This is the first in a series of blogs I am writing over the next few weeks that will help define the high level framework for a whole system transformation using the lean methodology. I am not going to focus on the specific tools required to achieve each of the framework components because there are many […]
Congratulations to Eric Dickson M.D. and the work he did at The University of Iowa (my alma mater) and now the work he is doing at U. Mass. The results he reports in this paper from The Annals of Emergency Medicine clearly shows that successfully applying the lean methodology leads to remarkable results.The interesting point is […]
I am continually asked for the prescription to whole system lean transformation. Being a physician I guess people expect me to write it out and hand it to them. I suppose they think they can then go to the pharmacy and get the pills and they will magically know what to do. Unfortunately,nothing important in life works […]
White House Press Secretary Robert Gibbs said President Barack Obama and congressional Democrats should “let the dust settle” before making any decisions. Senior Senate Democrats such as Jay Rockefeller (W.Va.) urged lawmakers to take “a couple days to cool off.” And House Democrats such as Robert Andrews (N.J.), who chairs a health care subcommittee, predicted […]
Washington legislators remind me a lot of GM; top down management focused on the wrong problems leading to poor results. At great lean companies management exists to serve the needs of their customers. For years GM produced cars that many Americans didn’t really want with quality that was average at best. Management not only didn’t listen to their customers […]
Most of the energy in Washington has surrounded the insurance component of reform. Although it is a laudable goal to have all Americans covered with some form of health insurance it is only one step. without significant delivery reforms Medicare and Medicaid simply go bankrupt sooner. The first step in delivery reform should be transparency […]
Unfortunately, the language introduced by Senator Kohl regarding the Healthcare Value Leaders Network (HCVLN) did not survive the final senate bill. It’s unclear how the ballooning costs of healthcare are going to be managed if providers like those in the HCVLN aren’t studied and lessons learned not passed to the rest of the industry. At some […]
The WHIO data base has been 4 years in it’s development.This non-profit organization is a collaboration of many of the state’s key health care organizations representing payors, employers,providers,and the state government (see the individual organizations involved at http://www.wisconsinhealthinfo.org/about_us.php ) Presently 1.6 million Wisconsin residents are in the data base but at the end of next year […]
I have had the privilege of being the founding chairman of two organizations in the state of Wisconsin which are now considered national models by many leaders. The Wisconsin Collaborative for Healthcare Quality (www.wchq.org) is a unique non-profit focused on reporting all payor all patient quality data on a range of indicators. It was one of the CMS […]
The Medicare payment system is fundamentally flawed. It penalizes efficient providers delivering better quality. It incents over utilization and the building of over capacity. In this paper we begin to document the immediate things that must change if we are going to incent high quality, low cost care with appropriate utilization. See attached document for further details.MedPac_whitepaper_1209
