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The promise of integrated healthcare

Posted Jan 08 2010 11:36am

By Rick Norling
Retired CEO, Premier healthcare alliance

In the early 90s, ten health systems came together with faculty, including Steve Shortell, David Anderson, and the late Walt McNerney, to explore integrated care in the Health Systems Integration Study (HSIS).

For those participating systems, it was a tremendous learning experience and many great ideas were implemented.

At Fairview Hospital and Healthcare System, in Minneapolis, the idea of functional integration of pharmacy and lab across the system reaped notable results: 28 lab contracts across the hospitals and clinics were consolidated into 1 and a retail pharmacy initiative began which now links 30+ pharmacies with Fairview clinics and hospitals.

Likewise, clinical service line integration proceeded and was enhanced by the merger with the University of Minnesota Hospital and Clinics.

This story has been duplicated and enhanced in multiple health systems across the country.

So much of the cost and harm in the current system can be mitigated by reliable execution of the clinical evidence and effectively managing the handoffs between levels and sites of care.

Pending legislation is focused on providing access to the uninsured and reforming the health insurance market…both very desirable, but potentially compromised by an ineffective delivery system.

Concepts such as bundled payment, ACO’s, and value-based purchasing have surfaced but need to be accelerated or cost will continue to spiral out of control.

We need to focus on the goals that will really make a difference, including access and equity.

We need incentives and appropriate regulatory relief to encourage accelerated efforts by health systems.

Enlightened leadership in all sectors (healthcare and government) has a great opportunity in 2010 and beyond.

 

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