What is Required to Create Disruptive Innovation in Health Care (and why it doesn’t exist presently)

Solutions to health care's plethora or problems require unique thinking.

Solutions to health care’s plethora or problems require unique thinking.

This article, published in the on-line edition of Hospitals & Health Networks, takes a hard look at the missing phenomenon of disruptive innovation within health care.  Have a look:

http://www.hhnmag.com/articles/6870-a-step-by-step-guide-to-creating-a-culture-of-disruptive-innovation-at-your-hospital

RECENT ARTICLES FROM THE BUSINESS JOURNAL (National Edition)

See John Leifer's most recent contributions to the Business Journal.

See John Leifer’s most recent contributions to the Business Journal.

    • Has the time arrived to disintermediate health insurers?Dec 7, 2015, 10:54 AM  EST

      Has the time arrived to disintermediate health insurers?

      As employers struggle with the need to control ever-escalating health care costs while also providing some type of health benefit to their employees, they are seeking new models that achieve value delivery from their provider networks.

    • How to respond when cancer strikes a co-workerDec 2, 2015, 8:15 AM  EST

      How to respond when cancer strikes a co-worker

      How you treat your employee at this time of crisis may greatly shape how he or she responds to you in the future. Informed, empathic intervention will be warmly received, and you and your employee will share the gift of such grace.

    • Getting the most ROI for your wellness spendingNov 11, 2015, 11:13 AM  EST

      Getting the most ROI for your wellness spending

      Properly constructed and well-executed wellness and disease management programs can benefit the employer and employee. The key is having clarity of one’s objectives, and then developing the most efficient and effective ways of achieving those goals.

    • How educating employees can reduce your health care costsOct 23, 2015, 9:58 AM  EDT

      How educating employees can reduce your health care costs

      Research demonstrates that uninformed patients are less likely to use preventive services and manage their conditions, while being more likely to have unnecessary hospital admissions or visits to the emergency department.

    • 5 things business leaders can do to help change the dysfunctional health care systemOct 2, 2015, 7:24 AM  EDT

      5 things business leaders can do to help change the dysfunctional health care system

      Whether health care stays on a negative trajectory may largely depend on you — the nation’s employers and employees. You are the ones paying an increasing share of the bills, while receiving highly variable care.

PROFILES IN COURAGE — Four People Discuss the Profound Impact That Cancer Had on Their Lives and the Lives of Loved Ones

Meet Mary Diagnosis: Breast Cancer

Meet Mary
Diagnosis: Breast Cancer

Meet Ali: Diagnosis: Head & Neck Cancer

Meet Ali:
Diagnosis: Head & Neck Cancer

Meet Diane Diagnosis: Leukemia and husband died of melanoma

Meet Diane
Diagnosis: Leukemia and husband died of melanoma

Meet Darrell Caregiver for wife over 20 year struggle w/lymphoma and leukemia

Meet Darrell
Caregiver for wife over 20 year struggle w/lymphoma and leukemia

 

PLEASE INVEST 7 MINUTES WATCHING THEIR POIGNANT VIDEO at: https://youtu.be/1Dy4kO7Zk70

 

When Initial Treatment Proves Insufficient… Searching for the Silver Lining

shutterstock_252209614“Cancer is not a straight line. It’s up and down.”

Elizabeth Edwards

When an initial treatment proves insufficient

Cancer treatments fail. It’s that simple. Though patients enter treatment with great hope, that hope may be dashed when either further evidence of disease or proof of recurrence is discovered. Sometimes the failure is apparent immediately, as was the case with my wife, Lori’s, lumpectomy. Other times the disease reappears months, years, even decades later. Evaluation of the effectiveness of your cancer treatment depends upon the modality used.

 Hitting the reset button

If your initial treatment failed to cure your cancer, than you have reached another critical signpost along your journey: The need to modify your treatment plan to include new modalities of care. It’s a bit like hitting the reset button and starting the game over. This can be a particularly difficult time for many patients because the preferred treatment option has proven unsuccessful, often triggering new waves of anxiety and doubt.

 The “middle stage” of cancer

Many patients enter a midpoint in their journey with cancer. It is what author and ovarian cancer survivor Susan Gubar defines as the “middle stage.” Writing in a June 5, 2014 article in the New York Times, Gubar stated:

“For some of us, there is a middle stage in this journey. Because of advances in cancer research and the efforts of dedicated oncologists, a large population today deals with disease kept in abeyance. The cancer has returned and has been controlled, but it will never go away completely. Like me, these people cope with cancer that is treatable for some unforeseeable amount of time. Chronic cancer means you will die from it—unless you are first hit by the proverbial bus—but not now, not necessarily soon.”

The word “chronic” resides between the category of cured and the category of terminal. It refers to disease that is not spreading, malignancy that can be arrested but not eradicated. At times, the term may seem incommensurate with repetitive and arduous regimens aimed at an (eventually) fatal disease. For unlike diabetes or asthma, cancer does not respond predictably to treatment.

Still, quite a few patients with some types of leukemia or lymphoma, prostate or ovarian cancer live for years. While in the 1970s, 10 percent of women with metastatic breast cancer survived five or more years, today up to 40 percent do. Chronic disease may lack the drama of diagnosis and early treatment; even friends can get bored by mounting details. Its evolution does not conform to the feel-good stories of recovery that most of us want to read. But neither does it adhere to the frightfully degenerative plot of quickly advancing tumors.[ii]

 Allowing for disappointment while not relinquishing hope

When you hit these milestones, it is time to be kind to yourself: a time to express your disappointment without relinquishing your hope. You will be traversing a new path on your journey, but first, you must understand how the additional knowledge acquired to date about your condition impacts your staging, prognosis, and recommended treatment options. Your physician should provide this information, as well as recommended modifications to the treatment plan.

Now’s the time to take out your compass and reassess the direction you are headed. It is essential that you go through an appropriate level of due diligence with your doctor regarding the next phase(s) of treatment. Just as you inquired about efficacy, side effects, treatment duration, and other factors prior to your first course of treatment, you need to repeat the process again now. Three very important questions to consider are:

  1. what are the goals of this treatment;
  2. what is the likelihood it will be successful; and
  3. what short-term and long-term effects may the treatment have on my quality of life? Only once you’ve completed this process can you truly provide your physician with informed consent to proceed.

 Due diligence déjà vu

Just as you asked many questions about your initial treatment, so, too, must you feel fully informed about the next steps in your journey. In addition to understanding the fundamental nature of the recommended treatment, you may also wish to ask your physicians the following questions:

  • Why might this treatment be effective when others have failed?
  • Are there other options for treatment that we should discuss?
  • What are the side effects or after-effects of treatment that I may experience?
  • Who will perform this treatment, and what are his or her qualifications for doing so?
  • Will my insurance cover the cost of this treatment?
  • Where I can learn more about this treatment before agreeing to it?

It may be helpful to then take a few days, do your own research, talk with your caregiver, and then come to the most informed decision possible. Regardless of the outcome, you will feel as though you entered this phase of treatment with a solid understanding of its probable outcome, side effects, and costs.

 The End of Active Treatment for Lori

Lori endured a second major surgery—bilateral mastectomies. The difficulty of the recovery was far more than Lori or I anticipated.

(IN LORI’S WORDS) Once I had a chance to digest the news about my initial pathology, I knew I needed more surgery—a mastectomy. I also knew that my type of cancer was also more likely to be present in the opposite breast and to evade early detection by imaging. So, I opted for bilateral mastectomies. It would take coordination between my breast surgeon and my reconstructive surgeon, which even under the most optimal circumstances can take several weeks. I decided to allow myself my hour of sadness, but then take that energy, become my own advocate, and push hard to get things done as soon as possible.

While waiting for my second surgery, I knew I needed to take care of my spiritual, psychological, and physical needs. I packed much of our house to get ready to move, took time to exercise, read my Bible, talk to friends. Mother’s Day was during that time, and all I wanted was to see my sons, so my husband arranged for them to fly home from California and Wisconsin for the weekend. We talked, went to church, and even took in a baseball game. My surgery was scheduled for early the next week.

The day of surgery was also the day before our scheduled move. My sister Janet, a nurse at Duke University Medical Center, came the night of surgery to help with my care and allow John to be with the movers the next day. She stayed with me those first few days when I felt so physically helpless. She brought me “home” to our new house (and new beginning for me) where we were greeted by a chaotic setting of John supervising the movers. Her calming presence, encouragement, and hands-on care were invaluable. I will always be grateful she was there by my side. My brother Chris and his wife Gail took the second watch and stayed for several days, helping me as I struggled to gain strength, as well as helping John unpack our new house. They all dropped their jobs, families, and plans to come and help. Having my strong support system was a tremendous blessing, and I strongly believe it was a key to my recovery.

The final pathology report came out. I held my breath, said a prayer for strength, and waited on the other end of the phone while Dr. V. read me her findings. There had proved to be many spots of cancer creeping through my breast—that was the scary news. But this time there was excellent clearance around the tumor—the margins were negative! A genetic test done to predict my recurrence was also low—so I was not going to need chemotherapy. My risk could be reduced by taking a pill each day to block estrogen.

I knew I had found a silver lining—and a new beginning. Three weeks later I was back at work, now armed with a personal story to complement those of my patients. We would help one another on this journey.

 

[i] Elizabeth Edwards, BrainyQuote, http://www.brainyquote.com/quotes/authors/e/elizabeth_edwards.html

[ii] Gubar, “Living with Cancer.”

A One-Two Punch to Knock Down Health Care Costs

shutterstock_205423492As the nation’s health care bill breaks the $3 trillion mark, it’s hard to imagine anything that would deliver a one-two punch capable of knocking down such unfathomable costs.

After all, experience has taught us that reining-in health care costs takes far more than a jab here and there.  It’s going to take a systematic approach that demands that providers become far more efficient and effective in care delivery, and that employers and employees become vastly more informed consumers of health care services.

Attention Business Leaders:

Business leaders – your job, of knocking down health care costs, begins this minute. You have two, primary areas upon which to focus: 1) Initiatives designed to assess and improve the wellness and well-being of your employees; 2) Efforts to enhance the health literacy of your employees, as well as their ability to function as effective health care consumers. Chances are your HR department has already made significant strides in one or more of these areas, but there’s undoubtedly plenty of room for growth.

The initial steps are preparatory, and require that you:

  • Collaborate with your HR department (and any external employee benefits consulting groups that are actively engaged) to inventory all existing efforts related to wellness, well-being, health literacy, and enhancing health care consumerism.
  • Understand the metrics for measuring the impact of these efforts, and the corresponding gains that have been achieved since their implementation.
  • Review any employee surveys that have been conducted to assess attitudes and or interest in these topics – including reactions to proposed incentives or disincentives for participation in various health-related activities.

It’s Time to Plan:

Now that you know what has been done to-date, it’s time to develop a strategic plan that delineates additional methods for taking-down health care costs. Since you want the most efficient and effective strategies, a good place to start is with low-hanging fruit. In this case, that means identifying those areas where there is ample opportunity for improvement.

Begin by answering the following questions:

  • Do you have a cogent understanding of the health and well-being of your employed population – including: a stratified risk-profile of your employees derived from an HRA and/or biometric screening?
  • If so, what can be gleaned from this data to help you keep healthy employees healthy, while doing an ever better job of intervening to help manage chronic illness in the higher-risk population?
  • Do you have an effective program for managing chronic disease that is based upon best practices?
  • Have you assessed the health literacy of your employed populations, and implemented efforts to improve it?
  • Have you begun an educational effort to assist your employees in making value-driven decisions when selecting providers, choosing among treatment options, or requesting a prescription?
  • Have you aligned the incentives in your health plan to reinforce the behavior you hope to foster?

 

The more you, as a leader, understand about maximizing employee health, while reducing costs, the better prepared you will be to implement innovative strategies that are beneficial to the employee as well as your organization.

Leaders interested in becoming far more educated regarding the true nature of our health care system, may enjoy reading: The Myths of Modern Medicine: The Alarming Truth About American Health Care,Rowman & LIttlefield Publisher (2014). Author: John Leifer. It is available on Amazon.com.