Healthcare integration is an important path to greater efficiency and effectiveness. There are two basic types of integration: electronic and organizational. Although both are critical to long-term success, neither can ensure that the interconnection of hospitals, physician offices, clinics, labs, insurers, and others will work more smoothly.
Technology can help, but it is not a silver-bullet solution. Unfortunately, too many healthcare organizations have addressed integration through a series of acquisitions without the necessary structural changes, resulting in what becomes nothing more than overlapping individual silos of practice. The result is a mess. Here are some of the common problems:
- Medical practices aren’t actually integrated with each other or the hospitals.
- Providers and hospitals have competing offerings and capital spending.
- Decision making can take longer without clear lines of authority and responsibility.
- Best practices don’t spread through the system.
According to Laura Jacobs, an executive vice president at healthcare consultancy Camden Group, there are six fundamental steps an organization must pass through to approach the needed level of structural integration.
- Get the strategic plan straight. Integration must be a strategic issue, not a tactical one. Bringing together all the parts of a healthcare system becomes a priority. Not only must that happen on a top level of acquisitions, but on the more intermediate levels of clarifying how each business unit fits into the whole. Service portfolios, resources, and capital spending will need to fit within an overall plan.
- Unify operating plans. Integrated operations need unified operations. Functions that can be centralized should be. Some would include recruitment and talent management, risk management, patient safety, and staff training. There should be single pricing and payer strategies across all the facilities.
- Management and governance need a systems focus. A series of acquisitions can result in a confused organizational mess in which managers, governing boards, and committees aren’t sure who is in charge. Emphasize clarity in that regard while recognizing that you may need different people in roles because of the expanded operational breadth and responsibilities.
- Benchmark and spread best practices. With the growth of the organization comes the need to understand how well exactly it is performing. Dashboards and other types of overall reporting should tie in to sources of benchmark data so business units and functions see how they are performing in context.
- Make incentives support system success. Incentives that might have been effective can cease to be after a major change in strategic focus. Incentive programs should encourage participating executives and employees toward goals that support the entire system and not just one part of it. Balancing individual versus overall performance expectations is difficult but critical.
- Drive change. No change happens without support at the top. That will include executives, of course, but also individuals who are leaders within the organization. Following a course will be difficult as many people will resist, looking for their old positions.
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