Looking ahead to 2010
January 13, 2010

Now that the holidays are over, many of us are packing away lights and ornaments, wondering what we were thinking when we made our New Year’s resolutions, and realizing that the calendar has really moved on. So let’s look forward to 2010 and what it means for Group Health Permanente.

For our medical group, I want to clarify what our main goal is, how we will measure progress, what external issues to watch for, and where we need to focus internally. Here goes:

First, for 2010, our goal is as follows: We will lead the top delivery system in the state. We will monitor our progress by our transparent, demonstrable performance on clinical quality, service, access, and cost. What does that mean, exactly?

• Clinical quality includes HEDIS measures, which though imperfect are the “currency of the land” for both NCQA and the Puget Sound Health Alliance, and therefore the public’s view of our clinical quality performance. This performance goes beyond HEDIS, though. It includes efforts such as minimizing variation that serves no clinical purpose, having consistent peri-operative processes, minimizing readmissions of our patients, and all of the many ways we try to improve and assure consistent performance beyond HEDIS.
• Service is how most of our patients gauge our worth. It means each of us has to be good at exhibiting both professionalism and compassion. It also means insisting on clinical systems that best serve our patients, collaborating with patients on their wellness and treatment plans, and providing convenient services that respect their time and their needs.
• Good access is crucial to meeting the rest of our goals and must be offered through multiple channels (secure messages, phone, group visits, and traditional office visits.)
• Costs are an increasing concern for our patients. We have an obligation to them, through our resource stewardship, to remove affordability as a barrier to high quality care. We have created a great foundation over the past couple years and our efforts seem to be paying off. Harnessing our innovative culture, supporting it with Lean management, cutting across divisions, and leveraging our systems to make the right thing to do be the easy thing to do is our best path.
• Our success will promote growth of the Group Practice (we saw a net growth of 7,570 in 2009), enhanced reputation and brand, continued advances in recruitment and retention, and a growing set of innovative and effective partnerships with other delivery systems as we integrate our clinical systems to better serve our patients.

Things to keep an eye on in the external world include:

• Reform: As the implications of reform roll out over the next few years, there will be plenty of risk and opportunity for Group Health. We will need to position ourselves to benefit from these opportunities and minimize the risks.
• The economy remains a large concern. Most predict that 2010 will be “sluggish” but it is also possible there will be more recovery or even further recession. Clearly we will need to stay nimble with a set of strategies to succeed whatever happens with the economy.
• Changes in the health care market have been occurring rapidly, even before reform, but the pace of new alliances is increasing. We will need to keep up with our competitors without rushing to short-lived solutions. We will need to build smart new collaborative business relationships with other providers and delivery systems to better serve our patients across the continuum of their care.

For 2010, our internal focus should be on:

• Our medical group leading our care delivery system, collaborating with our partners in GHC to assure continued improvement in what is already the best delivery system in the state. Our patients' experiences with us need to be seamless.
• Cross functional work and partnerships, both internal (across Specialties and sites of care, between Health Plan and Group Practice) and external (clinical integration with external groups).
• Continuing our progress with Lean. We have seen some great improvements using Lean. Perhaps more important, we have kept from treating it like a religion -- Lean is not about Lean but rather about better care and lower costs for our patients. Our use of Lean tools and management is helping our front line people get much more involved in our improvement efforts. The more our doctors lead here, the better.
• Our patients! We went into medicine to work with people and help them through their health and wellness issues. They are the ones who trust us to partner with them on these issues. As long as we remember that and keep them at the center of our planning and our thinking, we are bound to succeed.

Thinking ahead:

My new partner James Hereford and I, along with GPDLT, are starting to ask this question: What would it take for us to be considered the best care delivery system in the United States in 3 years? We looking forward to exploring that with you.