The And is Everything

The word “and” is used as a link between two statements.

What better statement for a healthcare system to make than to add an and to its name?

Seventy-five percent of the United States annual healthcare spend goes toward the treatment of chronic disease. Three-fourths!

As of today, “approximately 412,857 people have died from chronic disease this year.”

Healthcare is beginning (a monotonously slow) transition toward realizing healthcare is more about health than it is about care. Payment mechanisms slow the progress.

It is incumbent upon today’s providers to acknowledge the reality that the patient not only needs care, but assistance with health.

New name, evolving approach, right focus: Sacred Heart Health and Care System.

The and is everything.

Choose Your Battles

A lesson in battle selection.

While no expert, I understand actuarial science. I’m familiar with the concept of an “uninsurable risk.” I’m even aware of the difficulties with interpreting congressional legislation.

But a concept I’m completely unfamiliar with is why a health insurance company would want to stage its first fight of healthcare reform against kids.

The New York Times reports some health insurance companies are getting technical with bill language in the provision of coverage for kids with pre-existing conditions. Say they about a supposed loophole: just because we’re required to cover pre-existing conditions for kids in newly issued plans doesn’t mean we actually have to offer insurance.

Here’s where it would be good to become familiar with the concept of “guaranteed issue.”

There’s a lot at stake here. But it seems detrimental to your cause to target the only group that the most engaged voting bloc cares more about than themselves: their grandkids.

There are plenty of battles to be fought as reform is implemented; none of them should be against kids–especially in a bill that some say is a handout to insurers.

Local possibilities in healthcare reform

Atul Gawande on local healthcare solutions:

The most interesting, under-discussed, and potentially revolutionary aspect of the law is that it doesn’t pretend to have the answers. Instead, through a new Center for Medicare and Medicaid Innovation, it offers to free communities and local health systems from existing payment rules, and let them experiment with ways to deliver better care at lower costs. In large part, it entrusts the task of devising cost-saving health-care innovation to communities like Boise and Boston and Buffalo, rather than to the drug and device companies and the public and private insurers that have failed to do so. This is the way costs will come down—or not.


For your next small problem (alas, none of them are small!) try something different.

Instead of finding the path of least resistance, choose one that makes a revolutionary change.

In this constantly turning world it’s easiest (and likely wits saving!) to find the simple fix. Simple fixes are divine, to be sure. But the fix that only pushes the headache to another day is not a solution.

Evolution is great, but slow. We’re (healthcare) now in a position where slow change is no longer an option. Reinventing how we do stuff (paperwork for a leave of absence, scheduling your staff, delivering care) in a evolutionary fashion provides (extremely) temporary relief. 

Sure, sending an email to a listserv asking for ideas or doing a Google search to see how others addressed the issue or calling an experienced professional for help are all good options. But don’t let them be your only options.

So start today. Do those things you usually do to solve a problem–and one more: add to your list of options a +1.

The +1 should be a radical departure from how you’ve done things. Make it exceedingly different than what everyone else is doing. Make it a viable, executable idea. Make it the item on the list that makes someone say “what’s this?”

Take that conversational opportunity to explain that there are surely easier ways to solve this problem–only to push the headache to another day. This +1 changes the game. It may be risky; it also opens the operation to new opportunity.

The +1 might not always be the choicest selection. But it pushes the envelope. And if there’s one thing we need in healthcare, it’s just that: a shove in a new direction.

We know that childhood obesity is a problem; but that’s just it: it’s a problem. The segment that begins at :51 transformed the ho-hum for me: this is an epic, all-hands-on-deck, if-something-isn’t-done-immediately looming disaster.

And then in one of those unexplainable, synchronistic moments when there’s no explanation for events transpiring except that there’s a master planner behind the scenes doing his/her best Alan Gilbert impersonation, the attention falls upon a subject in such a way that it seems an uncoordinated coalition of people are actually doing something about it.

Like Mrs. Q. She’s eating school lunch every day for a year to bring attention to what kids eat on a daily basis. From her blog:

I’m eating school lunch just like the kids every day in 2010 to raise awareness about what students eat every day. My hope is that the US becomes more reflective about how the food children eat affects their well-being and success in school. I certainly do not speak for all school lunch programs, but from the comments I have been receiving, what I eat is fairly typical of what most students eat in our country.

Like First Lady Michelle Obama’s “Let’s Move” effort “to solve the epidemic of childhood obesity within a generation.”

Like the Senate’s efforts to make school lunch more healthy. USA Today:

Senators cleared the path Wednesday for a final vote on legislation to bolster the safety and nutritional value of school lunches, including provisions to improve training for cafe-teria workers and to alert schools more quickly about recalls of contaminated food.

The Healthy, Hunger-Free Kids Act of 2010 would commit an additional $4.5 billion to child-nutrition programs over the next 10 years and implement the most sweeping changes to those programs in decades. Among other things, the bill directs the U.S. Department of Agriculture to set new nutrition standards for all food served in schools, from lunchrooms to vending machines.

All good things, all important work: efforts that are creating a critical mass of attention to the problems of childhood obesity. Today’s children are in serious jeopardy of becoming the first generation living shorter lives than their parents.

If you need a Biblical message (a grain of salt presiding), how about this (Reuters):

The researchers analyzed 52 paintings depicting the Last Supper which were featured in the 2000 book “Last Supper” by Phaidon Press, and used computer-aided design technology to analyze the size of the main meals, or entrees, bread and the plates relative to the average size of the disciples’ heads.


The study found that, over the past 1,000 years, the size of the main meal has progressively grown 69 percent; plate size has increased 66 percent and bread size by about 23 percent.

Design for Patient Dignity, a project of the U.K.’s Design Council:

Design for Patient Dignity is an initiative between the Department for Health and the Design Council that brings together designers, manufacturers, healthcare experts, staff and patients to design a variety of solutions to enhance and promote privacy and dignity in hospitals.

Other cool prototypes here.

via Core77