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April, 2012 | Healthcare Revisited

Healthcare Revisited

Consider how healthcare should be…

What’s the difference between healthcare and Cinderella?

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Glass slipper

Healthcare and Cinderella

The US healthcare system is facing an eminent change in its business model. Over the last several decades, through poorly aligned reimbursement systems and convoluted, market distorting subsidies, the business of our delivery system has become the filling of hospital beds. Sure, as a group, healthcare is filled with people who want to provide quality care, help patients, and improve outcomes, but that’s not what we get paid for. The vast majority of money in US healthcare is made by filing hospital beds, and by shortening length of stay.

In just the last decade, there’s been an increasing awareness of how broken our system is. We pay 2-3 times more than any other developed nation, and we have very little to show for it. In terms of performance, the World Health Organization ranked the US system 37th in the world; just above Cuba and Slovenia, and just behind Costa Rica and Dominica.

With the increasing visibility of how broken our system is, and the increasing industry awareness of the fact that the business models that have led to this travesty must change, you would think that more delivery systems would be seeking to shift to a more progressive solution. In an effort to help communicate part of why we’re moving so slowly, I wanted to share an analogy.

Let’s start by imagining a healthcare delivery system, all dressed up in a ball gown and glass slippers. Sould a little silly? Stick with me for just a minute more…

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It’s NOT the patients’ fault! Stop whining and fix it.

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Whining baby

Stop whining and make better tools!

Healthcare has to be among the whiniest of all industries. Can you imagine leaders in another industry blaming the consumer for not using their product? Can you imagine what would happen if a product director at GE, or Apple told his boss that the reason his product wasn’t successful was because of a problem with consumers? 

I can imagine it now, “Mr. Jobs, the product is perfect, just the way it is. The reason it’s not selling is because users are just too dumb to realize how good it is.”

It’s easy to see that response is whiny and lazy. They’d be lucky to get back to their desk before they were fired.

So why do we continue to put up with that mindset in healthcare? I recently read an Information Week article from Paul Cerrato titled, “Why Personal Health Records Have Flopped; It’s not a security, privacy, or data-sharing problem. It’s a patient problem“. In the article, he says that the problem with Personal Health Records is consumer apathy. That kind of thinking is no different than the ridiculous scenario we were imagining at Apple. Stop blaming patients, and put in the energy to figure out what they want and need!

Now Paul, just to clarify, I’m not endorsing Colin Evan’s belief that the problem is providers’ unwillingness to put patients in control of their medical data, either. What would a patient do with their medical data if they did have control of it? Medical data takes a lot of knowledge to understand and interpret, and the average healthcare consumer has about a 4th grade reading level (that means that half of them are actually reading below that).

What I am saying is that if we want to successfully improve the healthcare industry, we can’t be satisfied with blaming the patients. We have to take the time and energy to ask “why”. Why are people willing to spend twice the energy picking a TV that they’ll spend picking their doctor? Is it because they don’t care about their health? Personally, I have a much harder time believing that people don’t care about their health, and a much easier time believing that we’ve made crappy tools, that don’t adequately support consumers’ needs when it comes to the complex, confusing, and intimidating healthcare industry.

We need to know that we’re giving people access to good healthcare consumer engagement products that are functional, usable, and hopefully, even desirable. And to do that, we have to stop whining and recognize that it’s not the patients’ fault.