What if Henry Ford Had Been A Doctor?

Written by on April 3, 2012 in Features, Practice tips - No comments
Old Fashioned Cars

Henry Ford left his mark on America by creating the first mass-produced, affordable automobile. Henry Ford’s efficient, systematic method of production made an impact well beyond the automobile industry, revolutionizing manufacturing around the world. Considering the success of his approach, I wonder, “What if Henry Ford had been a doctor and applied his same techniques and vision to a service industry such as health care? Would this influence health care in a similar way, making it more accessible and affordable to today’s average American?”

Of course today’s health care system is not as it was in the days of Henry Ford. Prior to 1920, medical technology provided very little to patients, and most were treated in their homes by a family physician who knew each patient on a first name basis. Medical technology is clearly much more advanced now, enabling doctors to treat extremely complex conditions; however, the way we deliver health care is often inefficient and ineffective, leaving the benefits of modern medical technology to waste and health care consumers to suffer. This is where Henry Ford’s innovative approach comes into play.

Focus on the common

Henry Ford didn’t invent the car, but he made and sold a lot of them. During its first 16 years, Ford Motor Company produced and sold 10 million Model Ts. The success of the company stemmed from its clear focus on high volume production and affordability to the common consumer. Health care, for the most part, is also a high volume industry that focuses on the common consumer. Research demonstrates that a large percentage of healthcare costs are related to common, often preventable or manageable conditions such as diabetes, asthma and heart disease.  In addition to common clinical conditions, there are a multitude of common administrative and social-interactive issues such as billing processes, communication between health care settings, handling of patient complaints and patient non-compliance. Considering the complexity of health care and the small amount of time and money we have to deal with making changes, our only choice is to address these common, everyday concerns first. We simply can’t afford to put as much focus on the once a month non-emergent occurrence, as we must put on the day to day, week to week occurrences. If we do not identify and find ways to be more efficient with the common, repetitive occurrences, they will continue to drain our time and energy. One health care provider’s common conditions and situations seen in their practice may differ from another’s due to demographics, health conditions being treated and other factors. The key is to look at your individual setting, identify the common and then move on to the next step – finding the most efficient way to systematize your best practices to deal with the situations that you encounter the most.

Systematize the best practices

Henry Ford’s systematic approach was paramount to his success. Once he determined the best way to assemble each piece of the Model T, he made sure that it was done the same way every time. By doing so, he controlled costs, worker productivity and the quality of his product resulting in happy customers and lots of profit.  Likewise, health care professionals should  determine the best way to address each of their practices’ common situations and then follow that procedure the same way every time. Evidence based care guidelines or your own adaptation of such guidelines are a great place to start from a clinical perspective. From a non-clinical perspective, consult with administrators to identify problems with the current protocol and then establish best practices with regard to billing and collections, scheduling, customer service and other aspects of practice management and patient care. Once you’ve established the best practices for your most common situations, document them and put systems and reporting mechanisms in place to assure these best practices are followed every time by your staff.

  • What is the best way to handle prevention and treatment of common conditions in your area of specialty?
  • What is the best way to handle non-compliant patients, late appointments and no shows?
  • What is the best way to handle referrals moving in and out of your office?
  • What is the best way to handle chart completion, billing and collections?
  • Where are you inefficient and wasting time, energy and money with regard to the situations that your practice deals with day after day?

Systematizing common, best practices also makes the cross-training of staff easier as it is not as difficult to learn one “best” way to efficiently perform a task than five variations depending which physician you are working with.  Not to mention, consistency reassures your patients they are in an environment where quality is important which can help reinforce positive behavior. For example, if patients know they will be asked to reschedule or wait for the next open slot when they are 15 minutes late for an appointment, the likelihood of them being late will drop.

Automate it

While Henry Ford was putting systems in place to perform tasks the same, “best” way every time, he was also automating as many processes as possible, further driving down costs, improving consistency and making work easier for his employees. Rather than taking the worker to the car, Henry Ford, brought the car to the worker, perfecting the production line such that a car could be produced in 90 minutes. We might not like to admit it, but much of our health care system is a high production, low profit business.  And if your particular specialty or area is not there yet, it is likely headed in that direction. The only good way to deal with a high production, low profit business (and the only way our health care system will thrive) is to automate as many operations as possible. In health care, much of our “manufacturing line” relates to analyzing and communicating information. Health care decisions, processes and workflows are data driven and information rich. We must stop burning human capital and energy on information processing and transmission that can be done consistently and accurately by a computer such as:

  • Automating care gap alerts to address scheduling of physicals and chronic care visits.
  • Automated point of care reminders for routine labs, tests and vaccinations.
  • Automating appointment reminders to address no shows.
  • Automating the delivery of test results.

In general, things that can be automated by a computer should be. Personal service is important but our health care system is beyond the point of using “personal service” as an excuse against leveraging technology to automate daily operations. Frankly, given the state of health care, we cannot afford to deliver personal service for some things and most patients, if they knew the potential ramifications, would not want it. I have seen examples where failure to automate created dangerous, potentially life-threatening situations because information got lost in the tangle and plethora of the common, mundane tasks – like a needle in a haystack. We are burning human capital on things that can be done faster and more consistently by a computer. We must automate the common tasks, and fully leverage our human capital for things that require reasoning, personality and person to person interaction. Not only is this automated approach efficient, it is more rewarding for the health care worker.

Innovation

There is a caveat regarding the idea of performing common tasks more efficiently by doing them the same, “best” way every time – we must leave room for innovation and change. One of the most important benefits of the human element is the ability to reason and see beyond the limited capacity of a machine. Be sure to give your staff the right to override the system when appropriate. However, deviation should only be allowed under the condition that those who do not follow protocol (including physicians), for any reason, must document the event and bring it to the attention of the appropriate person to explain their decision. Allowing this autonomy will open the door for continuous improvement and innovation to your systems.

Finding the common, systematizing, automating around best practices and leaving room for innovation; in Henry Ford’s case, it was about the birth of an industry; in the case of healthcare, it might just be about survival.

Robert C. Tennant is a Managing Associate with Health Directions, a national healthcare consulting firm. He has more than twenty years of experience leading business development software and IT infrastructure deployments, and has dedicated ten years exclusively to healthcare information technology and health information exchange in the physician practice, hospital and payer settings.

 

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