By Dr. David Butler, Vice President for Information Services,
EHR Optimization and Transformation Initiatives at Sutter Health
When you think about the future of healthcare, you may not picture roaring engines and screaming crowds. How can a sport that involves stock-car sprints around an oval track have anything in common with how we deliver healthcare in the United States?
Consider this: the synchronized precision of a pit crew in action. Men and women in bright, multicolored jumpsuits swarm a vehicle, each with their own specific task, but working so well together that roughly 14 seconds later, their work is done; the car is speeding away. The pit stop is choreographed so meticulously, so precisely, that each individual role must be practiced thousands of times until perfection is reached.
Even though a typical hospital visit or doctor’s appointment usually lasts more than 14 seconds, there is much that those of us in the healthcare industry can learn from this model. A high level of cooperation and communication that puts the “patient” at the center of the process is the ideal that we should strive for as we continue to improve our healthcare system.
According to a Council of Economic Advisers (CEA) report, U.S. healthcare costs currently exceed 18 percent of GDP and are projected to rise sharply. It states that if current trends continue, that percentage could increase to 34 percent by 2040. This is a sizable portion of our economy, yet what are we getting for such a large investment? How are we measuring the benefits of what we do?
Currently, our healthcare system is largely a business that some say is “incentivized” by the volume and variety of services provided. It has been historically physician centric and reactive, focused on treating each patient with care customized for various diseases and symptoms. Patient records were paper-based and difficult to share; research studies were extremely labor intensive and time consuming.
Things have rapidly changed in the past few years with the help of technology. Electronic documentation allows for easier and faster communication and information gathering. Care models are moving toward a patient-centric focus. Quality measures of care are becoming more transparent to the patient, i.e., consumer. Given the increase in deductibles and intensified competition, providers are scrambling to convert to more of a “retail” model of care that will attempt to provide a higher level of interactivity with patients. Reimbursements in the near future will be largely based on the quality of services provided, not only on the quantity. There will be more focus on preventative and wellness-based care as well as the health of “populations” of patients with key diseases and symptoms.
I believe that we are moving in the right direction, but we still have a few more laps around the track to go. My hope is that we can continue to innovate, to redesign the American healthcare system by focusing on important areas for improvement that the Institute of Medicine, the Agency for Healthcare Research and Quality, and many others have shown to be effective.
Working together, we can create a system that is fully patient driven and transparent, with collaboration among patients for solutions. Compensation will be tightly aligned with quality, service, and affordability, with transparent pricing in an increasingly competitive marketplace. Care will be population based, re-engineered to put the patient at the forefront, and delivered by integrated teams. Technology will allow us to meet patients wherever they are and intervene early based on algorithmic and predictive models. Electronic health records will continue to evolve from just data collectors to “provider coaches” with connections to other sources of patient information.
How do we get there? I believe we can take some lessons from other industries. How have the airlines managed to deliver high quality and reliable service under such regulatory scrutiny—with an emphasis on accountability, and process improvement efforts to drive out waste. How has the banking industry handled remote and mobile access and 24/7 self-service retrieval of resources—through aggressive reallocation of work to the maximum of licensure, and the use of international technical standards. The restaurant industry’s employment of surveys and point-of-service communication tools as well as customer service standards are relevant as well. The technology and gaming industry has much to teach us with its focus on software usability, intuitive user interfaces (UI), and overall user experience (UX). And yes, even stock-car racing can show us a few things, including how to work in highly effective teams.
The independent “cowboy” model of medicine—where the physician is at the center of all activity and largely works alone—is ineffective. We need the collective efforts of a cohesive team to provide the best possible care. Now let’s get down to the track and get to work.
About the Author: Dr. David K. Butler is the Vice President for Information Services, EHR Optimization and Transformation Initiatives at Sutter Health. His current range of responsibilities includes strategic optimization of people, processes, and technology pertaining to the implementation, stabilization, and ongoing utilization of the Epic Systems Electronic Health Record (branded “Sutter EHR”) by clinicians throughout the Sutter Health system. This article was originally published on the Spok Blog and is republished here with permission.