Monthly Archives: February 2009

Business Intelligence

Healthcare economy: How much countries spend on healthcare

Let us examine some interesting facts on healthcare spending.

U.S. Health Care Spending to Double by 2017

According to a recent report published in the online edition of Health Affairs,U.S. healthcare spending is projected to reach $4.3 trillion. This equates to approximately one fifth (or 19.5%) of the gross domestic product(GDP).Hospital spending is expected to increase and gradually slow down through 2017, going from $696.7 billion in 2007 to more than $1.3 trillion in 2017. Prescription drug spending is expected to slow down initially and then start to accelerate through 2017. Drug spending will increase from $231.3 billion in 2007 to $515.7 billion in 2017.

Healthcare spending to double in India by 2012

For an emerging economy, India spends a small $14.8 billion on healthcare which equates to roughly 5.2% of the GDP. This will however change quickly and the country is expected to spend $33.6 billion by 2012 with healthcare spending accounting for 8.5% of the economy.

Here is a graph comparing spending for some countries as a % of their GDP of their stack up currently (Source: WHO Health Statistics,2007).
health_spendj

Emergency Care, Lean, toyota

UK hospitals use lean to reduce costs and improve care

Video update!!!

British Healthcare system
The National Health System(NHS) is the publicly funded healthcare system in the UK. The NHS provides the majority of healthcare in England, including primary care (such as general practitioners), in-patient care and long-term healthcare. NHS hospitals are increasingly competing with other private health systems and facing financial difficulties.

Lean applied in Birmingham Heartlands hospital

Recently, the NHS health system and other health systems have adopted ‘lean principles’ that evovled from the Toyota production system to reduce waste. They are primarily focussing on clinical areas such as emergency departments but plan to use it ancillary areas, pharamcy and other support functions.
They have also come up with innovative solutions such as using Nurse practicioners in the ED to treat low acuity patients . They have been able to reduce the number of patients waiting from over 40 to less than 10.

Metrics, patient satisfaction

Healthcare Metrics Vol. 2: Physician rankings

Emerging trends in healthcare: Physician Ranking systems

A previous post, on this site briefly touched on ‘Zagat survey style’(for those not familiar, the Zagat survey rates restuarants in the US and around the world) physician ranking systems making their presence felt in the websphere. Believe it or not, this is not a flash in the pan. Infact, there are several establish sites that already rank physicians. Some others are extending this to hospitals, but more on that later.For this post we will stick to physicians and providers.

N.Y. leads the way

Late last year, New York’s attorney general Andrew Cuomo announced a first-of-its-kind agreement with Cigna Corp. The plan is to establish an industry standard for the doctor-rating systems that health insurers increasingly use to guide consumers. While health plans and insurers have been doing this for years, public will now have access to how health plans measure and rate doctors in terms of quality of care and cost efficiency.

Sounds fair and square? So what is the caveat? If you are a health professional you will probably identify right away that there is a possibility that this might eventually steer patients to the cheapest, rather than the best doctors and services. UnitedHealth, for instance, gives doctors and hospitals that follow certain care guidelines and are cost-efficient a “UnitedHealth Premium” designation.

Quality or Cost ?

Jim Collins in his best selling book ‘Good to Great’ says that Good is the enemy of Great. However the same logic can not be applied here. Meaning, “Quality is not the enemy of cost”. If you are not convinced all you have to do is look at other industries. In the auto industry for instance, they have realized that at some point there is a tradeoff between quality and cost and so good quality at a reasonable cost has become widely accepted. Quality guru, Walter Massing states that the only viable policy is to concentrate on failure costs and to justify prevention measures for one problem at a time.

What consumers need to know and health 2.0 sites need to publish?

So where does all this lead? Healthcare providers have a stake in this and so they will need to brace themselves, start looking at quality of care and efficiency a little more seriously. The serious Health 2.0 sites need to start publishing performance / rating on a host of information besides bedside manners and pleasantness of physician (which are important, but do not provide any insight to the physician’s chances of success in the treatment process).

Here is a sample list of indicators that we need to look at to determine the best doctors/providers for our friends and family.

Customer satisfaction metrics:Bedside manners
Process metrics: Average wait times
Clinical quality and outcomes: Hospitalization rate and risk-adjust mortality
Other measures: Clinically integrated IT systems (known to influence medication and surgery risks)

Announcement

HealthCare Management Blog 2.0 – New layout and features!!!

TGIF!! to all our loyal readers. We are happy to unveil our new presentation and cool new features.

Why we changed our site presentation?

As you can see we have changed our site layout design. The motivation behind this is to provide better readability and user friendly interface. Also, we picked this design after exhaustively researching usability of several hundred designs. As our site and community grows, we would like to provide many more exciting features and this site is better suited for that.

What is new ?

1. Registration: Readers can now register by simply clicking the register link under Meta. This is particularly useful for users who would like to contribute articles, ideas and tools on a regular basis

2. Search: We don’t need to explain that to the googler’s of the world do we ?

3. Entries RSS and widgets to embed in your site: You can now subsribe to this site via a host of reader services such as google reader, news gator, netvibes etc.

You can also embed entries on this site as a widget on your personal site or social network page!!. Just click on entries rss for this.

4. Monthly Archives: Access prior month posts quickly and easily with the archives organized by month. You can get to the archives using either the left navigation panel and the right navigation panel

patient satisfaction, toyota

Improving patient satisfaction – How Toyota would do it?

Survey rage

Measuring patient satisfaction and using surveys is getting increasingly popular in US healthcare. If you work for a hospital, physician practice or even a private clinic, you would have become familiar with some form of the patient satisfaction survey or another. If you are not then look online and chances are you are already being rated, ranked, scored and reported by someone online. Late last year America’s largest health benefits company(Well Point), engaged Zagat Survey to develop a new online survey tool. Even, Google is supposedly working on an online rating app.

Making sense out of surveys

But how do you balance these scoring systems , with more meaningful assessments of care quality and competence? Patient safety guru Bob Watcher, who coined the term ‘hospitalist’ says that a balanced approach is more important than a single peephole. What he means by this is that, it’s important to look at a number of different factors(such as hospitalization rates, acuity etc) while determining patient satisfaction. We will save the discusssion on what such a survey might look like for another day.For now, let us focus on how to choose and use existing internal and external patient satisfaction systems. Let us do that by asking a hypothetical question ….

“How would Toyota manage patient satisfaction ?”

Toyota management realizes the importance of accessing the “Voice of the Customer” . Its organizational structure has a customer relations department that handles customer satisfaction (i.e., patient surveys in our case) and customer relations (i.e., employee training and incentives, patient assistance center, and dispute resolution).

If you aren’t listening to your patients, you can’t have all the business attributes that provide them good care and value. However, if you aren’t using this information to create change, then don’t bother listening
Toyota might establish a customer survey system that measures patient satisfaction with the process of care, the delivery experience, the service experience, and clinical quality. Based on the results of these surveys, they would develop your strategic plans to improve customer service.
Deparment/Service line Reporting– Summary evaluations and specific, but anonymous, customer comments would be shared with the departments. Departments/specialities would now monitor their own progress, which puts less pressure on the measures
Elminitate inter department competition– Gaming occurs in nearly every system when two departments scores are compared. We all know how Inpatient units and Emergency departments often game the survey system to show inflated scores in hospitals. So Toyota would establish acceptable levels of performance and eliminate making distinctions of performance above that level.
Telephone Surveys– Telephone surveys would be conducted to determine initial satisfaction with the care process. Standards for conducting the phone survey and processing the data would also been established.