The Seamless Adjustment

There is an excellent snippet up on BNET from an HBR article entitled The Last Act of a Great CEO. The article provides five tips on how newly-tapped CEOs can seamlessly adjust to their new role:

Five Ways to Capture Your Predecessor's Knowledge:

• Empathize with your predecessor. During the transition, you and your predecessor may be less than perfectly comfortable. If the outgoing executive is retiring, he may feel that he's plunging into an abyss of insignificance. You may have anxieties about your own readiness to step into the role. Understand that you're both uncomfortable, and behave generously toward your predecessor.
• Solicit input about your new team. Ask your predecessor to identify your team members' strengths and weaknesses, their developmental goals, and their potential. Ask on what basis they were promoted into their roles. Find out who's most likely to tell you bad news when it needs to be told. And map out the dynamics and major alliances among members.
• Extract lessons learned. Ask, "What problems did you encounter early on in this role? How might I head off similar ones as I transition into the role? What other problems could come up that I'm not seeing, and how can they be avoided?"
• Share the "first 90 days" plan. In the earliest days, you'll need to make moves that exert a positive impact and that signal the key themes of your agenda. This includes ways in which you'll depart from your predecessor's strategy. Get your short-term plan on the table as soon as possible. Ask the outgoing executive which initiatives and capabilities spelled out in the plan are foundational and how best to usher them in. Probe for advice on low-hanging fruit you haven't yet spotted. If your predecessor is tempted to engage in any undermining activity, this sharing may help to bring him inside the tent.
• Don't assume you have to reach agreement. Evaluate your predecessor's opinions and perspectives on how to excel in your new role based on your knowledge of him. In comments you're inclined to dismiss, look for the grain of truth. In insights you're rushing to embrace, look for the grain of salt.

If you ask me, these tips ring true for any employee assuming any new position, regardless of title, CEO and analyst alike.

Database Auditing

I'd like to take this opportunity to call attention to Dana Blankenhorn once more, as he provides some excellent insight into an emerging database auditing business.

He has situated his observation within the context of the recent Ingenix settlement esulting from a fraud case filed last year by New York attorney general Andrew Cuomo.

"But there is another issue here, a tech issue. That is the need to regularly audit key databases, and the increasing risks companies run for relying upon them. We’re talking here about more than security audits here, but audits of the accuracy of information a database contains. The problem is especially acute for databases that include value judgments, like quality of care. Doctors as well as patients are going to be heading to court far more often, challenging medical databases."

And the solution?

"Potentially a giant new industry in database content auditing is about to spring up. Law students might want to take a few database management courses if they want to make the big bucks."

Is Mr. Blankenhorn on to something? Have any of the larger research firms performed any market sizing or landscaping exercises on this niche?

The 15 Promises

I took some time recently to revisit the Health Care Agenda posted on the Office of the President-elect's website at change.gov. I began picking apart the promises set forth, and have arrived at a working list of what I deem to be The 15 Promises.

In four years time, I intend to revisit this list and provide commentary on:

1. What was attempted.
2. What was achieved.
3. What progress was made.
4. What was successful.
5. What failed, and why.

The 15 Promises

1. Ensure everyone who needs it will receive a tax credit for their premiums.
2. Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
3. Require large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees.
4. Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
5. Require insurance companies to cover pre-existing conditions.
6. Minimum coverage requirements for preventive services, including cancer screenings.
7. Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan.
8. Reform the insurance market to increase competition by taking on anti-competitive activity that drives up prices without improving quality of care.
9. Allow the importation of safe medicines from other developed countries.
10. Increase use of generic drugs in public programs.
11. Take on drug companies that block cheaper generic medicines from the market.
12. Require hospitals to collect and report health care cost and quality data.
13. Invest in proven strategies to reduce preventable medical errors.
14. Prevent insurers from overcharging doctors for their malpractice insurance.
15. Increase state and local preparedness for terrorist attacks and natural disasters.

Collective Intelligence & Codified Rules

I am currently making my way through Jerome Groopman's How Doctors Think, and so far I am very impressed. It's a highly recommended read.

Throughout the early part of the book (as I am only 3 hours in via audio CD), Dr. Groopman supports his hypotheses with anecdotes that describe, often in profound detail, how a particular doctor behaved when confronted with an ill patient. What's interesting is that his analysis is just that: a series of personal anecdotes. He presents very little in the way of hard facts, numbers, and data. At least so far, his conclusions have been anecdote-driven, rather than data-driven.

This comes as no surprise, as Dana Blankenhorn observes:

"Under the current system a doctor uses their own instincts, and their own reading of the literature, deciding independently whether to follow the latest guidelines and directives or not.

What Klepper and Kibbe want to do is make this doctor-patient interaction routine, but also set down what doctors should do, based on an immense body of evidence rather than what any doctor might see in their own practice."

In these statements, Mr. Blankenhorn, whose blog provides consistent insight into all facets of health IT, really drives home the importance of decision support systems at the point of care. Using our collective intelligence, codified in a series of automated rules and treatment guidelines, will be able to move away from our reliance on anecdotes? Is it only a matter of time?

The Feminization of Poverty

This morning, the National Journal’s Health Care Experts blog posed the following questions:

What early health care victories should President-elect Obama and Congress seek before Washington works on broad health care reform legislation? What health care measures should be included in an early economic stimulus package? Federal Medicaid help for cash-strapped states? Legislation to lower drug costs?

The first respondent, Drew Altman, President and Chief Executive Officer of the Henry J. Kaiser Family Foundation, provides the following commentary:

“Federal relief for states provided in the form of additional federal Medicaid matching funds will… help women who will not benefit as much from other forms of stimulus spending such as spending for construction projects; women represent three quarters of adult Medicaid beneficiaries…”

What Drew is alluding to here, is the feminization of poverty, a concept to which I have had little prior exposure. There is a very good introduction to the topic, available here.

Healthcare Reflections

Life and its many diversions have hitherto prevented me from blogging regularly on a topic that has gripped me for quite some time: the state of health care in the United States. And now, with gracious support from friends and family, I have finally resolved to test the waters and begin blogging.

I am both a student and a young professional with a career interest in improving health care in the United States. I graduated four years ago from a small, liberal arts college with dual degrees in the social sciences. I promptly began my career working for a mid-sized, non-profit health insurer operating in greater New England. It is here where I acquainted myself with the problems and complexities facing our current health care system, and it is here where I cultivated an enduring passion for the health care industry.

What this blog is:

• Commentary on topics that interest me, a student of health care policy.
  
• Reflections on ideas that are novel to me, as a young professional interested in improving health care in the United States.

What this blog is not:

• Opinion from a seasoned health care executive.
• Affiliated with any established company or institution.

With this in mind, the mission of this blog is to actively engage its readership with the questions, topics, and trends that concern students of health care in the United States. I hope you enjoy it.