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Saving Healthcare in the US: Focus on Efficiency, Efficacy and Motivation

I won't bore you with the statistics on how the US spends more and gets less than any other industrial nation in the world and consumed about 17.9 percent of GDP last year.  Instead I want to focus on the goal of colleagues of mine who are serious about shaving 1% of GDP in healthcare.

How to do this?

First off, you need to measure precisely how much you actually spend on each patient.  Then you need to examine how much utilization of resources you actually are using for patient care (not how much you bill).  Focus on maximazing work flow and resource utilization and you now improve efficiency and save money.

But that does not mean you are doing the right thing by the patient.  Next you need to measure efficacy to see if you are getting the best results for what you did.  By doing so we found in occuptational health that patient outcomes improved while physician visits decreased by 40%.

While this is all well and good, it doesn't matter if no one uses it.  So you need to have the proper motivation.  Many times this means a cultural change in the organization.  For example we had a case where an organization could save $8M a year by employing these methods.  The medical director killed the project becauses he did not want his patient outcomes measured.

Efficiency, efficacy and motivation, when implemented, will change the landscape of healthcare.