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Month: May 2014

What Healthcare Can Learn from Pixar’s Braintrust

Screen Shot 2014-05-02 at 7.55.16 AMI am reading Creativity, Inc. right now by Ed Catmull, the president of Pixar Animation and Disney Animation.

One particular quote by Catmull that has stuck with me personally over the last few days is this:

“At some point, every Pixar movie sucks.”

Which got me thinking – are we in the “suck” part of transforming healthcare right now?

In my opinion, all roads lead to yes.  Still, I don’t want to dwell on the suck part, I want to focus on how one of the world’s most innovative companies, Pixar, transforms their “ugly babies” (mediocre ideas) into something magical (a la Toy Story 2 or my personal favorite, Up) – and how the healthcare industry can learn fromPixar’s “Braintrust” model.

Forget that it’s cliché – celebrate failure

One of the key things that make the Braintrust at Pixar unique is the fact that candor and honesty are truly placed on a pedestal.  More so, failure is celebrated to a certain degree in the culture Catmull outlines.

He writes, “If you aren’t experiencing failure, then you’re making a far worse mistake: You are being driven by the desire to avoid it.”

Which leads me to something failure related that many in the healthcare industry have debated – whether the government did the right thing by incentiving providers to adopt electronic health records (EHRs).  I think many would agree that the answer to that is no.

Instead of touting the percentage of organizations reaching certain stages of meaningful use attestation, would the government’s honest admittance of a certain degree of failure provide a chance to successfully redirect efforts?

I think yes.

Yet, due to the risk adverse nature of the healthcare industry and the engrained fear of failure in all of us, we (not just government) are all too often guilty of pushing forward with similar mediocre ideas merely to see them through when they may have been better served by being put to rest.

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Keas Poll on Workplace Stress and Disease Burden Provides an Education

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Al’s son once complained to Al’s Aunt Tillie about an overbearing supervisor.  Aunt Tillie suggested that he try to work under a different supervisor.  Tillie was one of those people – and we all know them – who could be counted on to inadvertently provide punchlines when needed.  Conversely, Al is one of those people – and we all know them – who can’t resist setting up those punchlines.  So I lamented that this suggestion may not work because, “Aunt Tillie, it’s a sobering fact that 50% of all supervisors are below average.”

Tillie replied, “I blame our educational system for that.”

Likewise, we may need to blame our educational system for Keas’ new poll on workplace stress.  To begin with, the lead paragraph from Keas — which like many other companies is “the market leader” in wellness – “reveals” that “4 in 10 employees experience above-average stress.”

SAN FRANCISCO, CA – (Apr 2, 2014) – Keas (www.keas.com), the market leader in employer health and engagement programs, today released new survey data, revealing four in ten employees experience above average levels of job-related stress. Keas is bringing attention to these findings to kick off Stress Awareness Month, and is also providing additional insight and tips to bring greater awareness to the role of stress in the workplace and its impact on employee health.

Wouldn’t that mean some other employees – mathematically, also 6 in 10 – must be experiencing average or below-average levels of stress?   It would seem like mathematically that would have to be the case.   However, the Keas poll also “reveals” that while some employees are average in stress, no employee is below-average – a true paradox.  Hence Keas’ selfless reasons for publishing this poll:  All employees being either average or above average in the stress department means we have a major stress epidemic on our hands.  This perhaps explains why Keas is “bringing attention to these findings.”

In a further paradox, Keas also uses the words “average” and “normal” as synonyms, even though they are often antonyms:  All of us want our children to be normal but who amongst us wants their children to be average?

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Who Should Pay Doctors?

flying cadeuciiHonest Pay for Honest Work.

Times have changed. And it’s time they change again.

In the past, medical care was more episodic than it is now. People went to see the doctor when they felt unwell. Diabetes affected mostly older patients, who didn’t live long enough with the disease to develop complications.

There were no blockbuster drugs for high cholesterol, Hepatitis C, fibromyalgia or chronic heartburn; we didn’t manage nearly as many patients on multiple medications as we do now.

In those times, a payment scale based on the length and complexity of the visit made sense, and there wasn’t much doctor-patient interaction between visits.

Today, we manage more chronic conditions, use more medications, do more laboratory monitoring, more patient education, and more administrative work on behalf of our patients than before.

Payment scales based only on what we do in the face-to-face visit have become hopelessly antiquated and stand in the way of the new demands of society – physicians providing longitudinal care for chronic conditions in patient-centered medical homes.

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10 Ways Innovation Could Help Cure the U.S. Health Spending Problem

flying cadeuciiThe United States spends more than $2 trillion per year on health care, surpassing all other countries in per capita terms and as a percentage of gross domestic product.

New, expensive medical technologies are a leading driver of ballooning U.S. health care spending. While many new drugs and devices are worthwhile because they substantially extend lives and reduce suffering, many others provide little or no health benefit.

Many studies grapple with how to control spending by considering changing how existing technologies are used. But what if the problem could be attacked at its root by changing which drugs and devices are invented in the first place?

Recently, my colleagues and I explored how medical product innovation could be redirected to reduce spending with little, if any, sacrifice to health and to ensure that any spending increases are justified by sufficient health benefits.

The basic approach is to use “carrots and sticks” to alter financial incentives for drug and device companies, their investors, health care payers and providers, and patients.

The ten policy options below could change which technologies are invented and how they’re used. In turn, this could cut spending or increase the value (health benefits per dollar spent) derived from new products that do increase spending.

We urge policymakers—both public and private—to consider these options soon and to implement those that are most promising. Policymakers should also consider how to reduce spending and get more value from health services that don’t involve drugs or devices.

The longer the delay, the more money will be badly spent.

1. Encourage Creativity in Funding Basic Science

The National Institutes of Health (NIH), the leading funder of basic biomedical research, typically favors low-risk projects. Funded researchers who fail to achieve their goals are much less likely to secure additional NIH funding. Encouraging more creativity and risk-taking could increase major breakthroughs.

2. Reward Inventors with Prizes

Public entities, private health care systems, the philanthropic sector, or public-private partnerships could award prizes to the first to invent drugs or devices that satisfy certain performance criteria, including a potential to decrease spending. Winners could receive a share of future savings that their product brings the Medicare program, which spends more than $500 billion annually.

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