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Fixin' Healthcare

Tuesday, January 30, 2007

Transformation Of Healthcare - To Transform Is To Reform

Society struggles to maintain the integrity of complex systems while adjusting to changing conditions and shifting needs. Change agents may be aware of the debate over reformation vs. transformation (upper limit hypothesis) but in the heat of battle the objective is to create change. There are always forces that serve to moderate change.

When any system reaches a point of diminishing returns, alternate processes become attractive. Alternate processes may be adjustments to the existing system (reformation) or an entirely new approach (transformation). It is conceivable for transformation to reform and maintain an existing system in a more productive mode.

Reformation of health care is a constant process but the adjustments have not altered the basic course or momentum of the system. And, for the most part, people are satisfied with that process. However, rising costs, increasing incidence of chronic diseases, health problems associated with advanced age and declining health status are creating an unsustainable situation.

Politicians are elected by giving people what they want and people want more health (medical) care. So, the politicians are focused on providing medical insurance to everyone. This will not change the system but it will calm the people. Unfortunately, the problems will continue to grow.

The policy Mandarins are implementing quality indicators to achieve improved care. Early results are encouraging but not overwhelming. It is another adjustment to the current system of medical care.

A more promising possibility is the proposal to establish an electronic medical record. It offers the promise to improve efficiency and effectiveness with cost saving. The possibilities can be greatly enhanced if it is both a health and a medical record, and if the health/medical record is both risk-oriented and problem-oriented. Now, that will be an instrument to achieve improved health status at lower cost.

The establishment of health promotion and preventive health care as the primary system that is applied to everyone throughout society regardless of health status will transform health care. The goal of such a system is optimum health status for every individual and the population. A smaller medical care system will focus upon each individual suffering from disease and trauma. The goal is to restore optimum health.

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