The McKinsey Quarterly had a nice piece this week - US hospitals for the 21st century - which identified some key problems for . These include medical safety issues, high costs and increasing economic pressure. Drivers include Consumer-Driven Health Plans (CDHPs) and other High Deductible Health Plans (HDHPs). In order to respond the authors suggest that hospitals will need to start thinking more like retailers -
"they will start to resemble companies in other competitive service industries"
So if a hospital starts to resemble other competitive serviceor retail companies, what will that mean? The report identifies a number of key issues and four, in particular, seemed to me to require an aggressive adoption of enterprise decision management as part of an IT strategy. Indeed some Commonwealth Fund research recently showed the potential for IT in health care. So how can EDM help build a hospital for the 21st Century?
- EDM is a key strategy to segmentation of customers when you have large numbers of them. As consumers want different things from their medical services it will be key for hospitals to segment them based on their needs, their desires and the way they are likely to respond. They will also need to consider how to include different types of insurance and payment mechanisms in this analysis. EDM offers an opportunity not just to use analytics to segment customers, but to apply this in high-volume, automated systems like the web. A number of posts relate to segmentation including this one and this one.
- A key to success identified in the report is the consistent execution of front-line tasks. Here again EDM shines. Not only do rules allow for potentially complex or impactful decisions to be automated, they also allow those who understand the impact of the rules to control them rather than surrendering this power to programmers. Hospitals are rightly nervous about automation of steps with medical (or financial) implications but EDM allows for the control they need to be comfortable. It also allows for rapid change when new approaches or information become available and for the integration of analytics.
- Drug safety is another big issue. The use of rules to manage drug interactions is increasingly well documented. There are challenges in building systems that work with physicians instead of against them but smart use of business rules technology is working to reduce medical errors.
- Avoiding bad debts in this new, more complex world will also be a challenge. Hospitals can't turn away patients based on their financial status (unlike some of their competitors in healthcare delivery) so managing the payment process so as to avoid acquiring a mountain of bad debt will require rules and analytics applied at the point of care or check-in.
Finally here's another posting about an article on retail healthcare and don't forget this podcast on some uses of business rules in healthcare and, if you are interested in how CDHPs and HDHPs can be managed using this technology, join me and SHPS next week for this Health Data Management webinar "I.T. Strategies for Consumer-Driven Health Care with SHPS"
