I recently wrote about an innovator’s dilemma of sorts – or call it a paradox – in healthcare. The paradox is that as we look to innovate in healthcare, the very authority figures we must turn to for fact-checking our innovative ideas are conflicted and highly motivated to support the status quo. I’m talking about physicians of course.
In a fee-for-service world, physicians are both the fountain of relevant knowledge and the source of all revenue. So we have built our workflows, systems and processes around their comfort and success. As physicians succeed, so does the rest of the healthcare juggernaut. I know other industries fall victim to these kind of MC Escher-like business models, but it seems particularly acute in healthcare.
My belief is that this paradox makes our industry highly susceptible to under-imagining what real innovation could look like. We have some pretty deep blinders on, it seems. One of my favorite Steve Jobs legends is that when asked about the consumer research that led to the development of the iPad, he quipped, “We don’t expect consumers to be able to tell us what they don’t realize they need.” [I am paraphrasing, but this is reasonably accurate.]
Patient-centered care and patient engagement have become central to the vision of a high value health delivery system. The delivery system is evolving from a fee-for-service transactional payment model to a value-based purchasing model using outcome data and quality improvement and attainment. The Centers of Medicare and Medicaid Services (CMS) and private payers have spurred delivery redesign of networks that focuses on a set of clinical quality measures and patient care experiences along with efficiency measures.
