Our Healthcare Future is Innovation: Climb Aboard

A footnote in history has always fascinated me: The computer mouse was invented 10 years before the PC. However, without the PC, the mouse—though a new and unique device—was hardly noticed in the marketplace. The invention was all but ignored until a decade later when the PC made its way into our homes. Today you can hardly use a computer without a mouse or some derivation of the technology. It's an excellent example of the difference between invention and innovation, and a good parallel to healthcare reform. 

Innovation is from the Latin "Novus" meaning new, to renew, or to create. What distinguishes an invention from an innovation, however, is when the idea or object becomes enmeshed in the marketplace and is successful. Say what you will about the Patient Protection and Affordable Care Act, (often referred to as Healthcare Reform) but the creation and introduction of this legislation into healthcare was a starting point.

Now, if healthcare leaders can correctly implement it, it stands to revolutionize healthcare as we know it. Right now though, it is much like the mouse. It is waiting for the PC to move it beyond a starting point and into the revolutionary. 

I was at the VHA Leadership Conference in San Diego last week and had the opportunity to speak with a variety of healthcare leaders ranging from chief financial officers to CEOs to chief nursing officers. The common thread in each of my conversations with these folks—aside from the lack of enthusiasm for the accountable care organization as CMS defines it—was the need for someone to offer a clear pathway for how to make healthcare outcomes and quality better (and do it in a financially viable manner).

I pressed these folks, asking, "Isn't that what Reform is trying to accomplish?" The resounding collective response seemed to be, "Yes, but the regs don't tell us how to do that; they only tell us the penalties for not doing it correctly."

The lack of a clear solution, or bundle of solutions, only adds to the sense of urgency healthcare leaders feel as the legislation continues to roll out new components. Dennis Dunn, Ph.D., and senior scientist at Thomson Reuters, spoke on insurance reform as part of Health Care Reform. Much of what he covered were data points on what is expected to transpire with the newly insured, and one of his statements struck me:

"If you aren't running fast by now, then 2011 is the time. Otherwise your ED will be overrun and you'll be in dire straits," he said.

He's not wrong—with all the newly insured coming in 2013 and not enough primary care doctors to meet this new-patient influx—these patients will likely head to your emergency department. But what made that point so interesting to me was the "act now!" nature of it. Still, no clear definition of how, though.

I'm currently researching an article for an upcoming edition of HealthLeaders magazine that looks at new models for medical group success. My research is offering some answers to the "how". I asked Medical Group Management Association president and CEO Dr. William Jessee, FACMPE, FACPM, what he sees taking place.  

"With all the ACO hype, folks are trying to figure out how to create these organizations, but they aren't looking at how they can be different tomorrow. Now is where the opportunities lie to improve quality, safety and patient satisfaction for tomorrow," he says. "With some creative engineering of work, they can get some impressive results."

So it comes back to innovation. There are models out there for folks to start from, but the thing about a starting point is it's just that – a place to begin. A finished and tested solution – which so many in healthcare long for – is not possible. Why? Simply, each market is vastly different. The needs and health issues of each community are different. So what works at Virginia Mason Medical Center may not work at Geisinger or at your facility. You cannot afford to wait for a packaged unilateral solution when applying the Patient Protection and Affordable Care Act.

"In the next several years a lot of models will be tested and we will see what works in what market. But as they say, 'If you've seen one model; you've seen one model,'" says Jessee. "The longer I'm in healthcare the more I know there is no single formula that will work in every area … the solution is what works for the hospital and with the payers."

Though many cringe at the lack of specificity and guidance in the Health Care Reform legislation, vagueness is an opportunity for innovation. Failing to recognize that opportunity will surely affect your finances in the future, but embracing it offers the potential for success. Indeed, there is financial success to be had with taking an innovative approach to areas like quality, safety, patient satisfaction, and outcomes. Though as many of the trailblazers – organizations such as Intermountain Health Care, Geisinger, Mayo Clinic, Virginia Mason and Cleveland Clinic – will tell you, you may lose some money upfront.

Innovation doesn't come without a price tag, yet it often offers a return on investment. In this case, it may start out by offering your hospital or health system a return in better quality, patient satisfaction, and outcomes. These early, nonfinancial successes will ultimately bring rewards to your bottom line, but you should anticipate that it will take several years to occur.  

Though we'd all like to pick apart the Patient Protection and Affordable Care Act and the new ACO guidelines, the fact remains they are in place and they provide a spark of invention. Turning that spark into a blaze of innovation is entirely up to those who put this information into practice. It's truly an exciting time in healthcare. Embrace the opportunities that come with it.