Reform Through Cultural Transformation

Last Tuesday, I had the pleasure of participating in the Philadelphia Business Journal’s inaugural “Health Care Innovation Awards” program. The event not only recognized some of the most innovative thought leaders in the area but hosted one of the most engaging health care panels I have heard in a long time.

When we talk about fixing the health care system, we often hear about innovation and technology driving change, but the panelists discussed a novel concept for the health care industry – the need to change the health care culture.

The main premise – to achieve long-lasting positive change, we need a culture in which ideas, visions and responsibilities are shared across all key stakeholders. When we can do that, we can break down barriers, develop multi-faceted approaches to solving problems and take advantage of opportunities to improve health care in this country.

But, cultural change is slow. It will require hard work and investments on many levels. Will it be worth it? The panel of experts said, “absolutely,” identifying five areas in which health providers, insurers and regulators could come together now in a “culture of collaboration” to improve our health system:

• Establish universal access to electronic health records;
• Improve coordinated care;
• Make hospitals safer;
• Share outcomes data and develop best practices to improve quality of care; and
• Enable nurse practitioners, pharmacists and other medical experts to practice to their fullest training.

I draw on the insights of one of the panelists, Rich Miller, CEO of Virtua and the Philadelphia Business Journal’s 2011 Health Care Innovation Awards’ “CEO of the Year,” to illustrate the concept. In the past, hospitals set goals based on occupancy rates – “heads in beds,” as he described it. Today, hospital leaders are discussing the need to keep patients out of those beds. Physicians will need to change their practice patterns, providing greater focus on wellness than sickness. Patients must change how they think and act when accessing the health care system. For example, non-critical care and preventive care services can be performed outside the hospital or doctor’s office – at their local pharmacies, for example.

Insurers will need to move away from their fee-for-service model, which rewards activity without regard to outcome. It will require that insurers become less transaction oriented and engage more as an insurer-activist… embracing sophisticated technology that leads to more and better data that is shared broadly to improve the health of the system and society as a whole.

Our collective goal should be a culture of care in which the five improvements mentioned above play a critical role, where patients receive the most clinically efficacious, cost-effective care in the right setting and at the right time by an appropriate medical professional to ensure the best clinical outcome.

We have learned from cultural changes of the past that results come from actively working together toward common goals – in the case of health care, an economically stable health care system and healthier Americans.

To learn more about the Philadelphia Business Journal’s Health Care Innovations Awards and the 2011 winners, go to http://www.bizjournals.com/philadelphia/news/2011/11/11/business-journal-healthcare-innovation.html.