in Business Design

Integrated thinking in health care

Brett points to The Quality Cure? (paid archive) a New York Times profile of David Cutler’s ideas for reforming healthcare in America, where providing more care without going bankrupt seems impossible. Cutler, an economist, developed financial models to show how we should “focus on improving the quality of care rather than on reducing our consumption of it. Rather than pay less, he wants to pay more wisely — to encourage health-care providers to do more of what they should and less of what is wasteful.” (see Atul Gawande’s The Bell Curve for more on measuring doctors’ performance.)

To accomplish this, he’s acknowledged that purely financial thinking isn’t enough, we need to integrate the economics with human-centered organizations, smarter use of technology and innovative organizational design:

Reoriented to managing ”health” rather than merely costs, H.M.O.’s might again become a useful part of the healthcare landscape, Cutler says. Managing care, he says, was a necessary idea that went off the tracks as H.M.O.’s became remote, single-minded cost-control freaks. His models for the future are the progressive organizations (he calls them hippie places) like Kaiser [Permanente, the insurer and provider based in California] that employ their own doctors, invest in computers and ”engage” their patients. They manage quality as well as cost.

Also see Aligning the Stars: Using Systems Thinking to (Re)Design Canadian Healthcare (.pdf).