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Healthcare Information:
Converting Water Drops to a Tsunami

Water Drops Become TsunamiI am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts.
Abraham Lincoln

A free-market system is most efficient when consumers have relevant facts about the products and services they desire. After all, knowing the cost, features and benefits of each consumable good or service is the first step in having informed purchasers.

But unfortunately, this is not yet reality within the U.S. healthcare ‘system.’ A group of highly-imaginative, energetic people armed with the world’s largest chalkboard could not purposely design a more complex, dysfunctional system if they had tried. To put it mildly, our currently-structured healthcare system is so complicated and rife with economic conflict that every attempt to simplify it actually complicates it further.

An April Health Tracking Poll from Kaiser Family Foundation indicates that very few Americans use quality and cost information on hospitals and doctors – and the reasons are numerous. First of all, finding access to updated comparative quality information is a hit-and-miss process, with only 13 percent of Americans claiming to have seen quality information comparing hospitals or doctors (10 percent) during the last 12 months. Of those people, only four percent used the information for hospitals while just six percent for doctors. As for pricing information, a scant six percent saw comparative pricing information for hospitals or doctors in the past year, and only half as many actually used the information.

These numbers are dismal. But the results should not suggest that Americans are indifferent in desiring this information. It is the complexities of our system that are preventing those who seek quality and affordable healthcare.

‘Reputation’ and ‘location’ appear to dominate the choice of providers we use, possibly trumping any immediate urge to seek ‘quality’ and ‘price’ information. For the time being, we haven’t made much headway in the development of reliable quality and price information. This is unfortunate since the healthcare sector sucks up about one-fifth of our economy!

Healthcare data needs a ‘Steve Jobs’ moment. As many Apple products revolutionized social and recreational connectivity through innovation, the creation of a huge data ‘bank’ can revolutionize healthcare. But this will only become reality when we desire to make the connection of quality and price to serve our best interests.

Can this be done? You bet it can.

Mount RushmoreIf humans can put a man on a moon using technology from the 60s*, dig a tunnel under the English Channel (31.4 miles long), chisel four American presidents from a granite mountain top, build pyramids in the middle of a desert (approximately 4,700 years ago), and perform other countless miraculous marvels – why can’t we figure out how to consistently deliver basic healthcare information to Americans (utilizing advanced technology we have today)?

The common thread that ties together each of these amazing feats is just one thing: Having the WILL to succeed. When it comes to healthcare, we appear to be a fractured country. We have failed to define our goal to engage Americans to be more involved with our health and, consequently, our subsequent care. Yes, our own behaviors determine our health, but we should not have to blindly seek the care we need.

Metaphorically, each of us represents a drop of water, placed in a vast ocean. By ourselves, we cannot cause a tsunami of change (or revolution) without first coming together with a massive number of other water drops to make the difference in how we desire to receive care in the future. Tsunamis have developed in other markets, and it is only a matter of time before we have monster waves appear in healthcare.

Each drop of water can make a difference!

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*Some Americans believe that having a man on the moon was merely a fabrication in the back lot of a studio!

What is Your Cultural ‘Pie?’

Strawberry Rhubarb Pie

Full Disclosure: This particular strawberry rhubarb pie was NOT made by Deb.

My wife, Deb, makes a scrumptious strawberry rhubarb pie. In fact, I really think she could win a blue ribbon at the Iowa State Fair with her recipe. OK, I must admit that I am just a tad bias – but it’s true!

Carefully measured sugar, flour, salt, butter and eggs are added to freshly-harvested rhubarb and strawberries. The pie crust is prepared to ensure the quality and appearance of the pie will not be compromised. How can the tartness of rhubarb and the sweetness of sugar make this pie so delectable to one’s palate? I have come to the realization that my taste buds must be suffering some sort of culinary schizophrenia – especially when a scoop of vanilla ice cream is added on top!

Using consistent ingredients, coupled with the desire to make the same tasting pie each time is a great recipe for success. Unique and positive experiences eventually result in an ongoing trust that the pie will be equally pleasing to the palate in future interactions.

What a powerful and priceless combination – creating a positive experience for the consumer and, consequently, earning their trust.

Developing and maintaining an organizational culture designed to elicit trust is similar to baking a consistently-prepared strawberry rhubarb pie. It takes the right ingredients and level of determination and commitment to use the same tried-and-true process without compromise.

The idea for this particular blog originated after I finished reading a recently published book, “Think Big, Start Small, Move Fast.” Written by three insiders from Mayo Clinic’s Center for Innovation, this excellent book is about developing and implementing a new culture of transformative innovation for not only healthcare organizations but for any organization that desires to adapt to, and possibly disrupt, the future environments and markets in which they operate.

According to former Mayo CEO Dr. Glenn Forbes, a desired culture must be imbedded into the DNA of the ENTIRE organization. “If you’ve communicated a value but you haven’t driven it into the policy, into the decision making, into the allocation of resources, and ultimately into the culture of the organization, then it’s just words.”

Of all health care organizations, one would think that Mayo could rest on their laurels and continue down the path of excellent care to their patients. After all, Mayo is all about the effective care experience for their patients. Simply put, Mayo practices that the patient comes first – at all times.

It started 150 years ago with William Worrall Mayo and his two sons, Will and Charlie. It continues today because of the consistent ingredients the organization has passed down generation-to-generation, with the same passion to serve each patient today and tomorrow. Similar to the pie, each slice is consistently processed and delivered. Each bite allows the customer to trust that the next slice will be no different.

Mayo continues to search for new ways to accentuate their tried-and-true culture so that they will be prepared to address the needs of the future. This never-ending quest serves as a great lesson for other organizations, both inside and outside of healthcare. When the public sees and feels that the organizational values are consistently customer-centric and baked within the culture of that organization, trust will inevitably endure.

So what beliefs, values and behaviors are reflected in your organization? What are the desired attitudes and behaviors that you wish to seek in the people you hire? Does your organization desire creativity, safety, collaboration or innovation?

Whatever the desired culture is for your organization, hopefully it is a positive one that permeates beyond the workplace setting and soundly resonates with the public.

Just like Deb’s strawberry rhubarb pie!

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Searching for the Medical ‘Black Box’

A black leather briefcase with words The Big Reveal inside as aWould hospital employees choose to receive medical care from their own hospital? Wouldn’t you want to know how hospital employees truthfully rated their own hospital’s safety culture?

Yep, me too!

The Agency for Healthcare Research and Quality (AHRQ) released their Hospital Survey on Patient Safety Culture results. This survey is very important for many reasons. One key reason is that these results correlate to infection rates and patient outcomes.

When you think about it, who better to ask about quality of service within a hospital than the frontline worker themselves – staff, nurses, technicians, etc.? In fact, when noted physician, Marty Makary and his staff performed a joint study with risk management firm Pascal Metrics, they found “hospitals that scored well on the staff survey had lower rates of surgical complications and other important patient outcomes.” (Marty Makary, MD, “Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care.”, Page 28)

Unfortunately, the results from the AHRQ survey are not meant for public consumption. They are meant only to be viewed by participating hospital administrators and the government. You see, this type of survey is not mandatory. In fact, U.S. hospitals participate in these surveys with the condition the results remain out of the public eye. Because hospital competition can be fierce within certain markets, reputations can be marred by having a low safety score – which adversely affects hospital revenue. Unlike the missing black box from Malaysian Flight 370, it appears this ‘black box’ of critical survey results is meant to remain hidden.

After learning of the 2014 AHRQ survey release, I quickly found that only 653 hospitals around the country participated in this non-mandatory survey (representing about 13 percent of approximately 5,000 hospitals in the U.S.). A miniscule 55 hospitals responded from 11 states within the region where Iowa was placed. The report from AHRQ does not list the participating hospitals, for reasons mentioned earlier. After a few email inquiries, I was able to learn that only 28 Iowa hospitals participated in this survey in 2012 and a paltry 9 hospitals in 2014 (Iowa has 118 community hospitals).

In all fairness, other research firms such as Pascal Metrics, also perform these studies. But once again, we have little knowledge on which Iowa hospitals participate and how often – let alone the results that come from these reports.

Dr. Makary’s view on lack of transparency for safety culture surveys is spot on:
“While I sympathize with hospitals who feel threatened by transparency of safety-culture results, I sympathize more with misled patients….In short, data transparency, properly weighted, would empower patients to make informed decisions about where they should spend their health care dollar.”

Compared to other developed countries, U.S. citizens pay world-class prices to our hospitals, but, in return, we receive little or no transparency on what matters most to us – our safety – and, in some cases, our lives.

This topic should be of great interest to employers when initiating (and leading) discussions with the healthcare provider community. Payers are entitled to know what they are paying for and, what the contents of the black box reveal.

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