The space that matters most

 The rubric is that the country must find balance between efficiency, quality, safety, service excellence and the ability to fund the mission of care through a sustainable margin in a high-cost /high-tech industry. Healthcare delivery must change by our design, it must become more efficient to ensure the preservation of the space that matters most. That space that really counts, the place and moment in time where care is delivered between the patient and the provider. This is the space where a lifetime of medical training, clinical education and experience all come together with focus on life-saving clinical decision making. There is no other option than to become more efficient if that space is to be preserved for future generations, to preserve it for us. What you might not expect or even want to hear, is that space might not be in the location of care traditionally provided. Today we are on the precipice of change in healthcare that will occur at an unprecedented rate over the next decade. Will you be ready ?

With the recent announcement of the Amazon-Berkshire Hathaway-JPMorgan Chase partnership, the topic of increasing efficiency in healthcare is even more relevant. In business economics, the concept is on its surface, remarkably simple. Increase efficiency by increasing the quality and quantity of your product, increase your price, and decreased your fixed and variable costs. Therein lies the rub. Healthcare in its current design and delivery state does not follow traditional laws of economics. If nothing changes the fundamental notion that the current healthcare delivery system can maximize the safest, highest quality most efficient use of its most precious resources its physicians, staff, facilities, in a controlled production output of healthcare is fundamentally flawed.

Today's healthcare delivery and care transactions at the micro-level are riddled with systems and business process complexities. While there is a shift towards outpatient, the incentive system still rewards year-over-year growth in volume for physicians as well as hospitals. Cost of all resources from labor, to supplies and implants, to costs associated with maintaining compliance with regulation, managing the physician plant, and replenishing large capital expenditures are unprecedented. Clinical communication and efficiency in healthcare is not optimized. Burnout in healthcare is at an all-time high among physicians and staff.

Regarding the economics of healthcare, as the industry increasingly shifts towards outpatient, clinical workflows and vital clinical communication challenges will continue to drive costs regardless of care setting. Inefficiency is where error occurs most often, and where the patient experience is left wanting, and the care provider suffers a sense of frustration and at times, a sense of failure. Inefficiency is where margin dwindles, and where the mission is compromised. It's no surprise then that care providers have become expert at designing work-a-rounds and hacks to workflow design flaws because they have no other choice if they are to deliver care to their patient when systems are broken. Market prices, a critical indicator for most industries, is often ever-changing. Increasing out of pocket cost to patients the most recent in a series of blows to revenues. As patients pay more, they pay more attention and reimbursement may not always be reflective of the value of care provided to the patient. Applying traditional methods of driving efficiency in healthcare must also consider supply and demand. Healthcare is unique in that the input is the patient, and out output is the patient, as well as the very outcomes of care delivered. Patients drive the volume, the cost expenditure of providing care, and define value. How patients come to access and utilize healthcare is driven by many factors from geographic / provider and payer access points, to their own lifestyle, social determinate s of health, co-morbidity and very importantly, increasingly, choice. Controlling the production of healthcare has many contingencies, very few of which are under direct control of the current healthcare business model but must manage efficiently and safety always.

To thrive long term, and to be relevant in the future, healthcare organizations must recognize also that the experience of the patient is a crucial element in any healthcare redesign towards efficiency. Any inefficiency that drives cost or variation in care or safety outcomes is an unsustainable model. Get ready, patient experience is and will drive early adoption of disruptive technologies. Real time access to care and clinical communication is an increasingly more attractive option. The space that matters most, the space between the patient and the provider may very well be delivered differently in the future and can be a strong concession when patients choose future location of care. Breakthrough technology will begin to provide real time access to care on mobile or digital devices - the expectations for efficient and safe care is about to be reset in a seismic shift.

There will be those that applaud the recent partnership, those that are concerned and issue grave warning.  Whatever side you are on, if we as a healthcare industry can find a way to keep people healthier, provide care in the right setting with the right skill mix, efficiently, leveraging technology eliminating the noise of unnecessary business process, redundancy, and miscommunication that interrupt care, then that is a recipe for success.  Greater efficiency has the potential of a tremendously positive impact on physician/nurse/caregiver burnout, giving them the time they need to be present in the space that matters the most providing care saving lives and making a difference too. #leadership #innovation #service #safety #hospitals #excellence #healthcare #M&A