Problem
Community Medical Associates (CMA) is a large urban health care system with two hospitals, 25 satellite health centers, and 56 outpatient clinics. CMA had 1.5 million outpatient visits and 60,000 inpatient admissions the previous year. Long patient waiting times, uncoordinated clinical and patient information, and medical errors plagued the system. Doctors, nurses, lab technicians, managers, and medical students in training were very aggravated with the labyrinth of forms, databases, and communication links. Accounting and billing were in a situation of constant confusion and correcting medical bills and insurance payments. The complexity of the CMA information and communication system overwhelmed its people.
Today, CMA uses an integrated operating system that consolidates over 50 CMA databases into one. Health care providers in the CMA system now have access to these records through 7,000 computer terminals. The next phase in the development of CMAs integrated system was to connect it to suppliers, outside labs and pharmacies, other hospitals, and to doctor's home computers, that is, the entire value chain. The case allows the students to apply lean principles to a large and complex health care network and think about the nature of the value chain. This case is best assigned to individual students or student teams and the class discussion can range from 20 to 30 minutes depending on what the instructor wants to emphasize. Like many cases in the OM text, we try to get students out of the goods-producing factory and into a service providing organization.
Elaborate on how CMA used the four principles of lean operating systems to improve performance.