Here are the final three items on my list of the top things I expect to see in health care over the next year.
I will stop at 10.
Which are on your mind? (Please post your comments, or your top 10 list below.)
Top 10 List, Day 3:
1. Fight Over Health Care Reform
2. Transparency. Moving Toward Reporting Performance & Outcomes in Health Care
3. Organized Physician Practices (Can You Say Accountable Care Organizations?)
4. Health Care Amenities
5. Recruitment, Retention and Engagement
6. Declining Revenues
7. Reduction in Cost per Unit Service
8. Looking for Solutions Outside of Our Industry. Health care has been slow to adopt business practice changes that other industries have used to be internationally competitive.
Industrial re-engineering, relentless process improvement and management transformation will increasingly be used in hospitals beyond the usual inventory and production functions.
Benchmarking of performance will become more focused on best in class, not best in industry. (Think of the service expectations set by an excellent hotel versus a traditional hospital).
9. Quality & Safety. There will be continued focus on both of these areas, but newer concerns are likely to surface.
Medication safety will be extended from the risks created by patients being treated with numerous medications to newly discovered, unanticipated consequences of therapeutic drugs, such as diabetic and chemotherapy agents. Surgical errors and external reporting will drive relentless focus on these problems.
Watch for unintended consequences as well, with surgeons and hospitals declining high-risk patients because they may adversely affect performance numbers.
10. Concentration of the Continuum of Care. Hospitals will be more concerned about what happens to the patient after he is discharged.
This certainly is the right thing to do, but the concerns will be greater if problems occurring after discharge lead to readmissions or adverse events attributed to the hospitalization.
Hospitals will be increasingly managing the resources needed by patients, not all of which are purely medical.
One approach championed by Dr. Richard Shannon at Penn is to ensure that extended Medicaid applications at the time of discharge are accompanied by food assistance applications. Food scarcity may very well lead to adverse consequences as quickly as failure to get necessary post-discharge care.
Hospitals will link directly with primary care providers to ensure a patient without a PCP is seen quickly after discharge rather than leaving this up to chance. This drives much of the thinking of organized physician practices and ACOs.