Wednesday, July 30, 2008

Interview with Health Care Buzz Word Expert

Medinnovation: Are you a health care buzz expert?

Buzz Word Expert: Indeed, I am. My remarks will reek of transparency, interoperability, transferability, the scholarship of quality and will be evidence-based and digitally-supportable.

Medinnovation: Well said. Can’t ask for anything more than that. But what exactly is a health care buzz word?

Buzz Word Expert: It is a fashionable word or concept associated with health care not understood by outsiders. It’s an inside game only buzz word experts can play.

Medinnovation: Could you be more specific?

Buzz Word Expert: Specificity is not the name of our game. The word or concept must be nebulous, noble, notable and express a common good for mankind. It must represent a quest for the Holy Grail. It must be unanswerable, unchallengeable, and smack of apple pie, motherhood, and fatherhood – all expressed in high-order language and words.

Medinnovation: Anything else?

Buzz Word Expert: Yes, the buzz words must be polysyllabic, and it helps if they come in bursts of three that can be used in any combination: quality information infrastructure, interoperable transparent organizations, performance improvement methodologies, evidence-documented medicine, comprehensive coordinated delivery, actionable support systems, implementable interventions, systematic re-engineering, measurable output parameters, and documentable quality indicators. These are admirable examples. The concepts have to be big, and the words have to be big too.

Medinnovation: It there any room for verbs?

Buzz Word Expert: Of course, Everything must be integrated, coordinated, digitally organized, universally applied. There is no space here for individualism.

Medinnovation: Why can’t you just use simple concepts and simple words for doctors. You might say, for instance: This is the right thing to do. Here are end points to aim for. Here is how to make patients healthy and well. Here is a check list to follow in your practice?

Buzz Word Expert: That is much too transparent and too easily understood by doctors, who we try to keep as “outsiders” in the quality game.

Medinnovation: Who are the “insiders?’

Buzz Word Expert: The “insiders” are outside experts, middlemen, and managers who must come up with a framework, the profits, the transferable information databases, all of which they can use to intervene to institute improvement in the multiple dimensions of quality to justify their continuing existence.

Medinnovation: Like health plans?

Buzz Word Expert: That’s a good example. Health plans can no longer justify their 10 to 20% administrative load by simply paying bills promptly, easing doctor transactions, partnering with physicians, or paying for people with pre-existing illness. Health plans must do something else to oversee the quality and outcomes processes and metrics to keep patients and their bottom lines well.

The insurers must demonstrate they can cut costs, improve health of members, or enhance quality of care and its various and multidimensional measurements at costs employers, doctors, and consumers will swallow. To care out these noble and irrefutable goals, health plans must manage care by data-mining and preventive and predictive model algorithms in order to splice, slice, dice, parse, and predict what might go wrong and how to make it right.

Medinnovation: But how do health plans justify costs of doing all these things? How do they convince skeptical doctors who have yet to see benefits for themselves or their patients on the ground? How do they overcome doctors’ deeply embedded suspicions that health plans rarely do anything constructive that is tangible in the trenches?

Buzz Word Expert: Health plans combine evidence-based medicine with evidence-based management to implement and intervene to impose quality improvement strategies of the highest order and the greatest magnitude and greatest good for all.

Medinnovation:: In other words, talk big, aim high, and let others walk the talk and absorb the cost.

Buzz Word Expert: Something like that.


Gary M. Levin said...

Brilliantly said. The air in Old Saybrook must have special anti-oxidants and neural stimulators.

The only Buzz I know is
Buzz Lightyear from Toy Story.

How about

premeditated medical malfeasance

Scott Hodson said...

Very creative and entertaining! However, I think that providers bear the brunt of the responsibility to improve the quality, efficiency and affordability of health care.

Many American health systems are significantly underinvested in quality management Infrastructure, Process, and Organization. To achieve breakthrough improvements in quality, patient safety, and resource utilization/cost of care, hospitals and physicians must work together to develop a "world class" quality management foundation that includes:

Strategy: including a clear linkage of quality and patient safety to the organizational strategy and a Board-driven imperative to achieve quality goals.

Infrastructure: incorporating effective quality management technology, EMR and physician order entry, evidence based care development tools and methodologies, and quality performance metrics and monitoring technology that enables "real time" information.

Process: including concurrent intervention, the ability to identify key quality performance "gaps," and performance improvement tools and methodologies to effectively eliminate quality issues.

Organization: providing sufficient number and quality of human resources to deliver quality planning and management leadership, adequate informatics management, effective evidence based care and physician order set development, performance improvement activity, and accredition planning to stay "survey ready every day."

Culture: where a passion for quality and patient safety is embedded throughout the delivery system and leaders are incented to achieve aggressive quality improvement goals.

My firm has assisted a number of progressive health systems to achieve such a foundation, and to develop truly World Class Quality.

kevinh76 said...

That's great, Scott. Now what computer or evidence tells me where to cut to remove an appendix. Boards, and "human resources" don't treat sick patients. Doctors do. Good luck with all that gobblediguck. I can't even read that crap you wrote and I graduated 5th in my med school class . Most likely, you and your firm are just trying to find a way to suck a tiny percentage of the 2 trillion. Annual health. Care expenditures just like so many other organizations.

By the way, the only published study on before and after CPOE shows an increase in mortality after CPOE implemented. And my colleagues with EMR uniformly state that the EMR costs them hours of extra work per day. Those are hours taken away from patients and family. Not so good for productivity. Don't think that you have all the answers because this is extraordinary complicated work.

Do I think CPOE and EMR have a future in medicine? Absolutely! The current systems are not ready for primetime however because of lack of knowledge about how physicians think and work.

Lucia said...

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