Optimism or Hope?
Jan07

Optimism or Hope?

During the week after I had given a very positive review of the 27th IHI Forum in my weekly “Healthcare Musings” I received an email comment from one of the regular readers who wrote to me saying that he admired my optimism, but he just did not feel it. The comment caught me by surprise because although I thoroughly enjoyed the Forum and was energized by the speakers and excellent sessions, I remain painfully aware of the huge...

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The Digital Doctor, 2016
Dec31

The Digital Doctor, 2016

One of the many lists forecasting what will happen in the New Year predicted that in 2016 many patients will begin  consulting a Digital Doctor by using a health app for the first time. The article also predicted a big rise in the use of video visits and video consultations with medical providers. Perhaps to some this sounds like news but my response is, “It’s about time!” The widespread use of computers in medicine has been a long...

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Pioneer ACOs’ Successful Efforts
May21

Pioneer ACOs’ Successful Efforts

Recently the Boston Globe published the much-anticipated results of the independent actuarial accounting of the results of the first two years of the Pioneer ACOs program of CMMI.(Click here to read the whole article.) I find it impossible to read this without wanting to comment. Many may not remember that the first accountings of the Pioneer ACO program were somewhat different. In 2013 there was an article in the Globe and in papers...

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Healthcare Innovation in Vermont
Apr28

Healthcare Innovation in Vermont

I am now involved in a small way with the Vermont Healthcare Innovation Project that is the latest of several efforts in Vermont to move away from healthcare that is fragmented, inefficient and expensive. Despite efforts to move toward value-based reimbursement and the presence of three ACOs in the state (the largest, OneCare Vermont, sees about one hundred thousand Medicare, Medicaid, and commercial patients), the current system of...

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5 Years Later, ACA Is a Big Deal
Apr21

5 Years Later, ACA Is a Big Deal

Last month we passed a big milestone: the fifth anniversary of the ACA (Affordable Care Act). Barack Obama used 22 pens on March 23, 2010 to sign the most important piece of social legislation so far in this young century. If you have about seven minutes, you can hear Joe Biden’s introduction of the President at the signing. Biden’s speech is pretty laudatory and positive but he does not overstate the significance of the President’s...

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Burnout: Enemy of the Triple Aim
Mar03

Burnout: Enemy of the Triple Aim

Burnout is the enemy of the Triple Aim. Some deny that it exists. Most press on with their work ignoring its symptoms in themselves and others. At times the impact can be disastrous for individuals and for practices. Burnout in clinicians often has an impact on patients and the care they receive. Dr. Paul DeChant recently “tweeted”: @Dr_CommonSense: @HealthcareWen Providers are responsible 4 coming 2 work with a full #compassion fuel...

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Creating the Future of Healthcare
Feb09

Creating the Future of Healthcare

Walter Isaacson’s latest book, The Innovators: How a Group of Hackers, Geniuses, and Geeks Created the Digital Revolution, led me to think about how we are creating the future of healthcare. Although the book is about how the computer revolution and the internet came about, it has a lot to say about how people innovate, create, and then make that innovation a reality. In its essence, the book is about creating and sustaining change....

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Lean: Look Back, Look Forward
Jan21

Lean: Look Back, Look Forward

This time of the year is terrific for what we call “Hansei” or deep reflection in Lean. One of my greatest sources of continuing satisfaction for 2014 was my work with others to spread Lean thinking. Most of my work with Lean was done with Simpler, in concert with Dr. Patty Gabow, the retired CEO of Denver Health. As Senior Advisors to Simpler, Dr. Gabow and I meet regularly with the Simpler leadership that also includes two other...

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