Amit's Profile

Very interesting topic. Technology hasn’t yet solved many of the problems in the existing system. Unless the system changes, health care professionals will have issue adopting/deploying the full potential of technology in health delivery. Arcane regulatory, billing requirements and lack of system thinking has stymied the deployment of technology and improvement in health care.

Dashboards are extremely valuable if data presented is meaningful to the users. End users have to be a part of designing and have to trust that the data is not collected for any other reason but to be transparent and improve. There are real issues at times, when the obvious problems become visible across the organization. Its a tool but also a way of thinking and organizational culture. Dashboards merely display data and cant solve problems.

Change is hard in most circumstance. Its probably harder in the situation you describe. Culture ( established way of doing thing) change is difficult and requires a very methodical approach. When established ways of doing things are challenged perhaps the first response is always to defend ( this is how we have always done it).
I am sure you are aware, John Kotter has written much on this subject from a very elementary who moved my cheese to a more methodical Accelerate. I found his books and article to be very informative on change management.
I had to go into two turn around situations and when planning a big change, I always thought of his methods to guide the change. I failed few times in implementing some changes and I went back and found the explanation.

We face a similar dilemma. We are the only free standing non affiliated respiratory hospital in all of Western States and we are small. Many times larger chains have made an offer to buy us up. We have believed that as long as we can produce better value there is no need for us to merge. However, the practical realities of ACOs, Mgd. Medicare Plans, bundling and contracting with health plans make affiliation/merger an attractive proposition. Larger systems also have lower supply cost but it comes with allocations and innovation becomes harder as part of a larger system.
We have decided to stay put for now and focus on our clinical outcome. We believe that better outcome will draw volume and there will be enough FFS Medicare patient in the near future to sustain us. This will allow us time to enter into favorable contract with mgd care plans based on outcome.

I think the willingness to fund it would definitely go up if the outcome of the cohort is demonstrating the value of the program. Beyond mortality and readmission, is your team collecting quality of life, ADL, Functional mobility outcome? Are you looking at reducing the risk for institutionalization, falls at home etc. as well.