The Crystal Ball 2

“Jaded Julie, during my days in industry there was an organization, supported by the industry, whose mission was the development of knowledge regarding the industry’s impact on the environment. This knowledge was for use in the near term, and it was developed in response to process changes and proposed government regulations. Basic research was done elsewhere, and an industry association handled government lobbying.”

“That’s all very nice, Curmudge, but why are you telling it to me?”

“I thought that for once I’d start by discussing a topic about which I knew something.”

“Well, that’s a switch, and it’s better than your usual prattle. But what does it have to do with health care?”

“Fortunately, there are similar organizations—developers and purveyors of knowledge—serving health care. People in hospitals are too busy with patient care, daily management (ready-to-serve time), hoshins (discretionary time), and other local issues to contemplate a global near-term future. That has created the need for outfits like the Institute for Healthcare Improvement (IHI), The Advisory Board, Sg2, and others. They are supported by membership dues and/or fees for participating in educational offerings and consortia devoted to specific issues.”

“These groups sound valuable, Curmudge. I understand that they are staffed by highly competent people whose job is to study, think, listen, talk, and write on behalf of the health care industry. Health care administrators are probably aware of the problems they will be facing, but they might feel overwhelmed by all of the countermeasures they could be implementing. According to their literature, these specialized consultancies help support and steer our thoughts in the direction of viable results with evidence and data to support them. Can you give me more specifics about these outfits?”

“As we said once before, IHI’s web site is a bit like a supermarket. If you have a problem, push your cart down the aisle; and you might find a solution. On our crystal ball timeline, IHI deals mostly with the present. However, its teachings will help organizations improve their near-term future. ‘IHI focuses on motivating and building the will for change; identifying and testing new models of care in partnership with both patients and health care professionals.’ IHI’s work is funded through their fee-based program offerings and services, and also through the support of foundations. Their reports, such as White Papers and Improvement Stories, are available to the public. Among the many subject areas are Office Practices and Patient-Centered Care. Here is an example of one of their forward-looking, fee-based colloquia to be held in 2011, ‘Thriving in an Era of Health Care Reform.’ ”

“Curmudge, I like your term, ‘purveyor of knowledge.’ Did you ever get paid for ‘purveying’ knowledge?”

“Not much, Julie, and any knowledge that I still have is free to a good home.”

“So what other purveyors of knowledge for the near term do we have for health care?”

“According to The Advisory Board, they are ‘the leading provider of comprehensive performance improvement services to the health care and education sectors—including operational best practices and insights, business intelligence and analytic tools, management training, unbiased technology evaluation, and consulting support.’ Note that they don’t work for health care exclusively. They have recently acquired Southwind, a ‘management and advisory firm focused on hospital-physician alignment and physician practice management.’ “

“It’s been awhile since we reminded our readers that a blog is not an encyclopedia or a textbook; all we hope to do is stimulate the readers’ interest. We can put them ashore, but they will have to explore the island by themselves.”

“For example, Julie, these are some of the programs accessible to corporate members of the Health Care Advisory Board: Strategy and Operations Research, Clinical Research, Leadership Development, Business Intelligence and Analytics, and Physician Performance. In our case, an Affinity employee can simply guide his mouse to the information of interest.”

“Curmudge, I understand that The Advisory Board has developed a lot of information on accountable-care organizations (ACOs). What’s an ACO anyway?”

“Good question, Julie, to which the answer is not completely defined. Here is the March 28, 2011 Wall Street Journal’s answer: ‘In broad outline (ACOs) propose to unite doctors and clinics or hospitals in groups that pool their resources with the goal of trimming spending while boosting the quality of care. When the group can show that it is improving care and delivers it for less than the cost projected—arrived at by crunching historical patient data for that market—a share of the savings goes to the ACO’s bottom line.’ This concept is part of the 2010 health care law and is not yet fully developed. It initially only applies to Medicare patients and, you’ll note, contains some features reminiscent of the medical home.”

“So what’s next, Curmudge?”

“What’s next will be in our next posting on this topic. Anyone who has read much about accountable-care organizations looks forward to quitting for the day, and c’est moi (that’s me). See you next time, Julie.”

Affinity’s Kaizen Curmudgeon