Archive | December, 2008

100 Smart Choices – Optum Health

Optum Health, a part of United Healthcare, has released a book called 100 Smart Choices. It lays out tips, advice, and tools to help you take control of your health. Since 87.5% of health care costs are due to individual choices, this is a big deal.

We don’t need to create the most medicated generation, we need to find a way to eat better, exercise more, have less stress, and act preventatively.

“Individuals can feel healthier and happier, avoid unnecessary trips to the emergency room or a doctor’s office, and cut their health care expenses by tapping the information in this book,” said Dr. Michael Rosen, national medical director for OptumHealth Care Solutions and consultant on the book. “As we developed the book, we made sure that all of the content was consistent with evidence-based guidelines and assisted members in making informed health care decisions.”

Insights From Mercer’s Annual Survey

Here are a few insights from Mercer’s Annual Survey of Employee-Sponsored Health Plans:

1 – Less than 1% of all employers have provisions where smokers pay more (but 15% of employers with over 10,000 employees have such provisions).
2 – 32% of large employers off on-site or near-site clinics. (WOW! That surprised me.)
3 – 8% of large employers have provisions preventing coverage of spouses who have other coverage.
4 – A $1,000 health plan deductible is the norm.

mercer-cost-increase
mercer-cost-pmpy
mercer-retiree-medical

10% of Older Men Taking Risky Combo of Drugs

A new study that came out looked at utilization of drugs by seniors and raises the flag that people are mixing drugs with other drugs or vitamins that may put them at risk. Since pharmacists and doctors don’t always know all the things their patients are taking, it is a lot harder to catch these issues than traditional drug-drug interactions which are caught at the pharmacy.

A couple of the most common combinations that they cite are:


Warfarin, a potent prescription clot-fighting drug, was often taken with aspirin. Both increase the risk of bleeding, so the odds are even higher when both drugs are taken. The researchers said these risks also occur when warfarin is taken with garlic pills, which some studies have suggested can benefit the heart and help prevent blood clots.

Aspirin taken with over-the-counter ginkgo supplements, increasing chances for excess bleeding.

Lisinopril, a blood pressure drug, taken with potassium, which combined can cause abnormal heart rhythms. Potassium is often prescribed to restore low levels of this important mineral caused by certain blood pressure drugs.

Prescription cholesterol drugs called statins [Lipitor, Crestor, Simvastatin/Zocor] taken with over-the-counter niacin, a type of vitamin B that also lowers cholesterol. This combination increases risks for muscle damage.

Mean Or Nice: Which Is More Contageous?

I found this blog entry on Dr. Gupta’s blog very interesting. It talks about the fact that being mean is more likely to stick with someone and effect them than being nice. Isn’t that frustrating? Wouldn’t we all like to believe that we could make things better by being nice when all it takes is a few rude people to change that.

That’s because, it seems being inconsiderate and rude to people has a much bigger impact than being nice. A recent study, conducted at the University of Chicago Booth School of Business, found feeling slighted can have a bigger impact on how a person treats another, than being the recipient of someone’s generosity.

Working with college students who were tasked with exchanging money in an orchestrated test of taking and sharing, researchers found the young people were willing to share at beginning of the study. But when they felt they were being taken advantage of, or that their fellow students were cheating them, they became more aggressive and greedier, rather than stepping back and appreciating what they were given.

Psychologists say this is not unusual. The meaner deed has the greater impact. Give something to someone and they may appreciate it. Take it away and they’ll fight you or at least object strongly.

As the doctor says “All this anger and hostility not only leads to unhappy people, but can cause anxiety, which raises our blood pressure, and puts stress on our hearts.”

Need A Brady Bunch Show About Health Plans

This is a thought that I have had multiple times. Think about what The Brady Bunch did for architecture. Subconsciously or consciously, I believe it created a positive impression about architecture in the minds of millions of people growing up. I don’t think this was something that architectural associations thought up, but it would have been a good idea.

So, why doesn’t AHIP, the organization that represents the health insurance plans, come up with a way to fund or collaborate with hollywood to create a web story, a sitcom, or a movie in which the hero is an executive at a health plan. By day they are running the company and by night they are moonlighting at a free clinic helping improve health.

Maybe I am crazy, but I really believe this positive imagery would help the industry. In it’s place, the only thing we have are negative images from the movie Sicko or from stories about people being denied care or from our first hand experience with our benefit costs going up. This may not matter as the health industry changes, but I think it will be a long-time before we every really move to a single-payor system or something that radically eliminates the current structure.

Viral Marketing in Health: Humana Steps Up

I talked about Humana‘s innovation group a few days ago. They have done it again with two new games. One is on HumanaGames.com and the other is a Facebook application.

The Freewheelin Cycle Challenge is an online bicycle-racing videogame that matches you and a quirky virtual opponent. To make it to the finish line first, players energize their bicyclist and pick up speed by capturing nutritious snacks, such as nuts and oranges. They lose energy, however, by rolling over holiday junk food, including candy canes, cookies and other sugary snacks.

“The Battle of the Bulge” is an application that will be available at Facebook.com beginning Dec. 24. To participate, users go to “The Battle of the Bulge” Facebook page and answer a few questions about their lifestyle, including exercise and eating habits. Based on the responses, users are assigned a virtual waistline, affectionately called a “bellytar.” The goal of the game is to maintain an ideal weight.

But it won’t be easy. Other “friends of flab” can “fling fat” your way, making your bellytar’s pants literally bulge at the seams. In a worst-case scenario, you could be headed toward an online heart attack. To shape up, simply answer questions about exercise correctly and watch your bellytar shrink before your very eyes. Then answer questions about nutrition correctly to fling some fat of your own.

I find these to both be great examples of viral marketing which Seth Godin does a good job of explaining on his blog. Obviously, there is a long-term objective here which is driving healthy behaviors and positioning Humana as a leading edge company. They also hope to learn about human behavior and understand how tools like these can affect healthcare.

No Man Left Behind

According to an interesting article in Fortune a few months ago, apparently men are losing ground from the classroom to the boardroom. It ask a few questions and talks about a new book – The Decline of Men.

* If the playing field is level, why are so many men tripping up and dropping out?
* Why have they failed to keep up not only with women but with the higher competitive standards of the global marketplace?

It throws out some facts:
* Women earn 60% of all college degrees
* Only 35% of men age 18-24 believe their prospects will improve greatly in the next 5 years (vs. 45% of women)
* 46% of men age 18-24 say they have already met or exceeded their career expectations (vs. 28% of women)
* Women ages 21-30 earn 117% of men in the same age group
* 13% of men between the age of 30-55 are not working (13%)

The article goes on to talk about women’s networking skills and social skills giving them an edge in the service industry and because women tend to know their customers better.

This change could play out in the way people communicate, brands are represented, companies provide benefits, and many other aspects. I guess it points out the need for evolution.

I was definitely surprised by the statistics.


The Decline of Men is a wake-up call to this distressing state of affairs. As award-winning journalist Guy Garcia reports, rather than working hard to achieve top grades or a promotion at work, too many American males squander their energy tracking their fantasy football league scores or mastering the latest video game. Men drop out of school at a far higher rate than women and are far likelier to die early because of poor health habits. Even the male Y chromosome is said to be at risk of disappearing altogether one day.

1% / 10% / 89%

I heard an interesting statistic yesterday at Lifetime Fitness.

It said that only 1% of people lose weight just through exercise; 10% lose weight through diet only; and 89% lose weight through the combination of both.

12 Minutes Of Exercise = 4 Hours Of Exercise

After using a bunch of elliptical machines and other equipment, I have been trying to figure out the “fat-burning” zone on these machines.  Is that where I am supposed to keep my heart rate when I work out?  I feel like I am not even moving.

My wife found a good video for me last night that talks through burst training versus endurance training.  It draws an interesting parallel of whether you would rather be a sprinter or a marathoner.  Compare the two.  Sprinters as with some other athletes don’t do endurance training, but they do very intense training.

Of course, if you want to race, you may need to do both types of training to both lose weight but also build up endurance.  But, the video makes a convincing arguement for losing weight through burst training.  And, who wouldn’t rather exercise for only 12 minutes per week vs. 4 hours per week.

And We Have Two Winners??

In looking at recent investor decks from both Medco and Express Scripts, I was surprised to find almost identical charts each claiming victory on drug trend management.  Here are the two charts…you can judge for yourself.

(Express Script’s from Credit Suisse Healthcare Conference 11/13/08)

(Medco’s from 2008 Analyst Day 11/21/08)

medco-drug-trendesrx-drug-trend

BCBSA On Consumer Driven Care

The BCBS Association released a study a few months ago on Consumer Driven Care.  Here is the presentation and a few highlights.  In general, it appears to show that it is working to save costs and get members engaged without negative side effects of them not using needed care.

  • CDHP enrollment is up 25%.
  • 10 percent more members said they would be careful about healthcare costs if they shared in the savings (incentives work)
  • 43% of those HSA (Health Savings Account) eligible with an open account use mail order pharmacy versus 30% of those with non-CDHP plans.  (Since overall mail use is around 18% this seems high, but the point is valid.)
  • 52% of those HSA eligible with an open account ask their MD about the cost of treatments
  • HSA eligibles are much more involved in tracking and estimating healthcare costs
  • HSA enrollees require more support from their plan – communications and service become more critical in driving their satisfaction.

Social Media Presentation

When looking for some information on social media and innovation, I found these two presentations which I thought I would share.

Rare Scenarios

A few months ago, I heard a few amazing stories that I am finally getting time to capture.

The first was of the baby who was 3 years old and hadn’t slept.  Can you imagine?  I used to think that not sleeping would make you so productive (with some caffeine), but if you had to watch your kids 24×7 with them being cranky and never resting, you would go crazy.  According to the ABC News story, he has a rare condition called chiari malformation.

The other was of a woman who could remember almost every day of her life.  Again, this is something that seems like it would be so great, but she has written a book “The Woman Who Can’t Forget” and talks about being flooded with random memories all the time.

“It’s a split screen in my head.  I am in the present, like right now, doing what I am doing, but I am also seeing my life run through my head at the same time.  The memories are random and out of order, but they are always there.”  (Interview published in American Way magazine, May 15, 2008, pg. 86)

Uproar Over “Reference-Based” Medicare Pricing – Please

Here is an overview of the issue on the WSJ Health Blog.

First off, I am not sure I would call it reference based pricing when the rest of the world calls it mandatory generics.  In many states, this is even a requirement where the pharmacy has to fill a multi-source brand (MSB) with the generic equivalent of the drug.

[In English, what this means is that once a brand drug has lost it's patent and the drug is available as a generic then the generic (which is typically much lower cost) has to be dispensed.]

So, the issue is that apparently Medicare plans don’t always point out that if members choose the higher cost brand product (Prozac versus fluoxetine) that they will pay more..and often a lot more.  Brand manufacturers raise their prices on the brands after they lose patent since they know there are people out there who really want to purple pill and not the generic white pill (for example).

I don’t know if Medicare plans allow it, but I know a lot of clients who allowed members to get the brand name drug at their copay (not at the drug cost) if the physician wrote the prescription for DAW (dispense as written).  The problem is the physician might simply do this at the member’s request even if they don’t need it.  From everything I have ever seen, it should be less than 1% of members who really need the brand versus the A-B equivalent generic.  (Look here for the FDA information on generics.)

I don’t disagree that for the 1% that have an allergic reaction to the inactive ingredients (e.g., blue dye #17) that there should be an exception process BUT we can’t build for the exception and manage costs.  Too many people will choose the easy path and drive costs up significantly.

A Few Examples Of Technology Going Mainstream

Two things caught my attention this week on how technology (especially social networking) is making its way into the mainstream.

In today’s USA Today, they compare this year’s Heisman winner (Sam Bradford) with last year’s winner (Tim Tebow).  As it runs through their statistics – age, year, records, first place votes, one jumped out at me – Facebook friends.  They actually compared how many friends the two quarterbacks had in Facebook.  Really…how does that matter?

A few days ago, Michigan’s GOP Chairman Saul Anuzis announced his interest in leading the Republican Party via Twitter.  Who was subscribed to his Twitter feed would be my question?

“It would be suicide for the Republican Party and conservatives to not aggressively embrace technology,” said Matt Lewis, a writer for the conservative Web site Townhall.com. “The world is dramatically changing in the way people get their information and the way they communicate — the party needs to change with it.”

Both examples make the point that these technologies are here to stay and are revoluntionizing the way we think about communications, marketing, personal branding, etc.  Where is healthcare?  When is the last time you saw the CEO of a major insurance plan providing his Twitter feed to the members?  In most cases, you can’t even find contact information for a lot of companies anymore.

Views on Electronic Prescribing (eRx)

I worked on eRxing when I first joined Express Scripts back in 2001. At that time, it was a huge focus with the recent investment in RxHub with Medco and Caremark. Everybody was drawing these hockey stick projections on adoption.

So, what happened…

  • Physicians began to use the technology in limited numbers and most of them ended up with equipment that didn’t work or didn’t seem more efficient that writing a paper prescription.
  • Vendors came and went so there wasn’t much stability.
  • The technology focus shifted to EMRs (Electronic Medical Records) which might have some eRxing technology embedded in it.
  • According to one slide I saw at a recent conference, there are estimated to be about 22% of registered physicians with the technology by the end of 2008 and 10% who actively use it.

The problem was that there wasn’t much alignment of incentives. A problem that I don’t see getting solved anytime soon. There is some legislation now to help drive adoption. Physicians who use the technology can get bonus payments from CMS in 2009.

I am still a skeptic.

Let me provide some representative perspectives (as I see them):

  • Consumers:
    • Generally, very positive.
    • You mean my physician will route my prescription electronically to the pharmacy of my choice, and it should be ready for me to pick it up when I drive there in 20 minutes. That’s convenient. (Something made a lot easier when RxHub and Surescripts decided to combine efforts earlier this year.)
    • Less errors is a good thing. (The study To Err Is Human really began this focus several years ago and more recent estimates are that 1.5 million people are affected by pharmacy errors each year.)
    • Why is my physician staring at a computer when they should be talking to me.
    • If this was done electronically, why do I still show up at the pharmacy and find out my drug isn’t covered (or not on formulary). (About 40% of claims are blocked for some administrative or clinical reason today.)
  • Physicians:
    • If this is easy (and inexpensive), I am happy to use this.
    • Is this faster than just writing a prescription on a piece of paper?
    • How much additional revenue do I generate from CMS and what do I have to do to earn that?
    • Patients like to leave with a prescription in hand. (Something that was solved by creating a printed “receipt” while also sending it electronically to the pharmacy.)
    • Who’s going to support this when it goes down? (For a small practice or individual physician, there are no onsite IT resources.)
    • This doesn’t fit into my workflow. (A lot of this is a generational issue. Medical school students are used to using technology as part of the process.)
    • This is easy. I can write a macro that when I write for a certain diagnosis code it brings up my typical set of prescriptions. (The tech savvy physician’s response.)
    • I can’t remember all the different formularies (i.e., drug lists) so this will be a lot easier.
    • I get paid per visit so what will this do to increase my visits? (Even though they get hit with a lot of callbacks after prescribing, doctors don’t feel this pain today since it is handled by their staff.)
    • I hope there’s not a bunch of advertisements on this.
    • By telling me whether my patient is compliant with the prescription I gave them, you are giving me new insight. (This is a definite value add that I know companies like CVS Caremark are working on with their eRx solutions.)
  • PBMs:
    • If physicians actually use this, we can really manage trend at lower cost by pushing edits to the POP (point-of-prescribing).
    • What additional information can we provide the physician that will improve adherence? What will the consumer reaction be?
    • What additional information can we provide physicians about poly pharmacy or patients that get multiple prescriptions from different physicians? Who should take action on this?
    • How much will the physician do with the patient sitting right there? Will they check formulary status? Will they switch drugs if there is a step therapy or prior authorization required? Will they take the patient’s credit card down to send the prescription to mail order? Will they take care of the edits (I.e., Drug Utilization Review…drug-drug interactions) that the pharmacy does today?
  • Pharmacies:
    • Will we get clean prescriptions (i.e., no additional work required other than filling it)?
    • How do we let the patient know when to expect the prescription to be ready for pick-up? (This can vary from 10 minutes to ½ a day depending on how busy the pharmacy is.)
    • How will we handle a new patient where we need billing information and allergy data?
    • How does that change our job as a pharmacist? Are we relegated to simply filling Rxs and no longer helping the patient manage their benefit?
  • Pharma Companies:
    • Will PBMs and their clients (managed care plans, unions, government entities, employers, TPAs) be willing to adopt more aggressive plan designs that defeat our detailing and marketing efforts?
    • How does this change the importance of formulary positioning and rebating?
    • How does this change our marketing strategies? (There are a lot of bright people in this industry so it’s not going away.)
    • If they physicians really use these, can we push advertisements (or let’s call them virtual detailing sessions) to the device (PDA, computer)?
  • Other:
    • Can you believe the errors in the industry? This will fix everything.
    • Why won’t someone want to adopt this technology?

Nothing is ever simple. This is a case of great intentions with lots of money and expertise being spent to solve the problem. But, aligning incentives and changing behavior is hard.

Will it happen? Yes.

Let’s put it this way…if it takes over 15 years for best practices in medicine to be adopted, how long will it take for this to be adopted?

More Guns and Safes but Less Pregnancies

Some of you will remember my blogging about Microtrends and Kinney Zalesne’s participation in the Silverlink Think Different event.  (Kinney is one of the author’s of the book – Microtrends.)  Well, the authors of the book are now writing a weekly column for the Wall Street Journal.

The first one is about the new Mattress Stuffers.  As we saw recently with people over-subscribing to treasury bills at 0% interest, there is a demand for safe places to put their money.  People have lost faith in a lot of the institutions that our economy is built on – housing, automotive, banking, government.  Purchases of guns are up this year.  Purchases of safes are up this year.

“refraining from having kids is the ultimate consumer pull-back”

As part of this consumer pullback, they predict that there will be a dip in pregnancies nine months from now.  We are certainly entering a new age that will shape this generation much like the Depression shaped my parents generation.  Expectations will be reset.  The way people invest will change.  People’s view of money (e.g., cash versus credit) will change.

I have already seen thrifty being “cool” versus extravagence being “cool”.  It won’t happen in this first wave of change, but I do think this is a good thing for preventative health.  People will be more interested in planning forward and making smart decisions that pay off long term versus figuring they can fix it retrospectively with money.

Humana is “Crumpling It Up”

I have given it away in the title, but would you have looked at the webpage below and imagined this was from Humana.

crumpleitupYou can go to their website CrumpleItUp to learn a little more about what they are doing with bikes called freewheelin and what they are doing around games and health.

They have a fascinating group there in Louisville that works on innovative ideas.  A lot of them don’t drive the core business of health insurance but they are related to improving the health of the general public or looking at interesting ways to use technology.

They have recently added a blog about this that you can see here.  Additionally, I had a chance to meet with Grant Harrison from this group at the WHCC and also hear him speak as part of a panel on innovation.  I was very impressed with him and a few of the other people in the group.

As John talked about over at Chilmark Research, it is refreshing to see someone focusing on this type of innovation.  When I talked about innovation with a reporter recently, I suggested that Humana would be one of the first groups that they should interview.

Is Your MD Honest With You?

They are probably not intentionally deceptive, but there are some things that doctors don’t tell us (at least according to Dr. David Newman in his book Hippocrates’ Shadow: Secrets From The House Of Medicine).

  1. Physicians don’t know as much as you think they do.
  2. Doctors do know that many of the tests, drugs and procedures they order and prescribe either do not work or have not been proven to work.
  3. Doctors disagree about everything.
  4. Doctors like ordering tests better than they like listening to you.

docs-v-internetIt’s a tough issue.  I talked about the placebo effect and the nocebo effect before.  That is exactly the type of things the USA Today article on this talks about.

Studies show half of patients who go to the doctor with a cold are prescribed an antibiotic.  Colds are caused by viruses; antibiotics kill only bacteria.

The idea that Americans get worse medical care that they realize- often because they get too many, not too few, tests, drugs, and procedures – is gaining ground.

The question still is whether you want to know everything.  Certainly, we should better arm physicians to talk about these gray areas and take them off the pedistal.  Part of that is addressing things like malpractice.  We will never control costs and improve care without eliminating the need for defensive medicine.

Spend Time With Your Positive Friends

Earlier in the year, there was a study that showed how your friends and social network can affect your weight loss.  I blogged about this and quiting smoking as part of your network earlier.  Now, in Penelope Trunk’s blog, she talks about how your friends can make you happy and that happiness is linked to better health.  Interesting, she also says that if you say you are happy then you get the same benefits.

“optimism, a trait shown to be associated with good physical health, less depression and mental illness, longer life and, yes, greater happiness”  Time Magazine article

It brings me to two thoughts:

  1. You should tell yourself that you are happy and you’ll feel better.
  2. Member communications should stress happiness and help people understand how they can be happy by taking certain actions.

happy

Black Is The New Pink

I am stealing this line from a tee shirt I saw the other day, but it immediately came to mind when reading an article about colors in the US Today. I was amazed when it talked about people buying new iPods (for example) since they wanted a new color. Just because I get tired of my green iPod…do I really go back and buy the red one (especially in today’s economy)?

“Bleak 2008 also happens to be the holiday season when shoppers may want their gifts to be colorful. Or at least, a different color from last year’s model.”

“When you add color to a product, you stimulate the consumer’s awareness that the version they already have is obselete.”

Some of the favorite colors were:

  • Blue, dark blue, dark green, and red (tomato) for men
  • Purple, blue, red (tomato), and blue-purple for women

It just makes me think about healthcare communications and what is the color switch that we need. Companies have talked about obesity, diabetes, preventative care, adherence, and many other actions for years. What is it that becomes different? How do we compel the consumer to act?

  • Is it a change in mode – direct mail to automated call?
  • Is it a change in tone of the message – caring to pushy?
  • Is it a change in message – qualitative to quantitative?
  • Is it a change in source – health plan to provider?

To manage healthcare costs in the US, we have to get individuals engaged in their care. The magic bullet is how to do this.

5 Myths of Health Care

Charlie Baker, the CEO of Harvard Pilgrim, has a post on his blog about the Five Myths of Healthcare. It’s worth a read as is his blog.

1) America has the best healthcare in the world.

2) Somebody else is paying for your health insurance.

3) We would save a lot if we could cut the administrative waste of private insurance.

4) Health care reform is going to cost a bundle.

5) Americans aren’t ready for an overhaul of the health care system.

Malcolm Gladwell Video

In case you don’t know Malcolm Gladwell, he is the author of Blink and The Tipping Point. He has now published Outliers. Here is an interview of him about Outliers.

You can also see him in an older video presenting at TED.

It is worth reading his books and understanding his principles. I have seen him present live once. He was very good.

Want Senator Daschle To Come To Your HC Party

Obama’s team is leveraging the power of the people to solicit input.  You can go to their site www.change.gov to provide input. 

He is specifically asking for groups to meet on healthcare and document their thoughts.  Senator Daschle will attend at least one of these events personally.

It worked to get him elected so it will be interesting to see what they get and how they leverage this.

Great Presentation – Mktg in Recession

I came across this presentation and loved its simplicity.  It delivers a crisp message using few words and a lot of visuals.  Given the challenges in the economy (and more on topic with communicating efficiently), I thought I would share this.

Six Steps To Innovation

Futurist Leanne Kaiser Carlson presented at the 2008 AHIP Business Forum.

Health is a growth field, Ms. Carlson explained, not only because of the amount of money spent on it but also its importance to everyone and the unique confluence of technologies that are on the cusp of revolutionizing health. Ms. Carlson showed examples of how computing, nanotech, neurotech, and genomics are coalescing to enhance human performance, human life, and human health from thought-controlled bionic limbs to artificial legs that are faster then human legs.

She presented six things that companies should be doing to innovate:

1. Pay attention to what is going on around you.

2. Create an innovation imperative.

3. Begin a specific fund for innovation and development.

4. Understand the landscape of innovation.

5. Create a culture of rapid prototyping.

6. Break competitive boundaries.

Healthcare Reform Proposal

AHIP (American Health Insurance Plans)  put out a plan for healthcare reform.  You can learn more about it at the website they set up.  Here are the key things that they are talking about.

ahip-principles

Design For Six Sigma (DFSS)

Getting it right from the start is always a critical issue when designing process-based solutions.  DFSS or Design For Six Sigma is an approach that companies are starting to use in applying the rigors of Six Sigma to their product management approach.  This allows them to leverage proven fundamentals using a DMAIC framework.  (DMAIC = Design, Measure, Analyze, Improve, Control)

DFSS is built around a couple of Six Sigma fundamentals such as the VOC (Voice of the Customer) and the CTQ (Critical to Quality) framework (example.  Understanding root cause of issues in your process allows you to start finding solutions for them.

And, however you approach this, it is critical to understand your value stream (i.e., where is value created) and have a statistically valid approach for capturing data and rigorously reviewing and improving the process (i.e., continuous improvement).

The other thing that all this Six Sigma talk makes me think of is an automation of process which can be seen in a lot of the BPMS (Business Process Management Systems) which exist.  These process based applications can be created as flexible tools that sit above (i.e., abstracted from your legacy systems) to run using an event-based architecture (i.e., data triggers) or SOA (service oriented architecture).

Why do you care as a member or patient reading this? Because you hate things that don’t flow smoothly.  This approach is supposed to begin with the customer, understand their needs, develop a process with minimal potential quality or failure points, measure and continuously improve the process, and then automate the process with the flexibility of making dynamic changes as the needs and market changes.

Why do you care as a healthcare enterprise? Quality is always an issue.  As the economic times squeeze everyone, it is going to be critical to find efficient ways of improving processes and automating processes to drive better results without sacrificing quality.

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