Connecting the dots

Nov. 28, 2023
French post-impressionist George Seurat recognized and understood that chromoluminarism and pointillism could generate beautiful art using dots in the 19th century, a philosophy shared by Roy Lichtenstein, American pop artist and abstract expressionist a century later. As consumers, we can benefit emotionally from what we see.
 
The same could be said – or hoped for – with the topsy-turvy contemporary American healthcare reform movement. So far, few, if any, seem to be connecting the dots in what could be described as conundrumism.
 
Unfortunately, the challenge with federal/national healthcare reform projects to date is that the efforts have been inverted. 
 
Oh, there’s the pretense and pretext on display for PR to promote how it’s all about access, but that’s as genuine as those trite platitudinals, “thank you for your service” and “thoughts and prayers” (especially ironic when offered by agnostics).
 
By inverted, the descriptor refers to efforts that start with the payers and move backward. It’s all about the accountability, paperwork and records designed to make the payer process more efficient for payers, but then their premiums and rates continue to climb with little accountability or even rational justification outside of making insurance company executives and shareholders happy. The challenge lurks somewhere between WaPo investigative reporters Carl Bernstein and Bob Woodward’s “Follow the money,” during their Watergate series in the early 1970s and actor Cuba Gooding Jr.’s famous line as athlete Rod Tidwell in the 1996 film, “Jerry Maguire” when he exclaims, “Show me the money!”
 
This does little for the patient, means more administrative work for the clinician, regardless of automation (including A.I., blockchain, etc.) and even less for supply chain. 
 
Nopity-nope-nope-nope – authentic and meaningful healthcare reform should start with the patient and move forward in terms of behavioral modification (yes, parenting) with appropriate incentives for compliance and penalties for non-compliance. The late corporate icon Steve Jobs was known for emphasizing that product development begins with the customer experience to which you then innovative and apply technology.
 
What have we accomplished so far? With the emphasis on electronic health/medical records usage, healthcare insurance coverage and supply data standards adoption and implementation as well as a host of other concerns, we’re still left with population ennui, clinician burnout and manic decisions/panic reactions to crises. 
 
Time travelers from the 1980s simply shake their heads in disappointment and exasperation – and not just because we don’t have flying cars by now today.
 
What do we need? Following are five suggestions.
  1. Everyone gets a baseline body scan – “free” as if either subsidized by the government or a credit by the insurance company that works with providers and imaging equipment suppliers to facilitate and enable access. This includes a full brain, heart, circulatory and digestive system scans.
  2. Everyone gets an EHR/EMR using the same legal precedence as the government requiring the switch to digital TV and providing COVID-19 tests and vaccines. People can be incentivized to input data in some way – be it via tax breaks or stipend to use on insurance premiums. However, they’re also penalized for non-compliance in that they either pay a tax or pay extra on their insurance plan, not unlike paying extra to have your telephone number unlisted in the Yellow Pages of yore.
  3. Everyone gets a baseline health app on their phone. HIPAA-protected data input then is automatically uploaded to their individual EHR/EMR and used to calculate their individual “health score,” to influence predictions, prescriptions, proscriptions and premiums.
  4. One’s health score is like a credit score where your purchases and payoffs affect your number that banks and employers use to determine risk. Hence, doctor visits, pharmacy visits, adherence/compliance to clinical recommendations and demonstration of healthy activities, behaviors and habits elevate your score and make you more attractive to insurers (think premium savings, etc.) and vice versa.
  5. Healthcare delivery, traffic and transactions should be safe and seamless with secure electronic transactions and the capability of receiving proper (as in comfortable, convenient, effective and efficient) care whether an inpatient, outpatient or at home. 
All this spans administrative, clinical, financial and operational aspects. Supply Chain, Sterile Processing, Surgical Services, Infection Prevention, Environmental/Facility Services, among others, work together to connect the dots. They investigate and procure what’s needed. They maintain sterile instruments and fields to prevent infection, which reduces the need for inpatient services so that patients are not discharged, and visitors do not leave with bacterial or viral infections that perpetuate a cycle of sickness.
 
Get the point? Work together to change behavior and generate healthy results.

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