Thursday, April 17, 2014


HealthLeadersMedia is a less known publication to physicians. The April print edition arrived on my desk, Monday.  The cover story is titled, “Physicians at the Crossroads”

Doctors face critical decisions that will affect their future role in healthcare delivery,especially when it comes to developing care and payment models.  What remains critical is the continuing engagement of clinicians in the process, which has become more difficult with increasing regulations, incentives and penalties driving change for the sake of change rather than applying proven models for increasing quality of care.

What people have underestimated is the complexitiy of workflow in healthcare in general and particularly in outpatient and primary care. The patient flow and variability of work require extreme flexibility for an outpatient clinic. This frankly is not assembly line production. Assembly line production is very modlable; you can calculate changes. The workflow that comes into doctor’s offies is a lot more complicated.

As health care administration has become more complex, more physicians seek and gain hospital or integrated health system employment.  Hospitals and providers alike now recognize that employment does not guarrantee effective integrated care, nor coordinated care.  Typically each hospital environment has had it’s own medical-politic of referrral relationships and services to it’s community.  This is often based upon decades of community involvement, and development.  This trend colors the new relationship between providers and inpatient facilities.

Integrated health systems, although growing. develop a silo mentality and are competitive, some times in the same or surrounding location.  While they are individual business and medical entities, the Health Information Exchange serves to bind them together overcoming regional competitive issues. At the same time the HIX also serves to strengthen the internal workings of the integrated health system.
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