This post could be titled
“Simplify healthcare to save money, improve patient service, transform the experience of care, drive outstanding quality, increase morale, decrease administrative costs, reduce errors, minimize frustration, reduce burn-out, retain experienced clinicians, increase joy at work and so much more.”
In healthcare, we pursue good things instead of important things and complicate care in the process. Everyone working in healthcare has the power to make simple things painful and complicated. Leaders especially.
Take information technology. IT experts value security and privacy, which are both good things. But they complicate life with timed log-outs that make users sign-in again and again, forced password changes every month, multiple portals just to see one patient’s results, and firewalls that block clinical sites. They complicate care. They can ruin a great experience while trying to do something good.
We pick on IT because it’s easy. But everyone can choose to simplify healthcare or make it nasty, brutal and long. New forms, checklists, rules, legislation, processing and dozens of other things can make care hard, slow, painful.
Simple takes effort and does not happen by accident. The Toyota approach to LEAN manufacturing has helped 100s of hospitals provide better care with less effort and waste. But it requires intention and hours of expertise to cut out useless work.
Ockham of Healthcare
Maybe healthcare needs a committee designed to axe committees? It could look at every process, legislation or regulation and ask,
“Does this simplify healthcare? If not, is there a simpler way to get the same or better outcomes?“
If it looks like there might be a simpler way, the committee could ask those who came up with the process to try to make it simpler.
Science informs modern medicine. All things being equal, science loves simplicity; it lives by Ockham’s razor. Ockham’s razor, or the law of parsimony, says we must not multiply explanations beyond necessity.
Maybe we need an Ockham’s razor of healthcare: Do not complicate beyond necessity.
I wrote about the legislation epidemic as have many others. Here’s a short list of some of the work being done mostly outside Canadian healthcare:
- Ministry of Administrative Simplification “Healthcare is turning into an industry focused on compliance and regulation rather than patient care.” Forbes.
- The effects of healthcare over-regulation.
- How government regulations made healthcare so expensive. Von Mises
- Healthcare regulation a $169 billion dollar tax. Cato
- Deregulation task force in Australia
- Canadian Red tape reduction action plan and reducing red tape.
- Administrative Burden Baseline
- Reforming regulation
- Over-regulated America. Economist
- List of Health legislation in Alberta (Ontario needs this!)
Simplify Healthcare
Simple takes effort. Some jobs depend on healthcare being complicated. Some people get paid to keep things complicated. Will we work and sacrifice to simplify?
Thank you Shawn. Right on point. I think this is my favourite of the many excellent articles you have written.
Keep it Simple S… Who could possibly object to this revolutionary concept.
I guess as you say those whose job depends on the growth industry of increased compliance and regulation in HC?
I will think of you on Monday when I boot (up) my computer, get a cup of tea while it is slowly grinding into action then hold my breath as The Machine decides whether it is going to accept the three separate passwords (and access card) I have to enter to access any patient data OR whether it will make me call IT about it’s misbehaviour – again.
Regards,
Helen
Hello Helen!
Thanks so much for taking time to read, comment and encourage with your kind words. You make a great point. I forgot that there’s actually 3 separate passwords just to get into my electronic medical records software! Sure am happy I don’t have an access card, too. 🙂
Thanks for engaging in the issues!
Best regards,
Shawn
Simplification is created by asking one basic question:
“Is the process we are about to undertake, program we are implementing or system we are creating going to give us more time with patients (in the long term, excusing time required to learn) or take time away from them?”. Most of us entered health care for a single reason, and that is the desire to apply our knowledge, compassion and expertise to individual patient problems and in an aggregated way to our whole patient population. I think we lose track of this when creating policies and procedures that complicate. We lose track of purpose. We inadvertently place barriers to innovation and change that could enhance patient care. We fall into mindsets of complacency and conformance. Simplification releases us from the burden of excessive layers of rules that stop us from thinking outside the box.
Its time to bring in Design Thinking when we remodel the Health System. This will focus on the outcome without losing track of the length and complexity of the journey. And we can get on to helping patients return to true health.
Great comment, Darren!
I love that your question forces us to ask how change will impact patients.
“We lost track of purpose.” Well said indeed. Perhaps, we could ask whether those making some of the changes were ever motivated by patient care before they were given the authority to make policy changes that impact patients. I suspect many people (bureaucrats, politicians) find themselves given responsibilities over portfolios that never pulled them into governance in the first place. So they make decisions that make us ask, “How could someone who cared about patient care ever do something that steals from patients?”
Thanks again for taking time to read and comment. Thank you, also, for all that you do on behalf of physicians in Ontario! I benefit from your work at OntarioMD every day!
Warm regards,
Shawn