Accountable care organizations and medical homes are terms being bantered about with reform. An accountable care organization (ACO) would consist of a group of healthcare entities that share responsibility for the quality and cost of care to a defined population. People I have talked to say that if you really look at this in terms of continuum of care then home health, hospice, adult day care, nursing homes and assisted living among others could be construed to be included as well. ACOs would receive financial rewards for meeting standards based on quality of care and efficiency in spending.
So this got me thinking. How in the world do you ever bring such disparate organizations together against a backdrop that includes: lack of communication among physicians; nurse-to-nurse hostility and overall distrust of the system?
I had an "a-ha" moment after reading a recent New York Times article about Apple CEO Steve Jobs: He should lead healthcare reform!
Jobs creates "edited products that cut through complexity, by consciously leaving things out." Who better to simplify resident and family experiences? Instead of an accountable care organization, Jobs would create "Your Accountable Care Organization," with just what you need when you need it.
Jobs doesn't design products by committee or based on market research data, but through a heavy reliance on "tenacity, patience, belief and instinct."
Healthcare gets so log-jammed pouring over metrics that there is truly paralysis by analysis. Jobs steps away and puts himself in the user’s (read resident’s) head. He reaches for what people only dream about or have not even considered dreaming about. Who thought you could put all that music on that little thing? Who thought I could go to my doctor’s office and the next specialist I need to see is in the next room?
Jobs surrounds himself with exceptional people who create "a-ha" products. His engineers and designers aren't just 30 percent better than their peers, but "ten times better," he says. Yes there is dead wood in healthcare too but there wouldn’t be in a Steve Jobs organization.
If you think I'm short on details, you're right. But perhaps we need leaders who have a right to be somewhat dictatorial because their vision is so strong as to not be denied. That might actually move healthcare organizations forward faster.
And all of us need to realize that accountability starts with each and every one of us taking control of our health so we don't need the system at all!
Anthony Cirillo, FACHE, ABC is a health care consultant, senior advocate and blogger for Wellsphere, Medpedia and others in the area of aging, person and patient-centered care and marketing. He consults with long-term care facilities and is available for management retreats and association keynotes. He is the author of "Who Moved My Dentures? His company, Fast Forward Consulting empowers organizations to change the healthcare experience and leverage it in their marketing. Hear him speak this month at both the American College of Healthcare Executives and the National Council on Aging annual conference in Chicago. More at www.4wardfast.com and www.anthonyssong.com.