To the best of my knowledge all the people talking about revamping healthcare seem to be more interested in cost-shifting than fixing the problem. In my opinion, the payers should require providers to implement a good management system based on Baldrige National Quality Award criteria or ISO 9001 or a system that combines the two.
If we don't fix the broken processes for providing care, we can dump tons of money into the system and get the same results we have been getting for years.
We need to overhaul the whole system relating to providing care in the U.S. We have the chance now and shame on us if we don't take advantage of this opportunity.
We need to limit lawsuits to those who really were harmed in some way. We need to reduce the greed in many aspects of the system of today. We need to monitor the actual outcomes relative to the planned outcomes. When the outcomes are not planned, we should take some action to prevent this from happening again if possible.
We need to limit the care to what is needed and not do a lot of the procedures done today to provide a better defense in court (assuming we can limit the lawsuits to those that are really necessary). We need to require providers to continually improve the processes, all the processes including the supporting or ancillary processes, so the doctors can practice more medicine and do less wasteful paperwork. We need to weed out those providers that don't provide quality care. We will improve patient safety if all the processes are done correctly the first time and on time.
Installing IT is great provided it is installed in a system that works. Computerizing a bad process only makes it "badder" and not better. The federal government needs to come up with the data format and system requirements very soon so we don't have a plethora of systems running out there that can't talk to each other.
The bottom line is lets fix the broken system and basically begin with a clean sheet of paper and build a system that works for all stakeholders.
According to the World Health Organization, the U.S. is No. 1 in spending and somewhere around 20th in quality of care. So if we improve the system by improving the processes, we should have more than enough money to pay for those that truly need help. To my knowledge healthcare is not a right spelled out in our Constitution. It may be morally right to provide care for all, but how and when we do it should be in a good system. Not all care should be the top-of-the-line. Sometimes simpler and less expensive care is better for all.
Mickey ChristensenPresidentTQM SystemsBaton Rouge, La.
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