Why is health care so complex and what can be done to make it simpler?

This is an important question and I’m asked it quite a bit. When I’m asked, I think back to a mountain bike accident I had one early Sunday morning last year that did some pretty good damage to my shoulder.

After my accident, I went to a walk-in clinic where I had an x-ray and was then referred to an orthopedic surgeon. Since none of the walk-in clinic records made it to the orthopedist, the paperwork, x-rays and insurance forms all had to be done again. The orthopedist then referred me to a rehabilitation program, where – thanks to their excellent work – I was able to avoid surgery.

Not long after, I started receiving bills from all the different clinicians who treated me. Some of the bills indicated unnecessary, duplicated efforts – both administratively and clinically – because the clinicians didn’t have the real-time capability to engage with each other.

Significant Challenges

While the care I received from each physician was excellent, my overall experience detailed three reasons why we need to bring simplicity into the health care system:

• My complex, fragmented experience is due to the system being formed around siloes
• Consumers are responsible for navigating the system, as opposed to the system doing this for them
• An episodic, transaction-driven system doesn’t provide a holistic view of the patient’s health journey

This last point really struck a nerve with me. Physicians need to be connected to each other so they’re taking a team-based approach to their patients’ health.

Don’t get me wrong: there are countless others out there that have had much more serious and difficult experiences than mine by a long shot. We owe it to all of them to help deliver a simpler care experience, one that doesn’t waste their time and is centered on helping them achieve their best health.

What We Can Do

Connecting the heavily siloed health system and physicians through technology enables the clinicians to have a more thorough understanding of how their service relates to the patient’s overall health. It’s not just about getting an injured shoulder looked at, but getting the patient on track to exercise so he or she can stay focused on their overall health. This not only leads to improved health but a better patient experience.

Speaking of technology, consider Charles Schwab and the financial system. They harnessed the power of technology to evolve from stock trades to helping people with long-term wealth management. The integration of financial transactions has lowered the cost of stock trades, while greatly increasing investor wealth management tools such as online trading, portfolio analysis, retirement planning and electronic access. And who would have imagined being able to make deposits via a phone? We can do something similar in health care.

Bills are too complex, and the fact that primary care physicians spend too much time dealing with the administrative aspects of their practices means we need to do better. The health care industry must also simplify its language and how we communicate. The language must be easy to understand – like a USA Today story – and have consistent definitions and descriptions. We don’t need a new health care playbook. Let’s make the one we have simpler.

In addition, physicians need to be reimbursed for the total health of their patients (Accountable Care), as opposed to being reimbursed for the number of services rendered. Physicians working together – aligned around the individual’s best health as opposed to just passing the patient through the system – merge siloes and incentivize and motivate all to work together.

Look for Inspiration

As consumers, each of us sees the power of simplicity every day, whether it’s using Netflix to purchase a movie or using your iPhone to download a song from iTunes.

John Maeda’s intriguing book, “The Laws of Simplicity,” should be required reading for anyone in health care. One of its ten laws touches on the concept of time – “savings in time feel like simplicity.” This is something that I’ve personally found to be very inspirational for making health care simpler.

Lastly, making health care simpler requires an empathetic approach. Putting ourselves in our patients’ shoes will help us truly understand what they face. It may sound like a cliché, but we’re in the business of helping people with their total health, not just when they get sick.

Sound simple enough?

Photo: val lawless/Shutterstock