The Circle of Non-Reality

July 1, 2008

Axioms can be illuminating. Take, for example, the project manager’s credo: “Fast, good or cheap — choose any two. You cannot have all three.” This is sometimes referred to as the Circle of Reality, though in some circles, reality is optional.

Axioms can be illuminating. Take, for example, the project manager’s credo: “Fast, good or cheap — choose any two. You cannot have all three.” This is sometimes referred to as the Circle of Reality, though in some circles, reality is optional.

Ever since Mankind built its first mud hut there have been strict trade-offs between budget, time and quality, and yet, organizations continue to believe they can have it all.

Government is like this. The U.S. Department of Health and Human Services (HHS) recently released its final rule on Medicare Part D claims data, which “allows the Secretary to collect claims data that are presently being collected for Part D payment purposes for other research, analysis, reporting and public health functions.” The rule effectively enables Medicare to distribute aggregate and non-aggregate claims data to other government agencies and 3rd-parties for the purpose of research and compliance with congressional mandates.

The mandate in question comes from the Medicare Modernization Act of 2003, which requires HHS to develop a plan to “improve the quality of care and reduce the cost of care for chronically ill Medicare beneficiaries.”

This is a somewhat isolated section of healthcare and it’s taken five years to get this far so, clearly, we’re going for Good and Cheap, not Fast.

The Trouble With Axioms

Creeds tend to be grounded in experience so one would think they would hold water, but we live in an age of promises with little oversight, therefore, political voracity outweighs the chance for success.

It’s negative, I know, to suggest that we cannot improve care while simultaneously lowering cost. However, it’s hard to imagine that we could spend less on healthcare, when prices for most goods and services in America continue to rise.

Adoption is the key. Once adoption increases, market forces will naturally bring costs down. But that’s the rub. How do we increase adoption?

More mandates is one approach, however, a better approach might be to make adoption fiscally responsible and financially advantageous for healthcare organizations.

Healthcare is a business, after all, and there’s nothing wrong with that.

New Content

HMT has a new department titled “The Healthcare CIO,” in which, each month, we will highlight and interview top CIOs around America to gain their insights on healthcare IT directives. We begin with C. Martin Harris, M.D., CIO of the Cleveland Clinic, who speaks about the CIO’s evolving role in healthcare organizations.

In September, another new monthly department titled “The Healthcare CFO” gets launched. Stay tuned.

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