or Six Sigma a new discipline. There are things, however, that are on the horizon that make this a very important place to be at this moment in the US healthcare saga.

Accountable healthcare is coming. There’s simply no way we will continue to throw money at a system that doesn’t have accountability to the patient, payer or society. Yes, there are three customers of healthcare, each with a different agenda, each just as important in the healthcare story. If we can’t serve two masters…how will we serve three?  Getting to accountable care won’t be easy.

Learning curve

Humans have to go through a process to get to what works. The question becomes, “How much can that learning curve be accelerated?” At ThedaCare in Wisconsin, they’ve made a remarkable journey in Lean healthcare but it has taken twelve years. They’re ready to be accountable as quickly as the market asks them too, but does our system have the time and patience to wait twelve more years to be in ThedaCare’s position?

At Kaiser Permanente, the Health Maintenance Organization model is now two decades old and providing evidence that accountable care exists on a large scale, but they built an organization from the ground up around this model. The rest of industry obviously can’t start over or from the ground up.

Roadmap to accountability

What healthcare needs is a roadmap. That roadmap needs to be in the form of a process framework that helps us to get from here to where healthcare needs to be. A framework isn’t a new idea…it has been around in other industries for a while and has a long-standing reputation for accomplishing the following:

  • Standardizing the language of accountability
  • Defining a target future state for new services
  • Allowing for gap analysis and prioritization
  • Defining touch points for the accountable network
  • Providing a place to ‘hang’ metrics
  • Defining the way jobs are restructured and redesigned
  • Benchmarking in an apples-to-apples way between organizations
  • Tackling waste and inefficiency so that ACO ‘works’
  • Keeping compliance intact through organizational seismic shifts
This roadmap can be adopted in part or whole, and can be initially overlaid as a reference model before it becomes an operational one. Most importantly, we need to get started on this model before everyone is forced to reinvent the wheel

Categories: Disciplines, 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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3 Comments on “Accountable healthcare: Can ya get there from here?”

  1. May 16, 2012 at 8:22 am #

    Healthcare is something like 17% of GDP. There are lots of entrenched interests who like the system today: insurance companies, hospitals, physicians, … The key to the pace and shape of change will be the WIIFM (what’s in it for me) for each of the major stakeholders. How can politics be factored into the discussion?

  2. Ron Webb
    May 16, 2012 at 8:48 am #

    I think the biggest gap right now for healthcare is the gap between how they currently provide services and how they need to provide services. For most facilities and systems it is 180-degrees from their current operating model.
    Having that roadmap to show what activities need to start, stop, or change to move from the current fee-for-service (manufacturing) model to the future fee-for-population (accountability) model is vital. Not to mention offering a clear view of the accountability required to make the change. Who is going to be responsible for starting, stopping, and changing those activities can be murky without a clear method for applying accountability.

  3. May 16, 2012 at 8:51 am #

    Ron, spot on. Going from fee-for-service where healthcare is paid for more work, to accountability (fee for quality) where healthcare is paid for less work, is a quantum leap and using ‘risky’ and ‘fraught with problems’ to describe it is gross understatement. AQPC has an enormous role in this.

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