Tuesday, July 19, 2005

Progress by Indirection

My eye was caught by two items in the July 11, 2005 issue of AHA news, the weekly newsletter of the American Hospital Association.

One was about the AHA Information Technology Advisory Group, described as a “panel of experts on a wide range of IT issues” created to “get you [the reader] the help you need to implement systems that can enhance patient safety and improve operating efficiencies within your hospital.”

The other was about the AHA-sponsored Center for Healthcare Governance launched earlier this year and “designed as a full-service resource on health care governance education, research, and innovative practices.”

If there are other industries that have needed this sort of prodding and support, I don’t know about them.

On the IT issue, the problem is that health care management is not operationally oriented. Instead of conceiving operational improvements that can benefit from IT support, the pattern has been to buy an attractive-sounding or fashionable piece of software and hope that something good comes out of it.

As to governance, the central difficulty is the reluctance of trustees to become involved in clinical matters, thus limiting greatly their ability to require cost reduction and quality improvement.

These are sensitive cultural issues that few want to address directly. That probably explains the indirect approaches represented by the two items.

One would like to think that grown-ups could approach matters like this head-on but so far that has not been possible. So we have to accept progress by indirection.

It’s better than no progress at all.

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