11 September 2012 — Like many I found the recent landing of Curiosity on Mars an enthralling event. I had seen the JPL’s video “Seven Minutes of Terror” so I had a feel for the challenge but, for the landing to work so successfully, was such a feat of outstanding organizational and advanced technical coordination, that it took my breath away. The excellence bar in space exploration has just been taken to new heights.It would be nice to think that this kind of excellence could be applied to more mundane tasks but, sadly, this is often not the case, and a prime example is the disease now affecting Health Care Administration (HCA) in the States. Please note that I am not commenting on medical health care standards, or on providers of health care, or any other aspect of health care policy or services, but solely on the administrative aspects.
Effective administration is a fundamental sign of how well an organization is working and in the case of health care, which is of course a complex interactive pyramid of competing organizations, it is not certainly working to the advantage any of the public organizations be they public at federal, state, or local level, and above all it is not working to the advantage of the ultimate consumer of these services, the patient.
However, it may be working to the advantage of the myriad of commercial entities involved and it is, perhaps, a sign of the comfortable profit margins that they are making that they do not seem overly concerned about their high costs of administration
When a patient has to supply the identical personal information – the same data – to numerous medical and related service organizations like insurance providers, just to begin a medical procedure then something is seriously wrong.
That in 2012 this information – or data – is often being supplied in paper form magnifies many times the cost of the required administration while, at same time, substantially decreasing the effectiveness and speed of administration. This is not just a disease it’s a chronic disease.
Many other US industries, trade sectors, government agencies, international organizations, and indeed, countries began to face up to these issues thirty years ago and have developed highly refined ITC based solutions, which have improved effectiveness, and customer service while substantially reducing administration costs. For example, can you imagine Walmart or FedEx being such successful companies without advanced and coordinated computer and telecoms systems?
The solutions to paper based administration and duplicative submissions of the same core data have been developed and honed over the past 30 years and are now implementable on a small or large scale in a safe, secure, and cost effective way. It is a sign of the depth of the disease affecting HCA, that with a few exceptions, these solutions have been ignored or implemented without the necessary vision.
I am aware that attempts are being made at the federal level to take a top down approach to these issues, and in a green-field situation, they might work. But given the diversity of the organizations involved and their competing objectives, it is more likely that they will run into the sand which, of course, for self-interest reasons, is exactly what some of the organizations involved are aiming for.
An alternative approach is to start by looking at the needs of the patient – the client – rather than the needs of the service providers, and work bottom up from there. Of course there are problems with this approach too but, if the data submission by the patient can be harmonized and standardized which is a feasible task, then there will be immediate benefits to the patient and to the whole administration of healthcare.
What is certain is that without an immediate and complete recognition of the issues, and the costs and waste of resources, and a determined plan of action, then the grandson of Curiosity will be landing on Jupiter while the HCA disease still rages in the USA, to the complete detriment of the ultimate consumer – the patient.