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Simpler Times and an Overwrought Healthcare System

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by bill bysinger, for healthleaders online, sept. 23, 2002


i have been spending today divided between working and watching tv regarding the ceremonies for 9/11. last year i traveled from the west coast to the east coast on the evening of 9/10 and watched the today show on the morning of 9/11 as the planes commandeered by the terrorists hit the world trade center twin towers.

having been in meetings in those towers, the horror was very personal and having also been in the military during the viet nam era i had a desire to go back and re-enlist to go to fight a new war against this attack on the united states.

so what has this all to do with healthcare?

it seems to me that what 9/11 should have done for the u.s. economy and u.s. culture was bring us back to basics regarding concern for each other, for our communities, for returning to a simpler way of living our lives. we have seen this in much of what has happened to american business and the american people. all of a sudden we are concerned with accountability, ethics and really understanding the value of what is being produced, versus an inflated stock value and over inflated compensation. we are also beginning to look for simplicity in our lives.

healthcare, on the other hand, with the exception of disaster planning, has not changed much at all. in fact, there are no signs that healthcare has made any move toward a simpler way.

instead what is happening?

*premiums are increasing at a rate that most businesses cannot even afford to offer much of a medical package to their employees without employees having to spend money on a major portion of the premium, while still having to pay high co-pays and high deductibles.

*physicians are being squeezed to lower their rates when most are so over extended in their practices that they cannot even see any real profit to sustain a viable business.

*healthcare executives are still being paid ridiculously high compensation when very little measurable results are even discussed, much less used to hold them accountable.

*patients feel disenfranchised and wonder how much it is going to cost them every time they go to seek treatment, versus looking at healthcare as a preventative process.

*healthcare information is still as bad as it always has been, with too much on paper, little integrated. if it is on a system, the software was probably designed in the 1970s and early 1980s.

*finally, government regulations are mandated with little understanding of the consequences or the penalties of non-compliance.

what we need in healthcare is what president bush has: resolve.

resolve to make the industry better. we need real leadership from every aspect of the healthcare industry.

we need more than talk and technology. we need vision. instead, we have created too much confusion.

as an example, we need look no further than hipaa. hipaa is on overload. i am invited to at least three hipaa conferences a week. i am asked to attend at least one hipaa conference call weekly, and i am asked to consider some new hipaa tool more often than time permits.

hipaa has become too complex. it was not meant to be. it was meant to simplify healthcare. unfortunately with the language in most of the rules and guides, along with the complexity most consultants and experts convey, the administrative simplification act has become anything but simple.

this is indicative of what healthcare has become: way too complex because it is being dragged down by inefficiency, waste, redundancy, high cost and questionable quality.

we need to take healthcare back and create the change to make it simple, cost effective, and participatory.

how do we do that? we can do it because we have technology and capability to make healthcare efficient, effective, and informative. we have the ability to create greater access through the internet and telemedicine.

we have models to deliver quality care through evidenced based medicine. we have clinical technologies on the leading edge of care. we have a process models, collaborative interactions and data standards in hipaa to create integration. we have a patient population that wants to take more control of their healthcare options and healthcare dollars.

what we need is leadership vision:

a collaborative mindset.

a desire to change.

a passion for quality.

a resolve to be accountable.

a realistic measure of success.

how we do it? we start with making hipaa simpler to implement. we can use hipaa as a mechanism for change (see is hipaa really happening? ). we can commit to implementing hipaa as the medium for process change.

we can begin to address clinical consistency through evidence based medicine and other like techniques. and we move the patient record to a useable, digitized model that can quickly be accessed and quickly be integrated across the continuum of care.

we need to build a model for healthcare based on the underlying principles of administrative simplification. these principles are cost reduction through process efficiency, easier access through data standardization, high quality through better integrated information and overall a better industry through the physical and electronic collaboration of payers, providers, employers, and patients.

we need to create a world were healthcare is affordable, accessible and consistently delivers information that is secure, private and integrated.

as a leader of the world in the 21st century, one of prime rights that we must protect is everyone's right to good healthcare. inherent in that is to make good on the promise to keep healthcare information private and secure.

we can overcome much of the threat of biological attack by making sure that none of the population's healthcare information is breached. at the same time, we can give everyone the peace of mind that if we have a medical crisis, information can be easily and securely accessed for care delivery.

hipaa must happen. the problem is not hipaa over load, it is healthcare complacency, not on the clinical delivery side, but on the information, process and efficiency side.


bill bysinger is the principal of wgb advisory where he advises healthcare organizations and healthcare technology organizations on hipaa, ehealth, and technology solutions for the healthcare provider market.

he may be reached at (360) 981-0173 or by e-mail at wgbysinger@earthlink.net.

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