Simple Health Solutions Are Often the Best and Cheapest

A year ago, life was bleak. Tendinitis in my elbow had forced me to quit yoga and squash, and typing was such a source of misery that I contemplated a career change. I tried everything. I went to a physical therapist, bought an ergonomic keyboard and mouse, and even tried a voice recognition system. (Hated it.) A steroid shot offered only temporary relief. Surgery seemed to be the only remaining option. Then a physical therapist suggested I try a new kind of brace around my forearm. Hallelujah! With this hard plastic, $28.95 band strapped below my elbow, I can play squash and I can type for hours pain free.

Simple solutions are often the best. They are certainly the cheapest. Unfortunately, our national health care system often encourages costly, ineffective treatments that boost health premiums.

So how do we change this health care system that Michael Porter of Harvard Business School describes as 21st-century medical technology delivered with 19th-century organizational structure, management processes and pricing models?

Some issues must be addressed at the federal level, where many policies are established through administration of the Medicare and Medicaid systems. But there is much that can be done locally, and nobody is better positioned than Washington state to forge new approaches to offering quality, evidence-based care.

We are already moving in the right direction: Inland Northwest Health Services is a pioneer in health care information technology; Group Health Cooperative is a national leader in taking innovative approaches that maintain quality care while holding down costs; Childrens, Swedish and Virginia Mason aggressively adopted lean management principles popularized by Toyota to boost quality and cut waste; and King County implemented innovative wellness programs that improved employee health while reducing premiums.

With the goal of putting our region in the top 10 percent nationally in the delivery of quality, evidence-based care, the Puget Sound Health Alliance has begun collecting data from medical centers across the region. The public will soon be able to see how individual medical centers compare to others in the Northwest and across the nation in such specific areas as asthma, heart disease and diabetes, thereby creating incentives for improvement. The data will also discourage unproven treatments like many types of back surgery.

The potential for improving health care has never been greater. Our health care leaders are already showing the way (see page 32). We must encourage them. But we also need to keep up the pressure for continuing improvement. Our health care system could emerge as an important competitive advantage for the region if it can raise living standards for our residents while also lowering costs for our businesses.