Untangling Complexity: Agile Decision-Making During the COVID19 Crisis

“The system is not really geared to what we need right now… let’s admit it,” said Dr Anthony Fauci from the National Institute of Allergy and Infectious Diseases.

The outcry for testing from patients and the media has challenged the US government, public health leaders and clinicians in primary care and hospital emergency rooms as they the battle the COVID19 pandemic. It is clear, the complexities of test development and deployment are only the tip of the iceberg as our fragmented healthcare system ramps up our response.

In an ideal world, the public health, care delivery, and payment systems are all components of a unified system – a three legged stool of sorts, guaranteed not to wobble and each carrying its respective weight in managing the health of the US population. Yet, in reality the three legs of the stool rarely collaborate. Each with their own ingrained cultural, political, regulatory and economic incentives. In this world, distinct responsibilities, bureaucratic processes and information systems burden decision making and slow down response.

COVID19, knows no boundaries. In just a few short days, it is smashing the complicated mixture of federal, state, local, public and private organizational siloes and accomplishing more than many of us who have spent our careers trying to improve the system.

The March 17th expansion of telehealth benefits for Medicare recipients by CMS provides a tangible example. Relaxation of HIPAA rules gives the country’s older population access to medical care (both virus related and for other services) without having to leave their homes. Providers can use personal video chat applications like Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype.  Rather than deploying technology for technology’s sake as we have done in the past, this step demonstrates:

  • Coordination across the silos of public health, care delivery and payment
  • Design of a new way of working – based on the needs of the at-risk population and their care providers
  • An agile decision that simultaneously untangled the complexity of the current system
  • Rapid communication of the change through multiple media channels
  • Quick tools forwarded to patients and their clinicians from health care industry associations, data and technology partners and advisors

The 9-11 Commission reported, “The 9-11 attacks revealed four kinds of failures: in imagination, policy, capabilities, and management’ (National Commission on Terrorist Attacks upon the United States 2004, p.339). Today, as we face this threat each step we take provides an opportunity to untangle the complexity, remove barriers and set the course for more agile and unified decision making. What other steps should we take?

 

Orchestrating Value: Population Health in the Digital Age

by Pam Arlotto

Contributors: Susan Irby

Orchestrating Value: Population Health in the Digital Age focuses on the leadership thinking and mindset changes needed to transition from brick and mortar healthcare to digital health and connected care. The fourth industrial revolution, with convergent disruptions in biology, business models, computer science, and culture, has the potential to transform the healthcare system like never before. Digital health startups, Big Tech and progressive health systems will change the way health and healthcare are delivered to increasingly digitally savvy consumers. This book challenges readers to rethink the role of data and technology in creating and designing the future. Rather than hooking value-based care and population health management onto traditional healthcare business models, it focuses on the emergence of digital ecosystems.

Using the analogy of an orchestra, the book introduces the importance of platforms in the formation of communities and markets with network effects to allow participants to collaborate, create, and innovate. With quotes from healthcare industry leaders and change agents, it helps the strategist understand the three stages of the transition from volume to value. As conductor of the orchestra, the CEO must navigate important leadership pivots to move beyond silo-based thinking. Finally, the Care Management Platform is described as a new operating model for population health in the digital age. As the next generation beyond foundational EHRs, capabilities such as interoperability, analytics, care management and patient/consumer engagement will fundamentally change the way healthcare enterprises operate and deliver value to customers.

 

Available through CRC Press and Amazon