Monday, November 26, 2012

11 . 29 . 12 | Continued Push Into Healthcare

2012 cases in healthcare numbered roughly a dozen in:
  • Reducing hospitalizations
  • Reducing re-admits
  • Reducing exacerbations for disabled populations
  • Increasing engagement in CM/DM and in wellness programs 
  • Improving treatments
  • Streamlining utilization management
  • Predictive modeling for CM/DM selection
In all these studies, the device Nobi pioneered of cluster randomizing (e.g. by nurses, not patients) made the findings easy, fast and pure. This has remained controversial (without reason) but with more researchers adopting, the issue is inching toward more mainstream acceptance.

In most cases, widespread acceptance has required backing out precursors (such as HCC score) analytically, to show the findings do not change (and instead strengthen). No surprise here since the theory has been around since the 1920s but remains notoriously hard to grasp. These more practical exercises of showing users in their own language have been well received.

Monday, November 19, 2012

11 . 19 . 12 | The Control Book

An ingenious management tool as client efforts expand to several statistical designs was suggested to us a while ago by a veteran CEO. It is a seemingly simple report, with one page for each project showing the improvement in the main measurement, annotated for actions taken.

In assembling the first edition for monthly update, the organization reaches agreement on the operational definition of the measurement. Discussions that take place after this discussion are more focused. The Control Book allows executive teams to manage the improvement effort in a short meeting every month. Financial information is also footnoted so that the overall ROI is clear at a glance every month. The idea is simple. Its execution is deceptively difficult but consumes little time. The tool also makes implementation straightforward whereas it can otherwise be elusive.

The reasons this simple tool can be difficult to introduce differ by organization and are best discovered by each client. Once in place and with a monthly forum for managing it, the tool is remarkably powerful and much liked. It is harder to accomplish than the statistical designs, mainly since sustained implementation is the hardest part of improvement.

The Control Book is the most effective way to manage implementation, short and long term.