What This Blog is About

A long time mentor and friend, Cicely Berry, often says: "all we do comes from our need to survive".

Cis is the Voice Director of The Royal Shakespeare Company. Her profound work and deep appreciation of the human spirit has affected diverse communities all over the world.

Will take you to my current work.

This blog is dedicated to the belief that the overall health of a community or organization is a clear reflection of their ability to communicate.

"Cada cabeza es un mundo" - Cuban proverb

"Every head is a world"

Wednesday, July 9, 2008

It's Upside Down -- Health Care That Is

This is a serious subject and a perspective worth developing. I believe this to be true.

I intend to further investigate but from initial conversations with people smarter than me, the response is supportive.

I believe that the business of health care is directly related to a misunderstanding of Integrated Supply Chain logic. Consequently, the Value Chain is disturbed.

Simply put, the business models of hospitals, payers and support services are currently based on traditional supply management designs.

It's upside down. Traditional models rely on Demand Creation and Demand Fulfillment. Indeed, many of the hospital Performance Improvement Plans that I have seen, seem to me to actually be re-treads morphed from old world Automotive Sales Incentive structures.

That's anecdotal of course, but a strong impression nonetheless.

The key point is this:

In the world of health care and health care professionals, we do not want to increase Demand Creation. We want the opposite. That is, to literally reduce the need for services so that Demand Fulfillment becomes more focused on well being rather than treatment.

Our entire structure is wrong and demands a fundamental re-focus. Our Integrated Supply logic is out of sync with the realities of the health work place and the patient experience. This misalignment affects every contract that doctors, payers and institutions create to "do business" to provide positive Demand Fulfillment.

Issues like EMR (electronic medical records) become clouded in a supply chain environment that is confused. Rapid adaptation to technology is inhibited by silo behaviors and proprietary attitudes to protect time and money in a highly challenged professional environment.

It's this overarching supply model that institutionalizes certain behaviors. These behaviors actually inhibit businesses like emergency rooms, where connectivity to information and communication are vital to implement quickly and accurately.

This is not a knock at the health care professional. It is in support of their commitment and expertise. However, sharing information is not easy in these places. Ask the workers. Ask the patients (customers), and ask the hospital business developers if they really have a picture of their customers from the conventional surveys that are handed out. It's a value chain nightmare in many cases.

It's that serious and perhaps, that simple an insight to understand, that in health care today, we have an inverted Supply Chain bias that is literally killing us.

I am claiming this discussion and inviting thoughts. However, this is one concept I will not give up on easily.


Sal Rasa

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