Which way should healthcare Lean?

There are two camps in the ongoing struggle to improve healthcare; ‘outside the system’ consumer/entrepreneur driven camp, and ‘inside the system’ healthcare administrator/government camp.  Both seem to be focused on improving health outcomes, reducing costs and improving patient experience (the Triple Aim) but despite common goals I see little evidence of these camps working together. 

So why is there so little collaboration between the two camps?   One reason could be in how each camp approaches a problem.   Entrepreneurs tackle a problem from a Ready, fire, aim approach,  while healthcare systems are traditional ready, aim, fire implementers, often so focused on perfecting the aim, the target has long moved away by the time they are ready to fire. 

There is some common rhetoric emerging from both camps.  In the entrepreneurs world "Lean Startup" (2008) is a popular approach for launching businesses and products that relies on validated learning, scientific experimentation, and iterative product releases to shorten product development cycles, measure progress, and gain valuable customer feedback.  In the healthcare administrator’s world, the Lean approach to healthcare focused on driving out waste so that all work adds value and serves the customer’s needs is gaining momentum.  Both processes depend on measuring results and this is the healthy change that will drive success.

Solutions will emerge when all parties recogize the strength that comes from the ability to measure success together.  The empowered healthcare consumer taking control of and measuring the factors influencing her health.  The healthcare provider working in partnership with the consumer implementing an effective approach to diagnose and treat the consumer that includes the measuring of outcomes.  And the healthcare administratorsand governments use those outcomes to measure the efficiency in the system.  

But it starts with the empowered consumer and there is a logical reason why. The empowered consumer is the link to bridging the incredible advances in healthcare technology emerging from forums like Future Med with the efforts of administrators and governments to make our healthcare systems more effective and efficient.  

The healthcare system isn’t ready for the quickly evolving space that health entrepreneurs are creating.  Bill Gates figured that out long ago, “The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency.” Apply this to a healthcare innovation like electronic health records and you understand why the implementation of EHRs is in such chaos right now.  Healthcare has never been a system based on efficiency (whether it should is a debate for another blog).

It’s OK that the system can’t handle the changes in technology right now, because healthcare consumers are ready.  The opportunity before both camps is to recognize the importance of the empowered consumer and to encourage their participation.  Entrepreneurs seem to recognize this which is why many new devices are marketed to healthcare consumers.  What we need is recognition from administrators, governments and healthcare providers.  The Fainting Goat has some practical advice for all the participants in this important work: 

• To all the entrepreneurs out there, please keep the products coming and educate consumers along the way.  Empowering healthcare consumers requires a significant cultural shift and you are doing the heavy lifting.
• To the healthcare providers, partner with consumers to use self-tracking tools as a way to better inform their treatment strategies and diagnosis. 
• To administrators and governments, these technologies will enable you to save money if you work with them and the consumers who control them.  Break down the barriers to using these technologies and create some consumer-enabling incentives such as tax breaks or reduced insurance fees.   
• To healthcare consumers (that is every single one of us) take responsibility for managing your health in whatever way is comfortable to you. 

As for me, The Fainting Goat is anxiously awaiting the Misfit Shine set to arrive next month and will gladly consider any technology that will help me to live a long and healthy life. 

It’s your health.  It’s your health information.  Manage it well.