The Next Wave

I was traveling recently and, as I typically do, I bought a copy of Fast Company magazine to read on the plane. I don’t subscribe, but I find that it often has interesting articles on the intersection of technology and business. In the July/August issue, there was an article about GE and its CEO Jeff Immelt that I think has important parallels with the current transformation of healthcare delivery.

I have always admired GE as a well-run company that gave birth to a lot of the current teaching about effective management and organizational improvement. That sentiment comes in part from a course I took years ago in six-sigma quality management that closely followed the GE methodology. I have also heard Jeff Immelt speak, and was impressed with what I heard and later read about him.

The article was about how GE is pursuing a long-term strategy to create the “industrial internet.” The idea is to imbue the large expensive things that GE builds – think locomotives, jet engines, power plants – with “intelligence” that allows them to monitor their own status and couple that with “big data” analytics to predict (and avoid) mechanical failures. The article posits that even small improvements in performance or reliability could have huge economic benefits for industries such as freight railroads and airlines.

Here is the part that made me think about health care. A GE executive was describing the company’s evolution and described three “waves” of how they interacted with their customers. In “wave one” (1960s and 1970s) GE sold heavy equipment with the promise of “if it breaks, we will fix it.” Wave two (1980s and 1990s) brought a closer relationship with customers through long term service agreements that assured a certain level of performance and included scheduled maintenance. The current wave was described this way:

“An approaching third wave, enabled by data and analytics, does something new. It strikes an agreement between GE and a customer for a certain kind of outcome, rather than a certain kind of functionality. It’s not only about measuring whether a jet engine is working up to its specifications, or about repairing it on time, but whether it is delivering, say, the agreed-upon amount of peak operational time.”

I believe we are in the midst of an analogous evolution of health care delivery. We can no longer think about health care as just providing a service (for a fee) to “fix” something that “breaks.” Health care should be – and soon will be – about achieving measurable improved health outcomes for the patients and population that we serve. Transforming our organizations to realize that goal is a heavy lift, and I think we can learn a lot from companies like GE about how to pull it off.

What do you think?

One thought on “The Next Wave

  1. I like your thought and hope, but there too many human variables in medicine. I’m from a family of engineers: mostly Grumman and North American. One uncle was weird and became an engineer for dams- Australia and Brazil. I had cousins with their own civil engineering companies. My daughter-in-law is an electronics engineer @ Magnavox in Ireland.

    Engineers are different-not so people oriented-and complaining about the human factor. The human factor is quite often the loose screw that fouls things up. I needed to contact my doctor. Technology rules and almost all doctors are represented by a central phone bank. These reps are nice and efficient.

    One day I did need to contact my doctor. The EMH patient messaging site advises the patient that it might take up to 48 hours for the doctor to reply. The phone rep politely told me to use the EMH. I asked her how to spell her name, and she spelled her name. I told her again that I needed to contact my doctor’s office, and explained why. She didn’t understand, until, I explained that this wasn’t a 48 hour question. I explained that she wasn’t the only one answering the phone, and I would keep calling until I found a more intelligent person. Then I would file a complaint about her. She relented. In 20 minutes, I was in the lobby, where the head nurse was waiting for me. The human factor.

    The complete problem was created by how a nurse interpreted my PCP’s orders and entered them in my EMR for Augmentin on discharge. @ the hospital, they read this as that I already had the antibiotic, and they sent me home with only a discharge paper.

    I protested, but I was kindly and firmly told that I was old, sick, high on morphine and codeine, and I didn’t have anyway to know what meds were at home. The human factor, and they all had good intentions. Several nurses asked why would it hurt for me to get a script anyway, as I didn’t seem loopy.

    People are pre wired and already programmed, Because of this, the human factor can’t be discounted.

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