Healthy Living A Conversation Amongst Dr. Pandey On Healthcare Transformation

Dr. "Ravi" Pandey is president of BIPRO Inc., a consulting company, which focuses helping organizations across the globe to attain sustainable increment inward surgical operation as well as consumer satisfaction. He is an practiced inward surgical operation improvement as well as strategy, as well as has potent ideas almost healthcare reform, which he expresses on his Healthcare Transformation blog.

I've known Ravi for over a twelvemonth as well as honour his intelligence, knowledge, experience, as well as dedication. We engage inward weekly discussions almost fundamental issues focused on transforming our healthcare system. Following I reconstruct a conversation we've been having almost healthcare policy as well as strategy.

Policy

Dr. Beller: What are your thoughts almost the healthcare reform struggle these days inward our country?

Dr. Pandey: Oh, don't teach me started on it. I was real optimistic earlier. Now I reckon lots of verbalize but no substance. If nosotros tin trace off something meaningful, it would travel a miracle. I mean, recall almost it, nosotros don't fifty-fifty take away hold a clearly defined goal? What would an ideal healthcare scheme be? And yet nosotros are already arguing almost cost.

Dr. Beller: Some people believe that you lot should know the toll first, thus that you lot tin create upward one's hear what the finish should be. What's your accept on it?

Dr. Pandey: It is all tricks to confuse as well as distract us from the existent issues. How tin you lot verbalize almost toll unless you lot take away hold a clear vision of the goals as well as the attempt needed to attain them? When I state goal, I don't hateful it inward damage of universal healthcare, or unmarried payer, co-ops, or anything similar that. Instead, let's state our finish is to attain world-class healthcare; as well as thus what does it mean? We involve to clearly articulate that. Then, nosotros tin struggle almost how to attain it.

All this give-and-take almost toll is premature...It's a giddy give-and-take to take away hold at this time. Let me enquire you lot this: We all concord that our healthcare scheme is also expensive, correct? If that is the case, as well as thus wouldn't spending to a greater extent than coin travel out far to a greater extent than expensive? We already take away hold the money, nosotros involve to utilize it better.

Our healthcare scheme costs 30-40 share to a greater extent than than it should. By the way, this I also heard on CNBC program. Sen. Frist was proverb the same affair that nosotros take away hold almost 1/3 of coin is wasted. That's to a greater extent than than 700 billion dollars of waste. This is non a toll issue. It is an efficiency, policy, as well as direction issue.

Dr. Beller: We'll come upward dorsum to this toll number later. Let's focus for the fourth dimension beingness on the policy as well as politics. Lots of people are proverb that the regime can't do anything right. If they run healthcare they volition screw it up, too.

Dr. Pandey: Again, that is simply a scare tactic. We should enquire those people if they are living inward the best province inward the Blue Planet or not! WE are the government. If regime is non good, nosotros take away hold made it that way. I hateful the federal regime is i of the biggest employers. Many of us Americans are working there. Now if nosotros state it is unproductive system, as well as thus nosotros are basically proverb that many of us are no goodness as well as are wasteful.

I also recall nosotros vanquish upward the regime for everything. Let me enquire you lot this, which of the next has given demonstrated spectacular surgical operation Enron, AIG, WorldCom, the Big three auto makers, private wellness insurers? I take away hold seen the private sector upward unopen as well as personal. I am non certain if their surgical operation is anything to boast about..

Dr. Beller: So, are you lot proverb nosotros should take away hold a regime controlled healthcare?

Dr. Pandey: No, that's non what I'm saying! I take away hold expressed my ain ideas inward bits as well as pieces on my blog, the Healthcare Transformation.

When it comes to healthcare reform, what I reckon straightaway is to a greater extent than of a patchwork beingness done. It is non a reform mouth as well as it is non a healthcare for all bill. Instead, it's a "healthcare for to a greater extent than bill"... to a greater extent than people as well as to a greater extent than money. Secondly, at that spot is also much finger pointing as well as distortion. That's because our scheme is built upon adversarial forms of competition. Unless you lot create a constabulary where no i tin render misleading information, insurance companies, the AMA, hospitals, large pharma, as well as medical device manufacturers take away hold the ability to derail the whole affair through blame shifting as well as misinformation. Remember the ads inward 90s against healthcare.

For whatsoever healthcare reform to work—which I would rather telephone band "healthcare transformation"—we involve to create a scheme that takes into concern human relationship the needs of everyone, including patients, doctors, insurers, etc. This tin travel done past times creating a competitive collaboration.

Dr. Beller: What do you lot hateful past times "competitive collaboration?"

Dr. Pandey: In a traditional sense, when nosotros compete, nosotros non alone essay to do better, but also nosotros essay to wound the competition. Creating a world alternative to compete amongst private sector insurers could do that. There's some other way to while the market. Let regime travel to a greater extent than focused on wellness care. The PCPs [primary attention physicians] would serve every bit wellness managers, that is, they would focus on managing their patients' health…keeping them good as well as making certain they teach the right attention when sick. There should usage evidence based guidelines as well as usage surgical operation metrics, such every bit a wellness index, that measures attention lineament as well as cost. And the insurance industries could render the supplemental insurance.

In that way nosotros are non competing, but complementing the marketplace needs. This is what I telephone band competitive collaboration. You piece of job together to succeed past times leveraging each others strengths. Not past times undercutting each other.

Strategy

Dr. Beller: Back to the coin issue. If nosotros do what you lot said before as well as define the finish of healthcare transformation, volition at that spot travel plenty coin to pay for it? Where volition that coin come upward from?

Dr. Pandey: Of course of report at that spot is. Let's start amongst administrative toll for insurance management, the toll of treating over a 1000000 avoidable injuries, malpractice premiums, over-testing as well as excessive treatments, under-utilized capital, as well as thus on. In addition, insurance direction as well as profits add together upward to 30% of the premium payments, compared to 3% that Medicaid as well as Medicare spend. There's plenty of error as well as inefficiency to travel out around as well as hospitals take away hold also many managers as well as bureaucracy, which agency at that spot is huge chance for productivity improvement.

Additionally, I heard this guy on CNBC panel give-and-take state that if you lot tin create a wellness plan as well as trim people's weight to pre-1991; it volition salve almost a trillion dollar. I am non certain where he is getting his numbers from; but at that spot is at to the lowest degree conceptual validity to his argument. He was also quoting almost some report that a Japanese ethnic grouping is twice to a greater extent than probable to teach cancer inward U.S. of A. of America than inward Japan. It's due to our eco-system as well as life style.

So, I recall coin should travel the to the lowest degree concern. What nosotros involve is to define clear strategies. I bet you lot could attain all the objectives as well as even thus salve some money.

Dr. Beller: How do you lot propose this travel changed inward guild to create an efficient healthcare scheme that works?

Dr. Pandey: The people working inward healthcare scheme cannot alter it. It is non almost their competence, it's almost a scheme that has travel out incredibly complex. We take away hold to redesign the system.

I hateful healthcare is a human relationship betwixt doctors as well as patients. You improve their productivity past times using nurses as well as technicians. Then you lot mightiness add together some diagnostics equipment. Would you lot non recall everything else is a waste? It is a simplistic stance to brand a point. However, what I hateful hither is that these are the logics you lot tin usage to reckon what should travel the toll of an ideal system. There's your benchmark then.

Dr. Beller: But wouldn't productivity travel to a greater extent than greatly improved if those doctors knew how to deliver the most cost-effective attention as well as were rewarded for doing so?

Dr. Pandey: Yes. That is the argue I was talking almost creating a novel scheme that incentivizes the right behavior. And nosotros involve to pass resources on research. You know that nosotros do non take away hold plenty data to individualize medicine. We launch a production as well as oft times nosotros uncovering months after that it needs to travel taken off the shelf. Why are nosotros failing? Where are nosotros failing?

A major burden is non on doctors, but on the pharmas. They should travel doing their question properly. Doctors prescribe based on what they take away hold been told. So a amend correlation betwixt medicine as well as an private volition improve the attention delivery effectiveness. I recall though it is long way away.

Dr. Beller: What almost wellness information technology as well as informatics?

Dr. Pandey: They take away hold a large role. However, these are alone platforms. Unless nosotros changed the procedure as well as behavior, the information technology volition alone accelerate the bad things. I take away hold been a large critique of most of the products beingness sold today. I was glad to reckon latterly an article where Dr. Blumenthal's business office was quoted every bit proverb that the electrical current EMRs are non upward to the criterion since they do non accept into concern human relationship of the needs of the stakeholders.

In my view, these products are piece-mealed together. In a sense, they were developed as well as and thus people tried to check them to encounter the healthcare industry's needs rather than agreement the needs as well as and thus developing the software. There are lots of horror stories almost implementing computer science products. To travel fair, nosotros also involve to improve the lineament of processes as well as projection management. We volition succeed if nosotros offset focus on edifice the procedure frame piece of job for healthcare delivery as well as management. And as well as thus create information technology products to automate it. Right straightaway nosotros simply travel out on on adding functionalities inward existing products as well as it keeps on getting worse as well as worse.

Take the instance of EHRs as well as PHRs. Why do nosotros involve 2 systems? It creates unnecessary confusion as well as duplications. Personal health, every bit you lot know, is a combination of genetics, medicine, habits, environments, etc. So if the solution to wellness is a holistic approach, as well as thus why non create systems that back upward the holistic needs.

I recall a bully scheme that tin travel implemented amongst relative repose as well as tin travel developed inward almost $1 billion or a flake more. Over $20 billion beingness allocated past times the white household volition cease upward inward the same hands that take away hold spent years to prepare a non-workable system. They are smart, but they do non know how to teach out of the maze that has been created. information technology civilisation of production evolution isn't suited for production pattern for healthcare manufacture due to its critical nature. They involve to convey some exterior experts to aid prepare their products. When MS Window crashes, it is non a large deal…but you lot do non desire those kinds of issues. Our information technology scheme has to transform its ain mental attitude towards production quality.

Dr. Beller: How would you lot summarize what should happen?

Dr. Pandey:

• Create a clear Definition of ideal healthcare system. And create strategies around that.
  
• Create a civilisation for salubrious living.
  
• Improve the lineament as well as efficiency of medical research.
  
• Demand a toll reduction of over 30% across the sector.
  
• Create a tiered scheme of coverage...basic provided past times regime as well as advanced through private insurance.
  
• Implement a novel scheme for handing malpractice claims.
  
• Scrap the entire wellness information technology scheme as well as recreate...it volition salve tons of money.
  

-------

This concludes the offset component subdivision of our discussion. Check dorsum for more.

Share this post