In this episode of Quality Talks With Peggy O’Kane, NCQA President Peggy O’Kane speaks with primary care and health IT veteran Dr. Marc Overhage.

Marc notes that many of health care’s challenges are design problems—and design problems can be solved. The conversation highlights trailblazing models like hospital-at-home and the need for better data availability at the point of care. Marc’s optimism about the next five to ten years is rooted in the belief that we have the tools, data and momentum to improve not just a handful of care processes, but thousands.

Topics Marc and Peggy explore include:

• How a Transactional Mindset Undermines Quality: Marc sees what he calls “transactional” care as a design flaw that reduces care to disconnected snippets, leaving patients confused and providers unable to coordinate or focus on wellness.
• Clinical Decision Support as a Design Solution: Embedding quality into the care process is preferable to measuring quality after-the-fact.
• The Limits of Traditional Quality Measurement: Retrospective scoring frustrates clinicians and fails to drive real-time improvement. A better way is possible!
• Redesigning Hospitalization: Marc highlights how better logistics, financial models and care coordination—like hospital-at-home—could reduce unnecessary stays and improve transitions of care.

Key Quote:

 It really is a question of how do you build quality into the care process, not measure it in. We all know that measuring into a manufacturing or a creation process is a limited strategy. It only goes so far.

And the Toyota Production System, the Danaher Business System, other very successful models are predicated on, How do you build quality into the process as it's happening, have the ability to pull the chain and stop the production line if something isn't working, and continuously improve it?

How do you stop and say, Okay, why are so many of our patients not being fully treated for their congestive heart failure? What is in the way? How do we improve it?

-- Marc Overhage, MD

Time Stamps:

• (02:57) Fragmentation and Transactional Care
• (07:04) Incentives and Profit Maximization
• (10:52) What Real-Time Data Helps Clinicians Achieve
• (19:34) Turning Clinical Insight into Actionable Care Plans
• (23:30) Encouraging Innovation and Trailblazing
• (29:12) Peggy’s Reflections

Links:

Connect with Marc

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