sábado, 14 de fevereiro de 2015
This post is part of an occasional series focused on the health care industry, where escalating costs are posing unprecedented challenges, new models are upending longstanding ways of doing business and the digital age is fueling a new era of innovation.
The challenges facing the health care industry threaten to spiral out of control. The high and rising cost of health care; the convoluted, disjointed medical care system; the massive and growing burden of obesity, heart disease, diabetes and cancer; difficult ethical questions about what constitutes appropriate care; incentives to provide more care instead of better care. This potent mix of challenges keeps a lot of very smart people awake at night. Sleep, by the way, is a pretty important aspect of good health and well being.
But there are rapidly expanding pockets of change, many of them, where stakeholders are partnering to brainstorm, test and optimize solutions. One of those is at Minneapolis-based HealthPartners Health Plan, where such initiatives are growing under the guidance of Dr. Shaun Frost. He works at what has historically been a sometimes difficult point of interaction – between the doctors who provide care and the insurers who pay for it. As a practicing physician himself, Frost walks into meetings sharing common ground with other health care providers, but more than common ground is needed to foster the innovation needed in health care. The goal of these collaborations is to improve delivery of care in three areas: health, patient experience and affordability, the so-called triple aim.
In the spirit of collaboration, Frost has shared his secrets to building relationships across silos – even those with historically complicated relationships – with his peers in the industry, and here. Read on for Dr. Frost’s prescription for collaboration, which starts with four tenets of leadership, followed by some of his guiding principles for navigating the choppy waters of change.
Leadership lessons for collaborators
Differentiate adaptive from technical challenges: Any change in an organization or system will bring about technical challenges, which may be substantial but can be solved using current ways of thinking. Examples might be adapting to a new type of technology or opening a new retail interface. Adaptive challenges, though, are only solved by creating entirely new ways of thinking with everyone affected involved with developing the new mind-set. “We need to create completely different ways of problem solving and different ways of thinking about how to address these challenges,” Frost says. “Designing new problem solving methodologies is usually more complex than solving the surface-level problems themselves. It thus behooves those affected by adaptive challenges to work collaboratively on the process of thinking differently.” For example, Frost argues insurers alone should not design and deploy value-based health care innovations. “They should be produced collaboratively through joint input from everyone who has a key interest in payment reform.”
Create empathy through generative dialogue: This tenet is key as distinct parties who may have had difficult relationships in the past lay the groundwork for collaboration. Frost also calls it “listening from outside ourselves, while simultaneously listening from inside the perspective of others.” Basically, you have to recognize that all perspectives are relevant, and everyone brings their own context to a problem, a dataset, a brainstorm. “True collaboration is facilitated by the degree to which we are able to genuinely understand the perspectives of others, and how those perspectives influence the environment in which we collectively operate,” Frost says. “This results from generative dialogue during which people honestly listen so as to appreciate the validity of viewpoints that may be different from their own.”
Shared accountability: In health care, recognizing that everyone interacting with a patient bears responsibility for outcomes is what Frost calls “the glue that pulls it all together” and the tool that cuts out blame and an us-vs.-them mentality when partners are developing health care collaborations. One way this looks is shared financial gains when goals under new models are achieved, and shared losses when they aren’t, rather than one party assuming all the risk.
Compete on execution vs. innovation: This is a principle Frost acknowledges isn’t right for all industries. But in health care and other sectors built around an altruistic goal, he argues it’s important to consider. Frost works on developing value-based (versus volume-driven) reimbursement models for delivering health care, an area where many insurers, providers and other organizations are testing a variety of approaches. He explains how “we need to recognize that by changing from a pay for volume to a pay for value system, those people who possess the tools that generate value will have an economic competitive advantage. If those tools are viewed as intellectual business capital, they may not be shared freely with others in the community – which would ultimately retard progress towards enhancing value for all.” He argues health care stakeholders should agree to compete on the implementation and execution of new tools, instead of competing on the possession of the tools themselves.
Stay on track while navigating change
Recognize major change is a marathon, not a sprint: Respect the magnitude of challenges and set smaller milestones. As Frost’s organization develops collaborations, they start with early adopters – those most likely to be on board and achieve success – and they break down goals by focusing on one piece of the triple aim, developing models that initially include upside risk only (their partner benefits when things go well but has nothing to lose if they don’t).
Stay flexible: Not every arrangement needs to look the same. When HealthPartners develops metrics for success under new models of care, they are menus that allow for solutions to be customized based on the partner and the collaboration.
Data without context doesn’t do much: Health care, like many industries, is heavily focused on collecting data and using it in a meaningful way. Used optimally, health data could unlock life-saving insights into how to treat disease and promote wellness in a cost effective manner. But not all of HealthPartners’ collaborators are prepared to handle analytics and act on insights from data. So, HealthPartners provides resources to facilitate interpretation and action.
Ensure fair process: What this means at HealthPartners is everyone gets to speak their mind, through a variety of channels. There’s input from all angles before decision making and again after. Which sounds a lot like collaboration.
* Dr. Shaun Frost is associate medical director for care delivery systems with HealthPartners Health Plan in Minneapolis. He is also a practicing physician with Regions Hospital and a clinical assistant professor of medicine at the University of Minnesota Medical School.
* Melissa Turner is an editor on SmartBrief's health care team, handling briefs on policy, insurance, medicine and veterinary medicine. She's a former newspaper writer and copy editor and is a trained wildlife biologist with background in biotechnology.