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TECH/CONSUMERS: It’s care delivery that matters most

Here’s my FH editorial today….

This week two very different healthcare conferences rolled through San Francisco. One was about Consumer-Directed Health Care and was a cross between a capitalist land-grab and a political pep rally for HSA-backers and Canada-bashers. There are clearly interesting ideas from many start-ups as to how to better serve consumers , and plenty of new initiatives from bankers wanting to get at the new accounts being set up within health care. Google’s announcement of its new “Co-op” service that includes a “Health” component, and Intuit’s deal with Ingenix show that big time consumer companies are viewing this movement seriously.

Later in the week the National Patient Safety Conference saw clinicians discussing the issues of medial errors, nursing and clinical efficiency, and how to use technology to turn around provider performance. That is clearly a much bigger and even more intractable problem than making health care more consumer friendly. It’s also a movement that has been going on for more than twenty years, and we are really only seeing marginal improvements. Health care has many problems, but clearly the care delivery coal-face is where most health care money is spent, and where we have the most to change.

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Tom Leith
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Tom Leith

One of my former professors, with whom I am proud to say I did an internship, and another faculty member have published a paper in the April issue of the Journal of the American College of Surgeons about practice variability among surgeons. Matthew mentioned this study in FierceHealthcare. It puts on an emperical basis what has been “strongly suspected” for quite some time: even controlling for case mix, surgical complexity, and outcomes, the costs imposed on hospitals by different surgeons varies by almost 50%. As Matthew has hinted, here is where the coal is to be mined. While we’re trying… Read more »

Tom Leith
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Tom Leith

Yes. Becoming “Patient Friendly” requires no truly fundamental change in attitude. Doctors and nurses and managers want to provide the best service they (reasonably) can, and the whole debate is over what is “reasonable”.
In his Quality Digest article http://www.qualitydigest.com/june05/articles/05_article.shtml, Greg Brue talks about a collision between clinician attitudes and a dysfunctional reimbursement system that he says cause non-adoption of clinically-oriented quality improvement programs.
I’ve gotta go now — I’ll try to return to this later.
t