A change of Culture for Healthcare

Today the management of culture within healthcare is becoming more and more important. It is now viewed as a necessary part of the health system reform. In the United Kingdom, the National Health Service (NHS) reforms are based on the premise that any major cultural transformation of an organization must be secured alongside structural and procedural change, this in turn will deliver improvements in both quality and performance.

Culture change can be seen as a lever for performance improvements. The industry is well aware of the limitations of a mangeralist perspective. A new Committee of healthcare specialists believe that culture change within the industry must be targeted in one of two ways. Their first objective is to ‘do what you do better’. The Next Generation Healthcare Committee will meet at the NGH Summit in Miami.

“Many commercial organizations maintain a competitive edge by pursuing a policy of cultural continuity’, they capitalize on the lessons, working practices and traditions that have worked for their company in the past, for this to work they focus on the growth or reproduction and repetition”

The second option is to look towards qualitative growth, this is a more appropriate option in a situation where the existing culture has become stale and a complete overhaul is required. This is also the position that the US healthcare system has found itself in.

“Second order change is often invoked in response to a growing crisis or deficiency in the existing culture, which cannot be addressed adequately by a change in culture but rather demands a fundamental change of culture. If politicians and management gurus are to be believed, health systems in many countries stand perennially on the threshold of such fundamental change.”

After seeing high profile reports in the US which have documented gross medical errors, policy thinking is embracing the notion of culture change as a key element of health system redesign. Jeff Rose – VP Clinical Excellence, Informatics, Ascension Health wishes to address the committee on the principles published as A Leadership Framework for Culture Change in Health Care. He believes it is key to outline the core elements, or ‘5 C's' of culture change needed to move the US towards the adoption of new tools and processes in healthcare that enhance care quality and provider adoption in the interest of high reliability environments. It gives a simple and readily recalled set of principles by which the traditions and resistance of many healthcare organizations can be both led and managed by caregivers and executives so that expenditures on technology, information and evidence availability, collaborative processes and principles of high reliability human factors can speed our mutual journey to highest quality lowest cost medical practices in our rapidly changing world of technology, incentives and regulations.

Jeff Rose will be joined by representatives from Cleveland Clinic - Martin Harris, Chairman of IT Division and CIO, Catholic Health East - Mike McCoy, CMIO, MedStar Health - Gerard Burns, CMIO, Sentara Healthcare - David Levin, CMIO and VP Medical Informatics and Ascension Health - Jeffrey Rose, VP Clinical Excellence, Informatics.

Appeals for culture change in health systems have been a long time coming it is now key to draw upon a belief that culture is related to organizational performance. Are organizational cultures capable of being shaped by external manipulation? If so, what strategies are available to managers wishing to encourage an appropriate organizational culture?

The Health of US Healthcare

With Healthcare reform driving national attention to record levels of uninsured patients, the role of the CFO is becoming more difficult and crucial to the success of a hospital or healthcare service center. Due to the public eye scrutinizing this level of a corporation, CFOs across the healthcare industry are meeting in Miami for the CFO Healthcare Summit 2010 this October. The driving focus from attendees is to understand the right revenue cycle implementation and what is the most cost effective Supply Chain Management (SCM) procedures that can give their respective organizations a competitive edge.

Raising issues of this caliber needs to be relevant for a private insurance environment as well as an increasingly socialized medical environment. For this reason representation from private institutions like Catholic Health East or the Baylor Health Care System, as well as leadership from uniquely positioned public systems like Cleveland Clinic or the NYU Langone Medical Center will be present at the Fairmont Turnberry.

One of the unifying topics, Revenue Cycle Solutions, stands as a key talking point due to the need for financial departments to lower the number of days a payment stays in the receivables account. What was seen as the back end for dropping a bill has the ability of becoming a more comprehensive service between the patients calling in to determining eligibility.

PNC Bank is taking the time to explain that revenue cycle management is a great solution for developing this area but they also take a relationship component and add it to the model. What PNC are looking to propose is unity across both the insurance side as well as the healthcare provider side. This could allow healthcare institutions to receive quicker confirmations on eligibility from the insurance side as well as having sufficient processing systems internally.

Looking at revenue cycle management solutions is great, but what interested executives like Janice Ridling,VP of Revenue Cycle at Baptist Health System, is developing questions of efficiently training staff about the increased capabilities these solutions can provide and how internal policies regarding patient financial responsibility can streamline the process.

Financial departments in healthcare institutions need to juggle more than one system on a daily basis and another focus area that looks at saving money through Supply Chain Management. Steve Huckabee the Corporate Vice President of Supply Chain Management at Kettering Health Network has deployed targeted tactics as a way to enhance the network's position for increasing revenue and growing market share.

Those tactics include creating a sourcing environment allowing physicians product choices while achieving cost savings; creating a research environment for physician-scientists to engage in the science side of healthcare to complement their expertise; and creating a full continuum-of-care model that is an alternative source of revenue which engenders a strong referral relationship.

Healthcare in the US is constantly in a state of movement, but there are certain undeniable constants in the market place that hold true whether or not new policies are adopted. For this reason revenue cycle management and supply chain management solutions are at the forefront of the topics being discussed in Miami. Standing as a testament to the health of the healthcare industry is the ability for competitors and colleagues alike to openly discuss the mutual obstacles that occur on a yearly basis, so the market itself can maintain stability whether change takes place or not.

Time is Money in Healthcare

The healthcare industry in the US has been a bone of contention for some time now. The reform and economic crisis have taken their effect. Job losses are ripping out the heart and health of America and improved systems to deal with the changes bring their own challenges to the community. The NG Healthcare Summit which has just taken place in Florida has been key the sort of future planning which will protect the industry into the future.

The United States spends around $2 trillion a year on healthcare expenses, more than any other country across the globe, but critics are still questioning if the country’s finances will be able to support the reform. Despite original predictions that costs would be initially reduced it would do little to stem healthcare expenditure, something which executives from the industry are determined not to let happen.

Electronic medical records (EMR) have been named as key technology innovation to improving patient care and reducing medical errors say the NG Healthcare committees who have just had their latest meeting. This has been backed through federal stimulus money that along with legislation can reshape the healthcare industry.

Still, talk to people in healthcare and it is clear that there are myriad issues that need to be resolved before there is unanimous adoption of electronic records. Key challenges include financing the conversion from paper to computerized records, designing the work flow, making systems easier to use, integrating files from multiple sources and, of course, ongoing technical support.

“Staff time is valuable especially within the healthcare industry where understaffing can mean the difference between life and death. Rather than paying trained staff overtime to enter data at the end of their shift it allows them to update as they go along without having to input the same thing multiple times” The discussion was moderated by Greg Caressi —the SVP of Healthcare and Life Sciences at Frost and Sullivan—and is was used as an exercise to openly discuss the common challenges that the group is facing as they move their respective hospital systems to a more digitally-centric future. Participants included, Mark Elmer, the CTO of Texas Health Resources; Paul Brown, the CIO of Trinity Health; Tom Doyle, the VP & Chief Architect from HCA; Eric Paternoster, SVP and Unit Head—Insurance, Healthcare & Life Sciences at Infosys Technologies; Jeff Gartland, VP of Business Development for RelayHealth and Diana Nole, President of Digital Medical Solutions for Carestream Health.

The Federal stimulus Bill has promised anywhere from $44,000 and $65,000 to doctors who convert to electronic records but the funds will be paid in increments over a span of a few years and there are still questions the committee wants answered.

“We must also remember that a shift to electronic files will not just be a financial strain but will require an overhaul of the processes used for treating patients, to make this a smooth transition is key to success”Continued the committee “With the targets set it is now up to us to implement the strategies to achieve greatness within the industry.

Despite the concerns it has never been argued that change isn’t hard but with a united industry and the budget to support the future seems set.

EHM – Probable problem or Serious Solution

Electronic medical records (EMR) have been named as key technology innovation to improving patient care and reducing medical errors say the NG Healthcare committee Meeting in May in Dallas. This has been backed through federal stimulus money that along with legislation can reshape the healthcare industry.

Still, talk to people in healthcare and it is clear that there are myriad issues that need to be resolved before there is unanimous adoption of electronic records. Key challenges include financing the conversion from paper to computerized records, designing the work flow, making systems easier to use, integrating files from multiple sources and, of course, ongoing technical support.

The NG Healthcare Committee believe it is the responsibility of the healthcare Giants to support the smaller midsized companies and a meeting such as the NG Healthcare summit (hosted by GDS International) by openly discussing there implementation techniques.

Key challenges to be faced as raised by representatives from Mark Eimer – CTO, Texas Health Resources, Steve Heilman – CMIO, Norton Healthcare, Will Showalter – VP and CIO, Sisters of Mercy Health System, Mark Gilliam – VP and CIO, Ardent Health Services are the obvious fiscal responsibilities. To convert the millions of paper files to digital records will be expensive. The Federal stimulus Bill has promised anywhere from $44,000 and $65,000 to doctors who convert to electronic records but the funds will be paid in increments over a span of a few years and there are still questions the committee wants answered.

“We must also remember that a shift to electronic files will not just be a financial strain but will require an overhaul of the processes used for treating patients, to make this a smooth transition is key to success”

So, leading executives from the healthcare industry will address some of the key barriers to adoption and standardization is the federal support enough to back the change?

Healthcare CFO’s V-tach on Obama’s Healthcare Reform

Urgent meetings are being held by the financial leaders of American Healthcare companies in the wake of Obama’s Healthcare Reform being passed 219 – 212 in the House of Representatives. The introduction of this policy heralds a transformation in the fabric of American society, and the way U.S citizens receive medical care has suddenly been revolutionalised in a direction which healthcare CFO’s cannot afford to ignore.

Obama states: “[It] answers the prayers of every American who has hoped deeply for something to be done about a healthcare system that works for insurance companies, but not for ordinary people.”

As miraculous as this sounds, the campaigns against the bill have been vehement, and during these unstable economic times not everyone is content with Obama’s changes. CFO’s need to strategize together to implement a plan that ensures the successful revenue cycle of their organizations. Industry leaders such as Vince Schmidt SVP and CFO of Multicare Health System, Mark Spafford CFO and VP of Health Management Associates, Robert Booth CFO of Summit Medical Group, and Larry Dupper CFO of Valley View Hospital are attending a series of closed door meetings at the ‘CFO Healthcare Summit US 2010’ in Arizona to discuss at this illustrious occurrence what action needs to be taken, and how.

A leading source, who wished to remain anonymous stated, “ I think most CFO’s feel thrown in at the deep end like never before. It is sink or swim, and we need a consistent approach to tackle these difficulties so the ‘CFO Healthcare Summit US 2010’ is a crucial event for our company, and for the American Healthcare industry as a whole.”

Obama’s greatest allies and fiercest critics await the outcome of the ‘CFO Healthcare Summit US 2010’ with baited breath, as not only the financial future of the American Healthcare system will be decided, but also the sagacity of the bill which Obama fought so hard to win will be revealed.

Chief Medical Officer ‘very concerned’ about Obama’s healthcare reform agenda

Robert Spiegel, Senior Vice President and Chief Medical Officer for Schering-Plough Corporation (NYSE: SGP), the global science-based healthcare company, says he is “very concerned” that changes to the healthcare system by the Obama administration could affect public health.

In an interview for MeettheBoss.com, Spiegel was asked about the impact of President Obama’s stated aim of increased access to ‘generic’ medicines on the pharmaceutical industry.

“Fixing the healthcare system in America is a very complex issue and I am not an expert on all aspects,” says Spiegel, “the collaboration that has existed to date between academia, government, the pharmaceutical industry and the bio tech industry has been extremely productive … we’re very concerned that changes to the healthcare system and its reimbursement could easily shift this delicate balance that has worked well in the past as a way to make sure that new discoveries do get developed and turned into medicine.”

Spiegel also believes it is ‘ironic’ that part of the stimulus package will be pouring money into the National Institutes of Health to improve and give funding, which has not been “as high as it could have been in recent years to basic science”.

His arguments may seem expected from any Chief Medical Officer who is naturally looking at the situation from a business angle, yet Spiegel is very aware of public perception and the pressures on the Obama Administration to reduce cost and increase medical accessibility for the nation. His reasoning, however does not appear to be determined by business profits, but a future lack of further medical discoveries which may be held back due to a more focused approach towards generic funding, “new drugs don’t come from the NIH, they don’t come from university research labs, they only come out of the industry that’s made to develop and find ways to use the advances in science into drugs... if we say that generics are good enough, that the current medicines you have today in 2009 are probably good enough and we don’t really need any new medicines, I think 20 years from now we’re going to have major issues with an aging population and many diseases that still have major unmet medical needs.”

With media-flooded articles on global diseases such as the recent Swine Flu pandemic, and the Asian Bird Flu, this perspective from an expert in the field pulls into question public concerns on developing new medical discoveries in time to combat disease – will our scientific knowledge be up to adequate standards to withstand any major future pandemic threats? If Spiegel is correct and attention to new drug discovery slips, what will happen when the world is faced with the next major pandemic crisis?



Watch the full interview: http://www.meettheboss.com/Broadcast-Player.aspx?Play=1&MediaID=112