Straight Talk - "Healthcare Change"

June 7, 2012

Dear Friends and Colleagues,

Healthcare Change was on full display at last week’s Florida Hospital Association’s Board retreat, attended by 23 healthcare system CEOs and leaders from around the state.  We were exposed to many thought-provoking ideas, most built around the theme that prevention of illness is better for all and less expensive in the long run than treatment of sickness.  Here are a few highlights:
  • A population’s health is made up of the health outcomes of a group of people regardless of their socioeconomic status, gender, race or any other demographic.  The strengthening of population health is a key to keeping whole communities well by prevention rather than “repair” after an individual is sick.  Picture everyone in southwest Florida—regardless of socioeconomic status or neighborhood—having access to high-value healthcare.  This would translate into a stronger, more vibrant community, more resistant to economic downturn.  There is a direct correlation between better health, productivity, life satisfaction and happiness.

  • Integration—providing high-value, seamless care with compassion—is the core competency of successful organizations.  High value takes into account both quality and cost.  Integration requires one seamless information technology system across the entire continuum of care, a common vision to provide high value, and appropriate incentives for everyone.  Patients would be encouraged to eat wisely, never smoke, etc.  Caregivers would follow evidence-based medicine.  Such a system would allow creation of better health for a population, improved outcomes for individuals, engaged and satisfied physicians, nurse practitioners, physician assistants, nurses, and all other care providers.  Care coordination is essential and requires excellent information technology.

  • Transparency lets everyone know about quality, cost and value; and is possible with a robust information technology system.  Insurers traditionally have used claims data, not nearly as valuable as clinical data.  Knowing the entire medical picture for a patient and population will facilitate positive change.  Collier County has been blessed with recognition as the healthiest of Florida’s 67 counties for two of the past three years.  Most recently, we dropped to 4th place because our newborn birth weights are not as good as in the past.  We still rank near the top in morbidity (sickness) and mortality and have plans for helping our newborns.  Sharing knowledge with the community is very much part of our NCH mandate.

  • Organized physicians with a common goal of quality care can do better for patients and themselves by having support services on site (dieticians, social service, and other therapists), with a focus on prevention and education. Doctors can still be well-rewarded, even when seeing fewer patients per day.  Insurers accrue savings, which can subsequently be shared by lower premiums for patients and secure incomes for providers.  HealthCare Partners, led by Dr. Robert Margolis, in attendance at the state association retreat, has practiced this physician-led collaboration strategy in Florida and elsewhere (
A wise and experienced friend of mine advises industries in transition that there are two fundamental approaches to change: (1) Resist and get trampled; or (2) Adapt and thrive.  I’m reminded of white water rafting where going against the current is futile—you get overturned or worse.  It’s much better to go with the current and avoid the big rocks.  You might take on some water, you might get sunburned, but you do travel to a new and stimulating place.  We continue to head to new places, always learning from others further down the river.

We also have one new nice event to share:  Lee Pitts Live has a short interview about NCH’s U. S. News and World Report recognition and other nice happenings airing this Sunday morning at 8:30 AM on Fox Channel 4.


Allen S. Weiss, M.D., President and CEO

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and The NCH Healthcare System
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