Health care is vital to society and has also become a potent economic force that is nearly 18 percent of the U.S. GDP, according to the World Bank. But the expansion is outpacing inflation.
And even as life expectancy has improved recently in the U.S., in most causes of premature death U.S. outcomes are typically worse than other similarly developed countries. According to the Conference Board of Canada, out of 16 developed countries, the U.S. ranked last with a score of D.
Whether from the point of effectiveness or economic stability, something has to change in how health care is delivered in the country. Harvard’s Forum on Healthcare Innovation — a joint project of Harvard’s medical and business schools — undertook a survey and study. The effort resulted in five suggestions — “key imperatives,” the group called them — that managers in the field and people studying for an MBA health care degree should consider.
Make value the central objective
Attention on health care is often split between controlling costs and improving outcomes. However, the public needs and expects more. Better outcomes won’t matter if people cannot afford them, and reduced costs don’t help if outcomes degrade. Energy and innovation must be directed at these combined problems. The legacy approach is not working. There needs to be coordination of care and the industry should share information to avoid wasted duplication of efforts.
Promote novel approaches to process improvement
As the old saying goes, repeating the same actions and expecting different results is a form of insanity. Rather than focusing primarily on new treatments, drugs, and devices, the industry should begin continuous improvement of processes, learning from mistakes and improving previous efforts. Executives and policy makers will need to design incentives to encourage improvement in how vendors, providers, and patients take part in the system.
Make consumerism work
Many interests harness consumerism effectively by focusing on the delivering value to the customer, not to the company providing a product or service. The same must happen in health care, with a focus on providing value for the patients first rather than making the needs and interests of caregivers of primary importance. Patients must also become active participants in managing their health.
Decentralize problem solving
Centralized problem solving might sound efficient, but business has shown that it can be a big mistake. People at the top of an organization are typically far removed from the actual operating conditions, the pressures, and insight into what might actually help. Using better use of non-physician personnel, like nurse practitioners and physician assistants, could help control costs. Physicians should have access to many technologies that might previously have been the province of expensive specialists and hospitals. Innovation also needs to be expanded outward.
Integrate new approaches into established organizations
Finally, improvements only work if they are used. The established structures of treatment, payment, and product development must join in the changes necessary for the health of the entire system. That also means collaboration with community organizations and accountability in maintaining the health of communities.
It’s a challenging and exciting time in health care. Managers who understand the changes necessary and take part will not only enjoy professional success, but the deep satisfaction of having left the world a better place.