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Published: February 28, 2012
 / Spring 2012 / Issue 66
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Health Reform by the Numbers

By using data to target inefficiencies, leading healthcare systems are proving technology’s potential to revolutionize care delivery.

More than a year after the Affordable Care Act was passed, it is clear that a sweeping policy change will not be enough to repair the U.S. healthcare system. As an industrialist in the healthcare business, I can see that the fundamental driver of high costs and quality issues is the inconsistency of healthcare delivery and outcomes from region to region, state to state, and even hospital to hospital. Such variance is evil: It is bad for your health, it is bad for your local doctor’s business, and it is bad for the healthcare system as a whole. But I also know that the part of the business perceived as less exciting — process and information technology — can drive revolutionary change.

The good news is that certain pioneering institutions are already using IT and process engineering to reduce costs and improve health outcomes. They approach healthcare as a science, not as an art. They’ve used data to target areas of underperformance and waste, and they’ve employed technology to transform their systems. Their solutions can serve as best practices for patients and businesses alike. (Disclosure: GE makes some of the technologies used by these companies.)

Virtua, a comprehensive multi-hospital system based in southern New Jersey, is considered one of the best-performing hospitals in the nation — both clinically and financially. Its leaders accomplished this by using data to understand performance and drive day-to-day process improvements while expanding their technology capabilities at the system’s nine locations. Virtua has seen many changes system-wide, ranging from improving staff scheduling to decreasing by two-thirds the amount of time it takes to treat a woman who discovers a lump in her breast. As a hospital system that generates in excess of US$1 billion in annual revenue, Virtua has been able to save $23 million in unnecessary costs since incorporating Six Sigma as a process improvement tool.

Virginia’s Bon Secours Richmond Health System, which recently announced a data-rich “no-wait emergency room,” has also saved $5 million through technology that enabled the organization to eliminate unnecessary spending on equipment; the health system now deploys 30 percent fewer intravenous pumps alone. And with the use of technology and a strong governance structure, the system estimates that its 20-minute reduction in overall surgical procedure time could expand access to more than 500 additional patients per year.

The Tampa, Fla.–based H. Lee Moffitt Cancer Center and Research Institute, one of the leading cancer centers in the United States, used sophisticated computer modeling to reconfigure its surgical block schedule, freeing up capacity for 900 additional cancer procedures a year without adding operating rooms or hours. That new capacity improves access for patients (up to 12 percent more medical procedures can be performed) and makes good business sense (about an $8 million annual margin for the center).

Sometimes less is more. At Boston’s Brigham and Women’s Hospital, GE is supporting efforts to ensure more appropriate imaging. Software that aggregates decades of evidence-based medical best practices provides diagnostic options based on historical effectiveness and patient history. It may seem counterintuitive for a medical device manufacturer to recommend fewer tests, but this kind of effort has the potential to curb the number of unnecessary imaging tests given at hospitals and outpatient clinics around the world. If you understand variance, you know it goes both ways: For every unnecessary scan out there, somebody who needs one is not getting it. Those undiagnosed patients will inevitably cost more to treat down the road. Managing variance will improve healthcare quality and lower costs at the same time.

These institutions are at the vanguard of healthcare reform, harnessing data in practical ways to breathe new life into the existing system. It’s time to focus on solutions and employ the data, processes, and technologies available today to give doctors, nurses, and all other healthcare providers the best environment in which to perform. We know from extensive industrial experience that total dedication to efficiency will pay off in terms of improved quality, enhanced customer experience, greater patient safety, and reduced costs. Thoughtful leaders will become the heroes of healthcare reform by following the same formula.

 
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By MILAN
I have NO doubt that Supreme Court Justice will conform that health care reform was constitutional , because : This reform “ is NOT about politics. This is about people’s lives. This is about peoples businesses. This is about our future” - Pr Obama.
Health care reform was HISTORIC moment, making affordable health care accessible to more Americans ( NO more pre-existing conditions; you will NOT lost health insurance if you change job; children can stay on parents health insurance until age of 26; in new law, there is annual wellness visit…).
I worked as General Surgeon in Europe and as Surgical First Assistant in VA and MD for 8 years , so I understand very well how important health care reform was for us, our children, next generations… for USA future.
At 2009 everybody agree that status quo in health care was unacceptable; if we did NOT change anything, Medicare was facing bankruptcy by 2017; As you know, health care account for 17,4 % of US national economy ( as Pr. Bill Clinton said: “ If US spend 11,8% like France, we would save $ 870 billion per year”) , and still we will have a world class medicine!…
In the beginning, ALL Republicans said NO to health care reform, until FINALLY they understood that change was necessary!
-I am glad that CBO estimated that health care law will cut the deficit by $ 124 billion, in period 2012 – 2021. ( WP on 10.15.11).

-I agree with Mr. Donald Berwick , who conformed that:
1. USA spent tens of billions of dollars for hospital-acquired infections every year ( one in every 6 people who got into a hospital gets a complication from care, NOT from the disease);
2.Geisinger Medical group in NE Pennsylvania ( around 700 doctors) sign: if you return to hospital within 90 days of release, the group will cover ALL cost of care;
3. In Mayo Clinic ALL doctors are on salary ( NO matter how many test they run);
4. In Pennsylvania they already conform that there is “dramatic difference in the costs of the same procedure from hospital to hospital” and NO connection…

-“Health care law has been challenged by 26 of the 50 states”? I know that some people want to privatize Medicare and Medicaid, but : is this political game or diversion from real problems- unemployment , economy and dysfunctional Congress…?

By Axway
Ruby Raley, Director, Healthcare Solutions, Axway, commented on this entry recently.

Full post here: http://blogs.axway.com/2012/04/on-the-strategy-business-com-article-health-reform-by-the-numbers/
By BTSUSA
This is a great article! But there are other approaches to improving the American healthcare system. Humana partnered with BTS to develop a Health Economy Simulator (HES), designed to accelerate health care innovations in the market, region by region. Through the experience, leading hospital administrators, doctors and payer representatives come together, collaborate, and evaluate different strategies to improve local health economies. The simulation is generating real results. Read more at: http://www.bts.com/news-insights/press-blog/Simulating_a_Better_Health_Care_System.aspx
By John R. Graham
These are compelling cases. But I wonder what will happen to the "savings" described. In a competitive market, they would drive costs down. However, there are good arguments that PPACA is accelerating cartelization in local hospital markets. One of Booz & Co's competitors published a case study about how power is shifting from physicians to hospital administrators. Reading between the lines, I can sort of see that in this article too. We have yet to see how physicians will react when the new, "hospital-centric" model takes full effect. It'll be a significant leadership and organizational challenge. (But all big IT projects become such challenges in the end, don't they?)