Abstract
This presentation begins by outlining and briefly discussing seven critical problems and gaps in global integrated healthcare. These are the productivity gap, the resource gap, the equity gap, the adoption gap, the sustainability gap, the digital gap and the overarching gap, the management gap. This presentation then describes a grand coalition approach to tackle the overarching problem, the management gap based on key management insights from leading management thinkers such as Drucker, Crosby and Deming.
Deming estimated that 85% of all systems problems are management problems. Perhaps there is no greater challenge and indeed opportunity for management than improving the global healthcare industry and systems. Drucker famously said “Every organization, whether a business or not, needs a theory of the business. Indeed, a valid theory that is clear, consistent, and focused is extraordinarily powerful”. While we have such remarkable progress in global health over two centuries, with average life expectancy more than doubling, it is now clear that there is a significant crisis in Healthcare and I believe that Healthcare’s theory of the Business is broken. Driven by the ‘rule of rescue’ too often care is delivered in the most expensive place, i.e. an acute hospital and at the last possible moment, often in an ED department. Michael Porter of Harvard University has said in Healthcare, “too many people get paid more to pay the wrong thing” which is additional evidence that the theory of the business and associated business model for health is broken. A gigantic opportunity exists to radically transform health by simultaneously using digital technology and a next management initiative. We are working to build a Digital Health and Wellness Capability Maturity Framework (CMF), collectively developed which when applied can help drive a structural change in the global health industry and radically improve health outcomes. Capability Maturity Frameworks (CMFs) are breakthrough management tools which originated from Philip Crosby’s seminal work “Quality is Free” and subsequently evolved by leaders such as Watt Humphrey into capability maturity models (CMM) at the Software Engineering Institute. Subsequently the author evolved the concept into a broader Capability Maturity Framework which also focussed on outcome maturity and not just process maturity to create the IT Capability Maturity Framework which has been used by many healthcare organizations to assess and improve IT capability.
Peter Drucker said The most important contribution that management needs to make in the 21st century is to increase the productivity of knowledge work and knowledge workers. We can be encouraged by the productivity improvements achieved in manual labour with Drucker saying “The most important contribution of management in the 20th century was the fifty fold (50X) increase in the productivity of the manual worker in manufacturing”. With a new focus and use of breakthrough management tools such as capability maturity frameworks we can be hopeful that we can invent and innovate a new better and more sustainable healthcare system, accelerating the adoption of the Stay Left, Shift Left-10X paradigm and the IFIC nine pillars of integrated care.