A Snowball in June

The Institute for HealthCare Improvement (IHI) is one of the preeminent think-tanks in the healthcare industry today. The IHI created and coined the term “triple aim” which is a framework around how to reform the healthcare system in the United States.

The triple aim states that healthcare in the United States should evolve to:

  • Improve the patient experience of care
  • Improve the health of populations
  • Reduce the per capita cost of healthcare

So according to this idea, the industry needs to get much better at its core work of improving patient health and experience while reducing cost. How do we do better without more investment and spending?

The answer is that this question relies on the premise that healthcare in the United States is already optimized from an operations and cost perspective. In reality, it is far from it. As a country, our healthcare costs are among the highest and our outcomes are in the middle of the pack. We can and should do better, but it must be done through creative thinking and approaches that find ways to do more with less.

I gave a speech in 2016 when I was chair of the Committee for Montgomery about this kind of thinking as it applies to state and local governments who face similar challenges around how to do more without spending more money*.

In the speech, I tell a story about my father using creative thinking to stop a bully from beating up his younger brother (my Uncle Todd z”l).

Watch the speech to Committee for Montgomery here:

Creative thinking, design thinking, and innovation are what will save healthcare in the future. This type of innovation is currently happening in other places in the world, like in India as well as here in the United States. We are reading now about mergers between retail and insurance companies and new models of patient care with the new JPMorgan-Berkshire Hathaway – Amazon initiative led by Atul Gawande. These new models could be rungs on the ladder to reach the triple aim depending on how they approach their work.

But, we need to do more. As an industry, we are still big and slow. In other industries, like tech, companies have departments reserved for disruption and innovation. These “skunk work” groups gather people from various sectors, industries, occupations, and nationalities to work on the “next thing”. In healthcare, many companies have rested on their laurels and rode out the current system. Those days are no more.

One possible positive example of progress in this area is with Florida Hospital in Orlando, FL. Recently, they shed some light on a secret project they are working on called “Project Fulcrum”. This area of the company is designed to disrupt, which will ultimately help Florida Hospital thrive as the environment changes.

More healthcare systems should be using outside-the-box thinking, in a “formal” department with authority, resources and the ability to test their ideas within their companies and work with partners. Only through this work will the industry deliver on the promise of the triple aim.

KEY TAKEAWAY: To achieve the triple aim, the healthcare industry needs to be deliberate and strategic in investing time and energy around innovation. Simply expecting a company will be able to adopt to a new environment when it arrives is not a viable strategy.


*Innovative approaches to budgeting in state and local governments is not the topic of this post. However, there are some in the public sector that are achieving the aims of better outcomes at lower costs. I was privileged to hear from leaders from the City of Fort Collins, Colorado who won the Malcolm Baldrige National Quality Award. I was thoroughly impressed with their budget process that helps to achieve these goals. I encourage you to read more about it by clicking this link.