Healthcare is a '3 LOCK BOX'

OK, now maybe that caught your attention or it didn't. For those of you that know, it is a reference to a Sammy Hagar song/ album of the same title. Now, this is pre-Van Halen Sammy, but still pretty good. Man, I could really start in on tackling the age old debate of Dave vs. Sammy. But, that is for another time. :)

I mention 3 Lock Box because I was thinking about the problem of healthcare and my 30 second elevator speech. I see the problem of healthcare as a process that needs some tweaking done to it. Think of the tagline, " OPTIMIZE THE PROCESS, MAXIMIZE THE PROFITS". This can cause some heartburn with folks, because when you add humans and profits into the mix it gets really personal and icky. ( ok, maybe not the most technical term)

So, now you are asking , What is this 3 lock box? Very simply, it is something that requires 3 keys to unlock it. And, this is how I see a path to optimizing our healthcare system. And, I believe that these items should be done regardless of what our 'leaders' in D.C., will hopefully deliver. ( yes, and I think that to would be another blog)

Also, a really interesting coincidence is I have 3 things that I roll out in my elevator speech. So, hear they are:

1. Improve the Quality of the Process, ie. " Do it right the first time"

2. Increase the Efficiency of the Process

3. Eliminate wasted Resources in the Process

And, then you say, "Thanks, and how do we do that?"

Let me take a stab and we can see how the conversation goes from there.

1. Improve the Quality

We need to make sure that correct tests are ordered, and then performed. Asking what the customer (patient) deems to be the true indicator(s) of success and work toward those goals. We need to insure that everyone get the right procedure, test, medication, whatever the very first time. To NOT do so is UNACCEPTABLE, but if it happens then we resolve it IMMEDIATELY and work to prevent it from occurring again. Mistakes happen but the key is to make sure they do not lead to something catastrophic.

Efforts need to be made to have this mindset applied to everyone involved with healthcare, AND this does include the patients.

The patients need to have a bit of self-responsibility for their own well-being. Are they doing everything they can to promote a healthy lifestyle? Are they following the advice of their physician?

Also, I think there needs to be a shift in the mindset of physicians as well. We seem to have a system that focus on dealing more with the symptom rather than the root-cause. From my manufacturing days, if you don't fix the root cause, then the problem keeps coming back. Root-cause analysis is a key focus on any REAL effort to improve the quality of a process. So, I know we need to change the focus of our healthcare to prevention rather than treatment.

2. Eliminate Wasted Resources

Originally, I had this 3rd but I moved it up because I feel it is important to remove "the excess of the system" and then you optimize what is left over.

So, here we need to remove anything that is NOT adding to the patient's experience or care. This is where a lot of savings can be generated. Redundant tests, extra visits that serve no 'real' purpose, tons of paperwork, non-value added tests or medicines and I should say this also impacts the physcians as well. To often you hear the term 'defensive medicine', where physicians are doing extra to prevent from being sued. This has to stop.

Patients need to be a lot more aware of their own health and what is really something that requires medical attention. The internet is a wonderful thing and can give you all sorts of information BUT the human brain is pretty powerful too. Use the two together and try to apply some common sense. ( Somebody in your family has to have some). If you have a cold, take some OJ, hit the gym, have some soup, and go to bed early. See, no medical help needed.

Another aspect would be to get rid of antiquated ways of doing things if there is something better. Now, I am not saving move everything to the latest technology. Take medical records for example, there is no reason why this country is under 2% for electronic medical records. Hell, most people have email, and a debit card....we can move into the glow of technology for communication and banking. ( Sorry, Postal Service and Check Books)

3. Increase the Efficiency

I see this as, well all the wasted stuff is gone, now we just have to maximize the stuff that is left over. One way, is how do hospitals communicate with each other, with other labs, with other regions. If this can be improved, then we are going to make some headway.

Have we optimized the workflows and layouts of various facilities, labs, waiting rooms, etc? Do we have facilities located that be used by people in more remote areas, so they can get attention when they need it.

Are we making it easier for the doctors, nurses, lab techs to do their jobs? Have we made it our goal to help them perform their jobs easier and with less complications? Have we made the system robust enough to allow them to spend the needed time with a patient, to make sure all of their questions or concerns have been addressed?

When I sat down to put my ideas to paper, I realize just how interwoven these 3 keys were. I don't see how you can do them independently, BUT I definitely see that the must be done.

I guess, this was just an attempt to get some ideas down. I can easily see how my experiences would help to realize the concepts mentioned above in the healthcare industry.

Let me know what you think.

Health-care Credit Unions

OK, so here is a thought for you. What if we had an institution like a credit union BUT it was for healthcare. This has been an idea that has been floating around in my head for the last few days. So, why not put my idea down on 'paper'. Really, what is the worst that can happen? I mean I would have the same amount of results that we have seen from the U.S Congress.

Now, when I had mentioned this idea on my LinkedIn status I got a response of 'How is this different than Kaiser?' Additionally, the member of my network mentioned I should listen to the NPR interview with George Halvorson, the CEO of Kaiser Permanente. (http://www.npr.org/templates/story/story.php?storyId=106853465)

It was a fairly interesting interview, and it does seem to give a direction of where we could go. However, I still see Kaiser as an insurance company first and then a provider of health-care services. Hey, that is just my impression. I think there are some very good aspects, and I see it as a starting point. But, all things can be improved even if it is just a little or a lot.

The biggest positive of the Kaiser model is the NOT-FOR-PROFIT position of the company. This really puts the focus of the company on the true customer, wait for it, drum-roll, the patients and not stock-holders. The whole not-for-profit concept gives the idea (or illusion) that it is about helping people right from the get go. Also, my experience with Kaiser has shown me a company that is focused on using technology to improve the efficiency of the services they provide to patients.

Now, here comes the fun part. How can we improve it? I really think some of the ways are to try expanding upon the financial credit union model. The biggest idea would be to involve the patients as a part of the overall institution. So, as the credit union improves then so does your investment. The reward would be realize in lower premiums, when in doubt always impact the pocketbook to get a response.

1. What if a current financial credit union expanded into being able to offer health-care insurance? This could be an additional benefit of belonging to the credit union, having another option to gain access to health insurance. The credit union could offer their 'clients/ customer base' to a company that is similar to a Kaiser to achieve the group rate price which is so important to our current system.

If this was used, then you could also include a Health Savings Account as you method of paying for you health insurance and related expenses. In addition, this system could help to foster a sense of community between physicans, patients, and the the insurance company.

2. An underlying assumption to this concept is 'no person can be denied coverage'. This is such a cornerstone to any change that occurs. Based on this, it almost seems that a more radical change will be required. So, with that said I think we will need to have a separate type of entity for health insurance. I think this is the 'Health Unions'. An entire community would be included, and would pay into the system. Funds would be used to pay doctors, new technology, etc. Savings would be given back to the health union members in the forum of premiums that don't increase or maybe decrease. The use of HSA's would allow people to see their account funds increased, if they don't expense all of their funds. Here is where the overlap with a financial institution would be of benefit.

Again, there would be the underlying idea that people are only getting the tests they need. Or, doctors are no longer practicing 'defensive medicine' because of fear of lawsuits. Also, the shift in medicine would be to prevention rather than reaction. The pay structure for physicians would need to shift away toward something similar to Kaiser, where doctors get a salary. Almost forgot, I think it is important to say that we are focused on primary-care physicians, as these are the front-line warriors and who would be the ones that a majority of folks would need to deal with.

Ok, I think that is enough for now. The beauty of this issue is there is some much room and opportunity for discussion and real change.

Feel free to give me your feedback.

Wow. You just never know.

It never ceases to amaze me, what I will take away from an encounter with somebody. The person can be a close friend, old friend, new friend, brief acquaintance, co-worker, parent, roommate, whomever; all that matters is that you come away with something positive and MORE IMPORTANTLY you give away something positive.

Before, if I gave something away to the other person it usually focused on humor. I made them laugh, and hopefully the humor wasn't to sarcastic or nasty. Often, it wasn't.

Now, it feels like I am capable or more importantly, willing to give away more. It can be some positive feedback, or as simple as just listening. I find that I have so much to learn and there are all these wonderful people in my life to learn from. For once, I am much more open to listening and hopefully learning. I hope that I never become INDIFFERENT again. It seems like that was my default setting before, NOW I feel like I have to really try to put myself in that mindset, if I want to. AND, I am learning that it does NOBODY any good to be there. You close yourself off to learning from others, AND more importantly you CLOSE yourself off to helping/ teaching others.

Anyways, that was just a little thought I had rolling around in my head. And, I wanted to get it down. Later.

You got to laugh.

yesterday, i had some drinks with some friends from networking.   we are all in the same boat of looking for our next  opportunity.   i am amazed at how comfortable we are with each other, and just how funny we all are.   maybe, that is what we all have in common...an ability to continue to laugh and find the joy in life.    at several instances all of us were in tears.   IS THERE A BETTER FEELING THAN LAUGHING SO HARD YOU CRY?   if there is, i don't know what it is.

last nite was a reminder of how important it is to take the time out to decompress, especially in this environment.   but, we all need remember that.   if you can't laugh, then what is the point of it all.

anyways, i just wanted to remind everyone to LAUGH every once and awhile.  it will help.  trust me.

-thanks

SO WHAT IF YOU DON’T KNOW

It has been awhile.  Maybe I just didn't have anything to say.  Not sure if I ever do.  Well, here is a speech I am giving to my Toastmasters group.  Maybe it can help somebody. Feel free to let me know what you think. 

This year has been a very educational and challenging year for me, both personally and professionally.   My focus, priorities, and energies have all shifted.  The shift has been of my own doing, as a response to  uncomfortable and albeit slightly painful situations.   Now, this is nothing specific to me, as everyone is dealing with uncertainty these days.  The most challenging part has been the uncertainty that hovers over me and clouds my thinking.   I like to picture it as a storm cloud, albeit not to far away.   Is it going to rain, is it going to thunder, will there be lightning?   I don’t know.

 

The unknown has always been a source of fear for humanity.  

How scary was it for Columbus and his crew to sail across a “flat world”?   OR, how scared is the little child of the monster that MAYBE under the bed?

 

Dealing with the unknown is a very scary thing because you MAY have to try new things, learn new skills, meet new people, or even take a good hard look at yourself and most folks are not going to like what they see.   When we get out of that comfortable space in our life, things look scary.   And, for the first time in my life, I know that I am in that unknown space.   But, it does not have to be scary.  It was, but I am getting more comfortable with it.

 

You never know what will happen, but something always does.   Spirituality has always been a way people have dealt with the unknown or fear.   Sometimes that has been in the form of religion.   I see spirituality as the process of finding your own being or essence. For me, I have found my spirituality through meditation.  Meditation can be defined as an attempt (and that is the important part, the attempt) to achieve a deeper state of relaxation or awareness.

 

My path toward mediation started when I wandering through the library, likely in a bit of a haze, stumbled across the book titled, “Comfortable with Uncertainty” by Pema Chodron.   It felt like a smack to the back of my head, like a HS teacher does in study hall to that sleeping student.   HEY, YOU.  WAKE UP!

It completely summarized where I was in my life, lots of questions and no real idea where to look for the answers.

The book deals with meditation and is a collection of concepts, themes, and practices of Buddhism. The main focus of the teachings is to help us cultivate mindfulness and awareness.   WE TRY TO BE MORE IN THE PRESENT, WHILE BEING AWARE OF OURSELVES AND OUR INTERACTIONS WITH OTHERS.

Both IDEAS are key to helping us minimize the perceived impact of not knowing or uncertainty.  The real focus of Pema’s teachings is to become comfortable with the uncertainty, because UNCERTAINTY is all there truly is in life.

 

One concept that really struck me was tonglen.  This is a practice where you send out happiness to others and you take in any suffering that others feel.  In layman terms, think of it as allowing ourselves to be there to help others.  Everyone needs help, a shoulder to lean on, a listening ear, a hug, or a kind word.

 

A second concept that really struck me was ‘getting to know fear’.  They say that anyone who has stood at the edge of the unknown, without a reference point experiences groundlessness.   It is at this most vulnerable and unnerving place where we are able to possibly achieve a greater understanding.    Now we can start to get familiar with fear (not comfortable) and we start undo our old ways of how we sensed and experienced things; see, hear, smell, taste, and feel. We become humbled.  If we commit to that place, things will become very vivid. When there is nowhere to escape things become very clear.

 

The 2 ideas of mediation that I mentioned have helped in my journey.  They have helped to quiet my mind, and allow me to hear my real voice.   Just like normal “conversational” listening, it is much more difficult than one would expect.  But, I truly believe it is about the journey rather than the actual destination.   I see my Toastmasters as an extension of my meditation.   Maybe, because their starting points are similar OR maybe because both are helping me to express my true self to others and more importantly to myself.

 

I hope that I was able to pass along abit of knowledge.  They say when you can teach something, and then you truly understand it.  I hope that has been the case today.

Good luck.

My first time leading a Toastmasters Meeting

Today, was a really good day.   It was the first time that I got to run the weekly session of my Toastmasters group.   It was a really great experience.   Leading meetings isn't a completely new experience for me, but it was definitely with a different purpose.   Before, it was about how to fix a problem, collect some data, or generate some sort of consensus with other engineers or managers.    Today, was a pure joy.   It was just to keep a meeting on track,  introduce speakers, and just have a good time.  I almost felt like Chuck Barris, but I was dealing with people who had talent.     

It was really quite an enjoyable experience, and I look forward to doing it again.    

So, with that said.  Let me talk the time to plug Toastmasters.   It is a really great venue to work and develop leadership, public speaking, and listening skills.   God knows, we need more people in this world that know how to truly listen.

Well, let me get back to watching my Detroit Tigers...who are getting worked as I type.

 

Improvement comes after pain, unfortunately.

I find it hard to believe that I am actually glad that this year has been tough for me.     Getting knocked down was a really good thing, it caused me to REALLY evaluate myself and where I currently was.   And, I wasn't really happy with what I say.   The best part has been making changes for the better, and not just accepting where I was.    But, based on my experience in manufacturing, things never get fixed/resolved until the pain level of doing nothing becomes to much.  You see it everywhere, business, government, squeaky hinge, piles of dirty laundry...you get the idea.

My pain has been both professional and personal, and the changes I have been making have been dealing with both.   It might have been better to deal with my issues before but I am not sure the lessons would have truly stuck.   We humans have to feel that pain... take the hand on the stove..ouch... but you learn and remember.

So, I am glad that I am making the changes.  I feel like I have made just a minimal amount of progress but that is good because it is just a start.  The other thing has been getting feedback from new friends, old friends, and family that there is a new side of me.  And, the feedback is good.   All I hope to do is continue my growth, and pass on what I can to others who want it.

I guess that is it.   Just wanted to get a thought down.   Later.

Gotta stay positive

It never ceases to surprise me how my mindset effects my day.   When I feel good, I have a good day and vice-versa.  Now, that in no way means it is easy to have a positive outlook...it is hard, but you just have to try.    Look to friends, family, or even that new acquaintance you meet at some networking event.  

For me, I have tried to do something that is new for me.  I feel that it has been really helpful and educational for me.   I have started to read about meditation, and started yoga.   And, I have also started to try and put my thoughts to virtual paper.   

Well, I think that is what I have for today.   

My first day as a 36 year old.....

Good news, I was able to get out of bed and I did not feel like I was senile.   All kidding aside, it just seemed like another day to me.   But, it got me to thinking about some of the changes I have gone through in the year so fall.   I have to admit, this has been a pretty bad year  BUT it really is all about how you choose to deal with it.   So, I have looked at those events as chances to recognize areas within myself to make changes.   And, I feel that I have been making real progress, and I guess that is what it is all about.  You only have to answer to yourself, but that also means that you have to take responsibility for yourself (and that includes your actions).

That tends to get me thinking about stuff, especially with our current crisis.  But, it really seems to me that the problems stem from people (individuals, political parties, companies, governments...) not being accountable for their actions.   Mistakes happen.  Really they do, and it sometimes drives me crazy how we think that nothing will ever go wrong.   We get so caught up in perfection, that we forget that it is really about how you deal with those problems or mistakes.   I know we would be much better off, if we could just say, 'OOPs, I F*'d up.'   And, then we start the process of fixing the problem or better yet the root cause.

I guess the process engineer in me came out.   But, I really do think if we applied some of those basic concepts (including common sense) we could really get this country back on track.

Thanks for your time.

Power BACK to the People...The Founders Party

The goal is to rise awareness, and hopefully generate a groundswell to pull the power back to the people of this country. So, let's see how this goes. I really need to get a job...

Our Positions:

1. Find the middle ground on the issue, and start on a solution from there.

2. Be aware that each solution will NOT be the homerun ball.   Small but constant improvements are what we need.

3. Let's address the issues that impact all of us: Education, Health care, Economy (jobs), and National Security.

4. Every citizen, and this includes our corporate-citizens (businesses) as well, need to be both morally and fiscally accountable.

The idea is to get the ball rolling.  We the people are starved for real leadership, and even more for real results.   If our given elected officials can not or will not do the job, then we must do something to change the process or the leadership.   I don't feel that we need to take to the streets, like an angry mob hunting Frankenstein, but we do need to do something.

So, it is my hope that this can generate some interest, and get people thinking and talking...not yelling like the pundits on television.   Ideally, it would be great if the ground swell became so much that a current third party would take notice and incorporate the ideas here.    

With that said, I welcome ANY of your feedback.  I have also created a Cause on Facebook, so if you like maybe you can join there.  That is how I hope we can track the impact.