Monday, July 27, 2009

High Quality / Low Cost Care - 10 Communities who are making it happen

Quite little conference brought 10 communities who consistently deliver high value health care meet in Washington DC to share with policy makers how they did it.

Last week several of the high priests of health care reform convened a little band of 10 top health value performers from accross the country to attempt to explain to each other and to the Washington on lookers how they were able to effectively "bend the trend". They came from all over the country and in as many geographic varities as they did demographic flavors: Asheville, NC, Cedar Rapids, IA, Everett, WA, La Crosse, WI, Portland, ME, Richmond, VA, Sacramento, CA, Sayre, PA, Tallahassee, FL. and Temple, TX. The one thing they all had in common was the fact that they had achieved what only a fraction of health service areas are able to achieve - consistent high quality, relatively low costs, and outstanding outcomes.

I had spoken with Elliot Fisher just prior to the conference and he was excited about how rapidly some of these organizations were able to respond to be in Washington sharing their stories. It seems that all of these folks are interested to share their stories and in some cases try to figure out why they have been so successful relative to others even within their region. For potential X PRIZE teams, I think there are some valuable lessons that can be learned. The highlights include:
  • Physician-hospital collaboration matters. They need to trust each other and have common patient-centered goals.
  • Data matters. All docs think they are doing the right thing for their patients, but they don't have the data to prove it, and when they do get the data, they often find plenty of room for improvement.
  • Teamwork matters; the myth of the "superphysician" who can do it all should be laid to rest.
  • Efficiency matters; philosophies like LEAN work, although you have to stick with them.
  • Leadership matters. Particularly physician-leadership.
In addition, focus areas on clinical and community cultures of health, smoothing of care transitions, and having plentiful data avaiable to measure, monitor, and improve outcomes. We have discussed several of these before and I believe that competing teams will need to master these and other quality / cost challenges to increase value by 50% in a community.

Looking forward to the full report coming out of the meeting.
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