Imagine a doctor’s office so efficient that the waiting room is empty. Imagine treatment time (and costs) being slashed. Imagine healthier, more productive employees.
In healthcare, this is dubbed the Triple Aim. It’s an approach that focuses on improving the patient experience, reducing costs and improving population health. This framework was developed by the Institute for Healthcare Improvement, whose former leader, Donald Berwick, MD, famously noted that 20 – 30 percent of health spending is “waste” with no benefit for patients because of overtreatment, failure to coordinate care, administrative complexity and fraud.
Although many outside of the industry are not familiar with the Triwwple Aim, it’s making a significant impact on the way healthcare is delivered:
- A common lexicon. The Triple Aim has been adopted by hospitals and health systems as a framework for implementing major improvements.
- Lean practices. Healthcare providers are using a version of the Toyota Production System to implement “lean” processes by eliminating activities that don’t add value or cause delays in patient care.
- Triple Aim concepts have been embraced by the Centers for Medicare and Medicaid Services Innovation Center, which is using $10 billion in funding from Congress to fix what’s broken in healthcare with demonstrations and pilot programs.
- Standard practices. Evidence-based medicine is becoming more prominent in healthcare, with standardization of treatment based on clinical research.
Employers becoming more engaged
Historically, employers have had little ability to influence how healthcare is delivered. That’s changing as companies like Coca Cola, IBM and American Express use their purchasing power and expertise in supply chain management to improve quality, remove waste and reduce costs. Formed in early 2016, the Health Transformation Alliance is a coalition of 20-plus employers (with 4 million covered lives) that aims to drive meaningful change by engaging local health systems.
It’s been proven to work. According to Harvard Business Review, an Intel-led effort in Portland, Oregon, chose uncomplicated, lower-back pain as one of its initial priorities in conjunction with a local healthcare system. Recognizing that most of these patients have good outcomes with physical therapy, back-pain patients were screened, and then quickly began physical therapy treatment. The result: Most showed improvement in about three weeks. In contrast, the traditional approach includes treatment delays, hi-tech imaging, specialist visits and then physical therapy, a process that typically takes nearly two months with added worry for the patient, added expense and identical outcomes.
The Intel-led project measured success with the following questions:
- Did patients receive evidence-based care for treatment?
- Were patients satisfied?
- Did patients have same-day access to care?
- Was there a rapid return to function?
- Was the care affordable and were savings achieved?
This kind of transformation might occur on a larger scale as more employers get involved.
“Employers are the ‘sleeping giant’ in healthcare …,” said Health Transformation Alliance Vice Chairman Glenn Steele, MD, the former CEO of Geisinger Health System. “If they act together, they can successfully deliver higher quality results at better costs for employees.”