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Health Care Needs New Rules to Enable Innovation and Reward Experimentation

Posted Jul 28 2009 11:15pm

(cross-posted on Microsoft on the Issues )<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

 

Technology is playing a major role in helping bring healthcare into the 21 st century.   Many of us have seen it first hand in treatment from our doctors, from MRI scans to laser surgery.  

 

But these clinical advancements represent only a small piece of what technology can do to transform health care.   The power of technology lies in the potential to transform the rest of the health care system, enabling new ways of working and communicating, new economics and new business models.   As consumers, we’ve experienced how technology impacts nearly every other area of our lives -- how we manage our financials, travel, communicate, shop and so on -- with more self-service, more control, more convenience and ultimately better value for what we spend.

 

Similar business innovation and consumer engagement has been slow to reach health care, where many physicians still opt for a pen-and-paper over a computer to maintain patient histories and chronicle treatments.   Patients continue to navigate frustrating and hard-to-understand medical and insurance organizations, physicians don’t always talk to one another about care and medical errors, waste and duplication drain the system of resources.

 

Today, we are finally seeing the first signs of systemic change in health care.   This change was clearly highlighted with the President’s recent visit to the Cleveland Clinic, which has leveraged technology to improve efficiency and health outcomes and give patients an active role in their health decisions.   But the Cleveland Clinic is just one example.   There are other health care institutions -- the Marshfield Clinic, Kaiser Permanente, the Mayo Clinic -- whose leaders have embraced technology to improve efficiency and quality while reducing costs.   And n ewer players are showcasing the possibilities brought by innovation, including virtual care fromAmerican Well and new delivery channels like Minute Clinic.  

 

But we haven’t yet seen widespread change.   The rules governing health care simply haven't allowed this to happen.  Congress created rules that have in fact stifled innovation (e.g. Medicare) by reinforcing volume over value -- reimbursing on a per-procedure basis rather than on the number of patients who remain healthy year over year.   Now Congress needs to look to the organizations that have used technology to create a new health care reality -- such as the Cleveland Clinic -- and develop a new framework that drives value, rewards experimentation and enables innovation.   Only then will we realize the policy goals of increasing access to health carewhile maintaining fiscal responsibility.

 

Reform efforts should focus on enabling the kind of transformation that Clay Christenson describes in his book "The Innovator's Prescription".  He describes how almost every other industry has been transformed -- complex, expensive products and services once only affordable to the wealthy have become accessible to the "masses" and provided by those with far less training.

As I described in my post this week on the Washington Post’s  Health Care Rx blog, real change requires:

  • Figuring out what works (and what doesn't)

  • Enabling supply-side innovation

  • Letting consumers do some of the work that expensive health-care professionals shouldn't be doing anymore

With our ailing economy and worsening health, it’s imperative Congress act quickly and tear down the barriers that exist to enabling innovation.

 

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