Six Innovations to Increase Productivity, Cut Costs, and Extend Coverage

Innovation Number One

Reprinted from Physician Leaders, June 14, 2007

Facilitating patient-physician information exchange as a key of productivity.
Many believe we can’t change the productivity of health care, changing the system would be akin turning around a battleship in a pond. Americans will only accept incremental change. In other words, because of the contrariness and fixed behaviors of patients and doctors, the system cannot and will not change. Besides, they will argue, human interactions take time, are imponderable and immeasurable.

If you believe that, you believe only rationing will cut health costs.
I reject this line of thinking. Instead, I believe soon most doctors' offices will feature information exchange stations. Some will be "virtual," connected to the Internet; others will be "real," located in doctors' reception areas.

These stations may go by various acronyms. Some may be analogues of ATMs, hence ACM (Automated Clinical Machines), and will feature "free" data entry, an important ingredient of clinical productivity. Others may be information shopping centers and may go by the name of EKIE (Engagement Kiosks for Information Exchange). Whatever one calls these information exchange sites, they will have four broad purposes:

•To make it convenient for patients to judge the nature of the practices and their services, view the qualifications and quality of its providers, schedule visits, refill prescriptions, submit personal health cards demographic, financial, and medical data, and communicate by email with their doctor about minor health problems.

•To allow patients to share their complaints and tell their full stories electronically without interruption in a narrative form by using easy-to-understand clinical algorithms, while at the same time, permitting doctors to zero in on patient perceptions without being overly intrusive and saving time and appreciating the complexity of the patient’s problems.

•To give patients realistic expectations about their disease or the procedures that may undergo using automated multimedia presentations--visual, voice, verbal--for patients to view and study in the comfort of their homes and to share with friends and relatives.

•To increase the productivity of the patient-physician encounter and information exchange by saving time and costs for both, reducing the time and personnel costs of data entry, making the transaction more transparent, completing or financial transaction or its credit terms at the point of care, and allowing the patient to leave the office with the histories, findings and treatment plans in hand.