Healthcare, as an industry, has historically been a tactical organism. This should be no surprise when you look at the evolution of medicine and care delivery. The primary model for centuries has been, someone gets sick then we figure out how to get them healthy again. The approach is reactionary by nature, which leads me to the question, ‘has this led to an industry that doesn’t know how to think strategically?’ Granted this is a broad generalization, and maybe it’s fairer to say the industry needs more deliberate practice at being strategic.
When you look at the issues the industry faces, from care models, to tools designed to enable care delivery, complaints abound about gaps being created and solutions quickly losing viability, or worse inhibiting the industry from evolving forward. A good example is looking at the current state of Electronic Health Records (EHRs). The intent behind these tools was good, get providers off paper and help reduce errors involved with paper based care. The problem is they are now being blamed for prohibiting healthcare organizations from taking the next step in care delivery, especially the interoperability needs to conduct useful analysis and population health management across the continuum of care for a patient.
As the industry attempts to move to a pay-for-value model success is going to be more dependent on the ability to easily share data and empower the patient with easy access and portability of their health data (or what is supposed to be their data).
Some may argue that some of these barriers may have been intentional by solution creators to maintain proprietary control, but I would argue that another part of the issue was probably less intentional. Many of the solutions on the market, or being developed, are to automate current processes and structures that are still focused on a fee-for-service model. Yet the discussion is how the industry needs to move away from this, not just around reimbursement models but in care pathways as well. In essence, what we are talking about is the industry becoming more strategic. Rather than reacting, think ahead (strategically planning) and keep invest resources to that common destination.
This is not limited to vendors and device makers, it can also be seen in the general confusion on what care pathway models should look like for the future.
So given the industry needs to make this shift, can we confidently say that there is a clear vision of what that looks like? Not how it looks today, but what it needs to look like in the near-to-distant future. Basically a common strategic vision for an entire industry that care givers, device manufactures, digital health companies, pharma companies, payers, patients, consumers, etc. can work towards and align their efforts to help move the industry there. Having that common vision would then allow all the players to back into what needs to get done from each of their unique perspectives. Rather than building well-meaning solutions or processes that only create barriers shortly after adopted. Look ahead and design to scale and evolve as the industry moves along its strategic trajectory. You could say that maybe the Affordable Care Act (aka Obamacare) was an attempt at this visioning, but even that was designed to go after specific problems it saw in the system rather than tackling the whole issue.
So to oversimplify this further, I go back to the well-known quote by Stephen Covey, ‘begin with the end in mind.’ To do this stakeholders in the healthcare industry may need to find a way to balance tactical execution with strategic planning to evolve the industry to where it needs to be. What are your thoughts? Do you feel the industry has a clear and common vision of the future?