The rise of the medical home model of care and ongoing Lean value stream improvement are among the top healthcare industry trends.
Illustrations: Bill Kline, SmithGroupJJR
I attended the Maryland Association of Healthcare Executives Symposium last fall. It consisted of four panel discussions, all of which were terrific. (Full disclosure: I was moderator for one of them.)
I started doodling as I listened and realized it is all about motion and connectivity. The diagrams below are cleaned up versions of my sketches.
Here are the top 10 issues I heard:
1. Kevin Sexton of Holy Cross Hospital in Silver Spring, Maryland, reminded us that 20% of patients use 80% of the resources and 10% use 65%. Successful organizations must manage these patients and their comorbidities.
2. The notion of sharing best practices across systems will become increasingly important. This “coopetition” requires hospitals and systems to think differently about their intellectual property. Steve Ports of the Health Services Cost Review Commission said that regulations in Maryland will encourage this among providers.
3. The medical home model of care is gaining ground and providers are utilizing it to manage patient care more effectively.
4. All agreed that a collaborative approach between clinical, financial and quality of care leadership will benefit inpatient facilities. Shirley Knelly of Anne Arundel Medical Center in Annapolis, Maryland, put it succinctly, “No outcome, no income.” Systems are linking spend data and procedural data, so systems can identify high cost devices and high cost physicians and administrators can understand if cost savings might be found.
5. All agreed that improving the transition of care from inpatient to outpatient will be critical to success.
6. Metrics will be based on the total cost of care.
7. A new level of focus will be brought to potentially avoidable utilization.
8. The push toward standardized care and clinical variation reduction will be balanced by the need and capability to provide more individualized care—an interesting dichotomy.
9. David Mater of MedStar Health publicizes never events which have adverse effects to patient outcomes within his organization. He feels this humbles the organization, creates transparency and accountability, and galvanizes improvement.
10. Ongoing Lean value stream improvement, while not universal, is utilized at many institutions. It seems both critical and inevitable.
About the Author: As the Washington, D.C., Health Studio Leader, Bill Kline manages some of the firm’s most significant healthcare projects for clients such as the U.S. Department of Veterans Affairs and the U.S. Navy. They include the National Intrepid Center of Excellence in Bethesda, Maryland, and the Center for the Intrepid in San Antonio, Texas, two of the world’s most advanced rehabilitation facilities for wounded soldiers. More posts by Kline.