During the mid-90’s, I worked for a consulting firm implementing electronic medical records. Our tag line back then was, “People, Process, and Technology”(PPT). In 1999, the Institute of Medicine (IOM) informed the healthcare industry that it ended the lives of close to 100,000 patients each year through preventable medical errors. So what did the industry do? Healthcare jumped in the middle of the PPT equation with both feet and focused on process redesign. We did all the process redesign we could think of; Hammer and Champy, TQM, CQI, Root Cause Analysis, Six Sigma, name your flavor. What was our return on investment for all the process redesign? According to the IOM 10 years later, the healthcare industry had made almost no progress in decreasing preventable deaths and untoward outcomes.
What to do next we collectively asked ourselves? Innovation has always cured America’s ills. Technology must be the solution! Today, we are in the throes of spending billions of dollars on technologies such as EMR’s, EHR’s, PHR’s. RHI’s, E-Mar’s and the like in an attempt to avert preventable untoward outcomes. During my tenure in the 90’s implementing these technologies, I and people smarter than I, could never develop a business case that would quantifiably demonstrate a positive return on investment for the implementation of these technologies.
What can we do to positively impact this epidemic of unnecessary injuries and deaths? Focus on the first variable in the PPT equation, the people. Patients seek healthcare for the “care”. The care provided by knowledgeable healthcare professionals. Patients do not evaluate healthcare organizations by which EMR or MRI they use. They do not make healthcare decisions based on which re-engineering strategy the organization chose to pursue. They make these decisions based on the trust they place in the healthcare professionals they select to be their advocates in this overwhelming system we call healthcare. Sadly, it is the people who deliver the care, the true value proposition of the healthcare system, that are the last point of investment in the PPT equation. More often than not, the education budget is the first to be cut while marketing budgets increase. Technologies exist that would greatly increase the knowledge and more importantly the competency of those delivering our healthcare. However, not a single care provider improvement technology was listed in HealthLeader’s Top 10 Technologies to Watch in 2012.
During these turbulent times in healthcare, there is no room for sacred cows and earmarks. There is a direct relationship between the providers of care, both in numbers and quality, and the outcome of the patient. The time has come to invest in people and people improving technologies if we are truly going to put an end to preventable healthcare injuries and deaths.
