Look Outside Hospital Walls to Collaborate, Improve Health

A recent trip to Denmark to speak at an IT conference reminded me how important it is for hospital executives to remember Joy’s Law. Bill Joy famously observed “No matter what business you’re in, most of the smart people work for someone else.” There should be a corollary that states “No matter what industry you’re in, you can learn a lot from people in other fields.”

If you take Joy’s Law seriously you start to think beyond the boundaries of your hospital system and realize there is much to learn and borrow from others. Don Tapscott and Anthony D. Williams in “Wikinomics” (New York: Penguin, 2008) describe how cutting-edge companies outside of healthcare are benefiting from mass collaboration made possible by digital tools.

Procter & Gamble has made “proudly found elsewhere” a mantra for the consumer products company that has a goal of sourcing 50 percent of its new products and service ideas from outside the company. Successful products such as Olay Regenerist, Swiffer Dusters, and Crest Spin-Brush are some of the hundreds of products P&G found by connecting with scientists and engineers who do not work for P&G.

Tapscott and Willams open their book with the Goldcorp Challenge, where a Canadian mining company offered $575,000 in prize money to anyone in the world who could identify targets to mine from analyzing the 400 megabytes of the company’s proprietary data about their 55,000 acres of land. The geologists, graduate students, consultants, mathematicians, and military officers who responded to the challenge identified 110 targets (50 percent of which had not been identified by the mining company) and 80 percent of the new targets yielded substantial quantities of gold.

I think we do some of this in healthcare but I believe that applying the lessons of Joy’s Law and “Wikinomics” would transform our industry with new ideas and approaches to the fundamental challenge of the 21st century: decreasing per-capita cost and increasing quality. The success of the Institute for Healthcare Improvement in increasing the quality of the care we deliver is based in part on creating highly permeable health system boundaries by facilitating sharing among hospitals that are working to improve their care.

On the way back from Denmark, I opened the November 2011 issue of Health Affairs and found an entire issue devoted to the need for hospitals and community development organizations to join forces to improve the health of our communities. According to one article, there is a nine-year increase in life expectancy as one travels the Blue Line from downtown Washington, D.C., to Fairfax County, Va. Research into factors associated with premature death reveal that health plays a small role (10 percent) and social circumstances, environmental exposures, and behavior account for 60 percent.

It sounds like hospital executives should be reaching beyond their health systems to partner with community development organizations to create well-stocked grocery stores, safe parks, and well-lit walking and bicycle paths in their communities. And it sounds like this would be a major contribution to making our citizens more healthy.

The digital age seems to demand that healthcare leaders recognize that most of the smart people work for somebody else in a field that we usually do not consider relevant to running a hospital.

Kent Bottles, MD, is past-Vice President and Chief Medical Officer of Iowa Health System (a $2 billionhealth care organization with 23 hospitals). He was responsible for the day-to-day operations of a large education and research organization in Michigan prior to his work with in Iowa with IHS. Kent posts frequently at his blog, Kent Bottles Private Views.