• July 2008 FEATURE ARTICLES •
From the Editor
The Circle of Non-Reality
By Michael McBride, Editor-in-Chief
Axioms can be illuminating. Take, for example,
the project manager’s credo: "Fast, good or cheap — choose any
two. You cannot have all three." This is sometimes referred to
as the Circle of Reality, though in some circles, reality is
optional.
Ever since Mankind built its first mud hut
there have been strict trade-offs between budget, time and
quality, and yet, organizations continue to believe they can
have it all.
Government is like this. The U.S. Department
of Health and Human Services (HHS) recently released its final
rule on Medicare Part D claims data, which "allows the Secretary
to collect claims data that are presently being collected for
Part D payment purposes for other research, analysis, reporting
and public health functions." The rule effectively enables
Medicare to distribute aggregate and non-aggregate claims data
to other government agencies and 3rd-parties for the purpose of
research and compliance with congressional mandates.
The mandate in question comes from the
Medicare Modernization Act of 2003, which requires HHS to
develop a plan to "improve the quality of care and reduce the
cost of care for chronically ill Medicare beneficiaries."
This is a somewhat isolated section of
healthcare and it’s taken five years to get this far so,
clearly, we’re going for Good and Cheap, not Fast.
The Trouble With Axioms
Creeds tend to be grounded in experience so
one would think they would hold water, but we live in an age of
promises with little oversight, therefore, political voracity
outweighs the chance for success.
It’s negative, I know, to suggest that we
cannot improve care while simultaneously lowering cost. However,
it’s hard to imagine that we could spend less on healthcare,
when prices for most goods and services in America continue to
rise.
Adoption is the key. Once adoption increases,
market forces will naturally bring costs down. But that’s the
rub. How do we increase adoption?
More mandates is one approach, however, a
better approach might be to make adoption fiscally responsible
and financially advantageous for healthcare organizations.
Healthcare is a business, after all, and
there’s nothing wrong with that.
New Content
HMT has a new department titled "The
Healthcare CIO," in which, each month, we will highlight and
interview top CIOs around America to gain their insights on
healthcare IT directives. We begin with C. Martin Harris, M.D.,
CIO of the Cleveland Clinic, who speaks about the CIO’s evolving
role in healthcare organizations.
In September, another new monthly department titled "The
Healthcare CFO" gets launched. Stay tuned.
