There has been a lot of talk (and blog posts) about accountable care organizations (ACO), medical homes, and value-based purchasing (I’m probably leaving a handful out)–especially since the reform package passed. It’s no secret the current model is too expensive and, frankly, doesn’t produce that great of outcomes for many patients.
But the interesting thing about all of this is that no one is quite sure how to proceed. Ambiguity isn’t something healthcare people deal with in a real productive fashion. Consultants aren’t that helpful yet as this is unfamiliar territory. Everyone is rushing around the country (have to do something!) trying to find examples of implemented ACOs (it’s a concept that is even difficult to define) and such (typical healthcare thing to do: what is everyone else doing?). All this while the words of someone I respect very much ring quite true, “if you’ve seen one model, you’ve seen one model.”
So here’s a thought courtesy of Saul Kaplan:
Instead of going to war to transform an entrenched operating model, create real world sandboxes right next door in which a new generation of transformative operating models can be explored. The imperative is to do R&D for new business models and systems the way organizations do R&D for new products and technologies today. The trick is to explore and test new models while at the same time continuing to pedal the bicycle of the current model. This requires establishing adjacent innovation platforms with the freedom to explore new ways to create and deliver value, especially approaches that are disruptive to the current model. Adjacent innovation platforms must have the freedom to experiment with different rules and financial models.
Experimentation isn’t something this industry has been game to promote. It’s basically a not-so-secret skunkworks but with a connection to the old world. A networked environment comprised of individuals open to failure and iteration looking for connections. Read this conversation between two very smart gentlemen, Kevin Kelly and Steven Johnson, an excerpt:
Johnson: It turns out that the lone genius entrepreneur has always been a rarity—there’s far more innovation coming out of open, nonmarket networks than we tend to assume.
Kelly: Really, we should think of ideas as connections,in our brains and among people. Ideas aren’t self-contained things; they’re more like ecologies and networks. They travel in clusters.
Healthcare types don’t deal well with ambiguity because it often involves risk. The current healthcare business model doesn’t reward risk taking; but with ambiguity comes a solution…sooner or later. James Shuttleworth, Chief Strategy Officer at Draftfcb Chicago (via PSFK) talks about ambiguity in ad agencies, same lesson applies here:
Ambiguity gives us the opportunity to be creative. Being prepared to face unguided situations enables planners to be creative. There is a need in agencies for collective genius, where people act spontaniously, while prioritizing the larger picture.
If there is something healthcare organizations need right now, it is creativity and the ability to follow spontaneity when it arises. The hospital/typical healthcare environment isn’t one that supports this type of behavior: less creativity = more control = fewer problems. That’s understandable and expected when it comes to central lines; but when it comes to the business model, tried and true methods will not cut it. Fred Wilson writes that you need some contamination:
If you want to unleash more creativity in your company, you need to allow for a little contamination. It is the sand in the oyster that creates the pearl.
Saul’s sandbox idea might just hold the sand for the oyster to create the pearl. It all starts with just trying some stuff.