OM: Brenner; Health Care Must Industrialize! - The Alliance for Rights and Recovery

NYAPRS Note: The week before Dr. Brenner appeared at the National Council in D.C., delivering the address discussed below, he offered an acclaimed presentation at the NYAPRS Executive Seminar in Albany. Industrializing health care by systematizing data and processes is not possible, he concludes, unless our business is about customer satisfaction. Ultimately, the sustainability of all businesses relies on that premise; if we are going to save our health care industry, we need to figure out what person-centeredness means to the actual people we are serving. Then, we need to do that, and replicate it, and create policies that allow us to flexibly and innovatively grow. View Dr. Brenner’s powerpoint from the Executive Seminar here.

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Monday, May 12, 2014

Health Care Must Industrialize!

OPEN MINDS Last week at the National Council’s Annual Conference, Jeffrey Brenner, M.D. of the Camden Coalition of Healthcare Providers (known for his work with local stakeholders to build a comprehensive, integrated health care delivery model that relies on data and care coordination) spoke about a big health care policy question: Is it really possible to lower costs and improve quality? The answer is yes, and to do it the health care industry needs to industrialize.

The key is creating “focused factories.” This more industrialized health care system would be built around highly specific practices that utilize focused and standardized methods of treatment (for example, ACT teams and Ryan White HIV/AIDS clinics). That model can then be expanded for greater population management, broadly defined by Dr. Brenner as “better care, at a lower cost, for everyone, every day.” But as he was also quick to note that the issue with this definition is that everyone doesn’t always need the same thing every day, which means that in order to effectively manage the health care of a population, we need to segment the population and then monitor the needs of individuals. To do this, Dr. Brenner outlined three system requirements:

Data – Often, we segment the population by disease and this fact is reflected in the data we collect. Often this grouping isn’t as useful as it could be: for example, a person with mild diabetes doesn’t have a lot in common with a person with sever diabetes. Rather, the person with severe diabetes has more in common with people who have other sever chronic conditions—they have the same co-morbidities, the same family issues, social needs, socioeconomic factors, etc. To address the needs of the population as a whole, we need to group individuals in different ways, and analyze the data from these groups to better to serve each segment.

Clinical Design – A big part of “industrializing” is standardizing clinical design for more effective standards and protocols. Having standard processes in place allows for better collaboration across primary care, behavioral health, and social services (see Be Big? Be Like The Cheesecake Factory). A great current example is the ACT Team model, which Dr. Benner noted is a successful “standard model” with an established team treatment approach utilizing evidence-based practices.

Patient Engagement – While behavioral health professionals have an established way of working with patients—one I would argue still needs work (see For Tech-Enabled Consumer Health Education, Engagement = Success)—there is no good model of engagement in medical care. This creates large problems, as for many patients, their entrance into the health care system is through primary care or the ER – not behavioral health.

My take away from the day: health and human service organizations need to think about systematizing both administrative and client processes – making steps to improve their economies of scale, their operational sophistication, and their analytics for better operational and clinical excellence, and better efficiencies. Interestingly, this issue of scale was a similar theme in last week’s discussion of participating in social impact bonds (see Thinking About Competing For Social Impact Bonds? A Few Considerations) and my colleague Monica Oss’ piece on the lean development initiative coming from India (see Will Your Market Be Disrupted By ‘Frugal Innovation’?).

For more on the challenges of size and scale, don’t miss the session, “The Challenges Of Size & Scale: Learning From The Experience Of Large Provider Organizations,” at The 2014 OPEN MINDS Planning & Innovation Institute, featuring Senator Joseph Rocks, Chairman & CEO, NHS Human Services; Michael S. Varadian, JD, MBA, Senior Vice President & National Director Of Health Reform, Providence Service Corporation; and Monica E. Oss, Chief Executive Officer, OPEN MINDS.

Sincerely,

Sarah C. Threnhauser

Executive Vice President, OPEN MINDS

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