POST 1
The McDonald article describes problems they see in Health Care System in the United States. Intel was a company that was being directly affected by the problems described. "Intel faced soring health care costs - estimated to reach $1 billion by 2012." The rising costs of health care were the root issue for consumers. Unfortunately, most approaches companies try in order to help curb the expresses for the company and employee are enough to solve the problem. Actually, they do not address the root cause.
I believe that the Portland approach offers a great approach and an extremely viable alternative. By treating the problem of high cost health care like any other goods or services purchased by a company, they started to find a solution. For some reason, health care seems to be a unique service in which the direct cost of service is not an immediate concern. The Portland approach faces this problem of cost head on and uses its leverage to lower the cost. It improves efficiency by focusing on quality of health care, which reduces cost in the long run, and cost, which has immediate savings. This is something that the federal government is not especially good at, efficiency.
Looking at the results of the approach, it is clear that it should at least be considered as a viable option in the future of health care. Cost, patient satisfaction, work missed, and health care supplier processes all improved.
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POST 2
I want to begin my post first with some initial thoughts about the article. For beginners, I want to say that I found the McDonald article extremely interesting and refreshing to read that someone out there has attempted to better the health care system in such a way. I had not heard about this system prior to the article. I am by no means an anarchist in anyway, but I am someone who is extremely hesitant about the government gaining a greater hand in the health care industry. I feel as though there are a particular set of views, goals, outlooks, and perspectives shared by most political powers that do not necessarily coincide well with the providing of care. With that being said, whether the Portland plan is viable longterm and will spread to other areas I don't know, but I do love that it was done in the first place and that the positives of corporation were utilized in such a way. This point to which I have opened with could very much be a discussion in its own, but before analyzing major points of the article I at least wanted to acknowledge that I love where the idea of HMC began.
After reading through the article and assessing major points, one thing that still escapes me is the actual flow of money. I don't believe that this article in anyway was intended to highlight dollar figures at each step, but I can't help but wonder like we mentioned in class how the actual flow of money takes place or makes sense. It is very simple to understand how this lean method of providing care cuts costs among other things, but I can't help but still be curious about the $ figures in each step. The figure on page 48 does a very nice job of summarizing and comparing the traditional process vs. the HMC's process and I completely support the statement that the traditional process is wasteful, unnecessary, and frustrating for all parties involved. I 100% agree that the process needs to move more closely to an HMC process but I do have some hesitation with the process itself. There are plenty of numbers to back theHMC's process up for back pain with nearly 500 patients over 35 months but there is still one spot that sticks out to me that makes me nervous moving forward to other ailments. It could be just my own nature but I see the HMC process as more of a honor system while the traditional system is overly controlling. While in the traditional system there are so many unnecessary steps and wasted time, you're very unlikely to have anything go unnoticed in your treatment including things you didn't know may have been present in your body. On the other hand the HMC relies on a screening call and while this system might work well with lower back pain, I see an issue with more severe ailments. It was noted in the article that the HMC was starting from the bottom up in terms of what severity of illnesses it was going to test this with so I'm not faulting the article at all. All I am saying is moving forward as the HMC approach is hopefully implemented more widely, some sort of double check or failsafe needs to be implemented to ensure that a patient isn't underselling or overselling their ailment upon initial screening. The last thing the healthcare system needs is a hardheaded middle aged male for example, who hates the idea of going to the doctor heading to a therapist first while a greater issue looms that the therapist has absolutely no way of finding; all because the patient wasn't honest about there condition. Once again this is likely an overly paranoid view of the HMC system and I 100% hands down agree that the process is a much better method for back pain, but for more difficult illnesses something closer to the traditional method may be a safer bet until improvements are made.
I think a great point in the article where a simple improvement was made through self testing and making the appropriate decision came on page 46. Within point 6 the article talks about the trial and correction involving back pain and specialist involvement at Virginia Mason, Providence, and Tuality. The point here was simple; the numbers and feedback don't lie and it makes sense to not be wasteful in having a specialist present. This could be implemented much more widely in the U.S. and would save huge dollar figures among other things (a sub discussion again here might be the predicted shortage of physicians). One thing is for sure and that is that after reading this article healthcare in the U.S. is certainly a situation and this post doesn't do justice to all that can be talked about. To get to where we need to be one day more plans such as the Portland plan need to be initiated to make things better and as the article mentioned it takes time to change mindset. If improvements are going to happen, it is going to take much more than this project to change the mindset of the population to buy into the HMC process. Moving forward the natural drive for best self interest and negotiations for market power must faze out of the healthcare industry and rather a more beneficial side of business and corporation noted in the article must creep in.
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POST 3
Health care cost are steadily increasing in the USA. Intel uses number of approaches to eliminate its soaring health services by implementing consumer driven health care, offering higher deductible plans, wellness incentives and opening primary clinicals at Intel work sites. None of these approaches were futile neither addressed the root cause of the problems. So, the company used the lean improvement methods to manage the quality and cost of its health care suppliers.
Intel launches Health Care marketplace collaborative that includes Virginia Mason which successfully reduce the cost of three common conditions by 24- 29%. It eliminated the unnecessary processes, reduce administrative burden, reduce the patient time.
The elements of collaborative model:
a. Make explicit what each player is bringing to the effort: Each organization brought skills and capabilities that is helpful for the betterment of market. It involves employees, providers, insurers or administrators,physical leadership. Intel generates methodologies that have privacy, lean on two providers that creates differences and applied to larger organization and also invited Mr. Mecklenburg as expertise of health care.
b. Establish a shared aim: Intel included stakeholders, patients, employees, health care providers. Its aim was to provide the right health care at right time at right place with right cost. It eliminates waste, zero defects and reduce the need for reactive care.
c. Don't reinvent the wheel: Intel used value streams and quality metric from Virginia Mason that focused on patient, rapid access, cost, patients lifestyles and quality of care.
d. Make it flexible: Intel realized that the two different health care providers are not same in size, operations, structure. So, they decide on how to adopt each of the new clinical processes. And the changes were compared, tested and look for the opportunities for the improvement.
e. Prioritize on the basis of impact and difficulty: Intel focused on the improvements so they formed the four criteria to establish priorities:expenditures, level of risk, standardization and benefit to health system.
f. Choose simple metrics and goals: the goal was to reduce cost and slow the rate of increase. So, they have adopted five metrics of Seattle Collaboratives for betterment, faster, more affordable care, satisfaction.
g. Use one improvement methodology: They got all the members to agree in one concepts. They had used Six sigma. Intel's RIL approach had many benefitted the length of time.
h. Fix the business side: The 25% of US hospital expenditures are in business side for booking appointment, billing not in clinical side. RIL remove the waste, non-valuable adding activities. Due to this $26 million were estimated to be saved annually.
Overall, these elements brought vast changes in the health care of Intel and all over the market. It standardized health care, focused on patient satisfaction, cost, recognized the need.
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