Innovation and change were common themes at this year's College of Healthcare Information Management Executives annual forum—from the challenge of working in a disruption-averse industry to the changes that healthcare will face in coming years, whether healthcare leaders want to face it or not.
The U.S. must move toward lower-cost caregivers and venues of care, said keynote speaker Clayton Christensen. To do so, disparate groups must overcome their reluctance to collaborate and share power to adopt changes that make common sense, would make care more convenient, and save money.
For example, he said, nurse practitioners could play a bigger role in administering colonoscopies, but physicians object. Meanwhile, physicians say they could do colonoscopies in their own offices, but hospitals object.
Christensen, a Harvard business professor and author, also said that current care delivery must be revamped. Too many healthcare organizations try to do everything for everybody—an inefficient and expensive model.
He cited as an example two manufacturing plants. The first organized its workflow around its expensive equipment and machinery. The plant could make any piece of equipment, but the steps to do so were constrained by the layout of the machines, resulting in a work process with many steps and an inefficient, multi-step, multi-directional workflow.
The second plant decided to focus on manufacturing specific pieces of equipment that worked with the plant's linear pathway. The second plant could not do everything for everyone, but it could do jobs that fit its schematic with higher quality and lower costs in less time than the first plant.
Most hospitals are set up like the first plant when they should be set up like the second, Christensen believes. The average hospital has 110 different pathways. And while we do need general hospitals, we just don't need quite so many, he said.
The second manufacturing plant is a model for what Christensen calls a "solution shop hospital." This type of healthcare facility identifies specific problems and finds and recommends solutions. National Jewish Health in Denver, a respiratory hospital, is one example of the solution shop hospital. A patient flies in and four pulmonary and respiratory disorder specialists come into his or her room, ask questions, argue with each other, look at the data, do some tests, and come to an agreement about the diagnosis and recommended treatment plan.
Even considering that the patient flew to the facility and spent 30 minutes with four different doctors, comparatively speaking the encounter was "dirt cheap," Christensen said. "A precise diagnosis is worth its weight in gold … and it will save money down the line in care."
Passion and dispassion
Innovation and change were also themes of Michael Leavitt's keynote address. Leavitt, who served as governor of Utah and as secretary of Health and Human Services, said the healthcare industry has always been driven by compassion. That is part of the American ethos, he said.