by Tony Chen

Last week, I was trying to explain to a 9-year-old how this financial crisis happened. I explained it this way:

"Let's say you get a dollar every day. But every day you spend a dollar and a quarter. After a few weeks and months, the people you've been borrowing that quarter from want their money back. so what do you do?" Obviously, this is an oversimplication of this whole deal. And I obviously didn't go into all the ins and outs of how everyday folks are allowed (and maybe even "encouraged") by various institutions, incentives, and policies to spend that extra quarter. Nonetheless, the kid was smart enough to say, "why didn't we just spend, like, 90 cents every day instead?" That statement basically sums it up for me.

Where does this leave hospitals? I guess it depends on whether we've been spending 90 cents or $1.25 on the dollar. And it depends on how much your hospital relies on credit. Here are a few broader implications that I've been ruminating over:

1. Bad Debt - This is always one of the key line items that Wall Street looks at, and rightfuly so. Are patients going to slow down payments? Will some bad debt turn into charity care?

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by Christopher Cornue

Anyone who knows me, knows I'm a very frequent (probably too frequent!) customer of Starbucks. During a visit there this past week, I noticed the 2nd in a series of "special reports" leading up to the November Election. These "Good Sheets," as they call them, focus on specific issues in each weekly edition. I was thrilled to see the one from last week focusing on Health Care. There were many facts and figures that I think we've all seen before; however, they were well presented and even offered an overview of each candidates policies for changing healthcare in their respective administrations. I applaud Starbucks for getting this information out to a larger audience who may not be living and breathing healthcare on a daily basis ... like most of us.

I encourage you to pick one up at your local Starbucks or visit their website to read. I think you'll find it very interesting and a quick read. Oh, and contrary to what you might think ... this isn't a paid endorsement of Starbucks, but a recognition of a major company trying to make a difference and educate folks about our healthcare crisis. Enjoy (& pick up a cup of joe while you're at it!)!

by Tony Chen

I recently read the cover story of the Sept/Oct 2008 edition of Healthcare Executive, "Technology in Healthcare" by Marc Larsen, FACHE.

"Not another article touting the benefits of technology, please" is honestly what came to my mind when I saw the title, but then I found myself nodding my head enthusiastically as I read through the article.

Mr. Larsen makes the point that investments in technology are crucial for the survival and continued success for hospitals everywhere, but few hospitals seem to have a disciplined approach to truly evaluating the technology's value (and not to mention, making it work the ways it's supposed to). Why is it that even "progressive" hospitals seem to look at new technology primarily from a capital/budget perspective only?

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by Tony Chen

Usually, it's us in healthcare that is learning from other industries. Previously, I've posted on what we can learn from the likes of Disney, Toyota, Jiffy Lube, autobody shops, and others. So, I was quite surprised to stumble upon a book that turns the table - it's meant for leaders of other service industries to learn from us hospitals. More specifically, the Mayo Clinic.

Management Lessons from Mayo Clinic is the most recent book I've booked up to sharpen the saw a bit more. (What are other folks reading these days?) And in the coming weeks, I'll be posting my reflections as I read through.

In some sense, it is a stretch to think that any other service industry is like hospitals. After all, our "customers" don't "want" us, they need us reluctantly. They come to us in the most vulnerable moments of their life, and our services can make them even more uncomfortable/vulnerable. Nonetheless, hospitals provide "services" just like anyone else - it's a hard-to-scale, labor-intensive, one-on-one experience that is provided to increasingly demanding and diverse consumers. When done right, folks can't stop talking about you.

Guest Post by Kristin Baird

Reputations are based on word of mouth. No amount of advertising will build the type of trust that you want from patients, their families and ultimately the community that you serve. You have to earn it. And you will only earn it through consistently positive experiences. No matter how much quality data we publish, people will gauge quality through their personal experiences. Consumers expect clinical competence but make decisions based on how the encounter made them feel. That means that even one disengaged employee can leave a patient and their family feeling nervous, insulted and on edge about the care.

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by Christopher Cornue

So much of the research and literature out there speaks to the uninsured, which is an issue that needs immediate attention; however, there is an increasing group of individuals for which a focus is necessary. According to the recently published report by The Commonwealth Fund, How Many are Underinsured? Trends Among US Adults, 2003 and 2007, there are an estimated 25 million underinsured individuals in the US, which is a staggering 60 percent increase from 2003. The majority of this increase is in the middle class, while low-income households remain at significant risk as well. The report details how folks are identified as underinsured (which is very interesting) and specific groups that are hit the hardest. The biggest concern with this is that often care is not sought, which obviously impacts the health of the individual and will eventually add additional costs to the healthcare system down the line. As with issues we?ve raised in the past, one of the biggest issues we have is ensuring that preventative care occurs on an ongoing basis. This underinsured issue will only complicate our health care system challenge further.

by Tony Chen

If you've been following Hospital Impact, you'll be very familiar with the voice of Nick Jacobs. If not, let me give you a quick intro: He's a middle school band teacher turned hospital CEO in a mining town that had no business surviving the loss of their mining industry. Some would even say that Jacobs helped save the town through the hospital he led and transformed, Windber Medical Center. Instead of dying a slow death, the small community hospital is now internationally known for innovation, for proteomic research, and for its patient-centric healing environment. Not a likely place for the largest breast tissue bank in the country or the daily smell of freshly baked bread, wouldn't you say?

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