As you know this is typically one of my favorite half hours. To have the opportunity to speak with you because not only do you get my mind stimulated and inspired but more importantly, I love your writing style. I love the way that you not only give practical advice but give really great examples.
This particular topic Jim, I have to just start by asking you what inspired you to tackle this issue?
I had been thinking about tackling this issue for a long while, certainly, all of the political debate. The debate that was going on around healthcare reform caused me to want to really address the issue from what I think is a different perspective and a different lens than our government. At least our political forces were thinking about it. I really felt in all of the debate and discussion around healthcare reform, there is not enough reality being paid to and enough attention being paid. To what was really going to get the cost of healthcare down and to get the quality and safety of healthcare improved although people debating healthcare would always mention cost and safety.
Nobody was really paying attention to how it was going to get done. Actually, I consider that a pretty dangerous condition because we put in place in our legislation which I think we would had to put in place in order to cover all of the uninsured. We’ve done it I think with some degree of naiveté about what it’s going to take to really get the job done. It’s a long answer to your question but that’s what inspired to me to what to write this book, answering the hard questions.
You did tackle it from a completely different perspective. I know that even to the naked eye, the problems in healthcare are countless. How did you and Dr. Greenspun start to break down the problems to boil it down to the final product that you guys put out?
Harry has been a practitioner in healthcare for many years; very thoughtful and very engaged in the application of information technology to healthcare, particularly the adoption of the electronic healthcare record. Harry and I just stepped back and said, alright what is it going to take to fundamentally rethink the delivery of care?
That’s what this book is about. This is about how to change the delivery processes of care. But I’ve known from my past work that you just can’t change the processes. That is, you just can’t change the work that people do, the work processes that people do without paying attention to the skills and the behaviors of the people and whose work you’re changing.
Also, that in healthcare, one of the great enablers of healthcare change is information technology. So Harry and I built a construct for this book that said, look, in order to change the delivery of care, you need to focus on people, process, and technology — those three elements.
By the way, if you don’t cover all of those elements, we’re not going to succeed in changing how healthcare is delivered but that was the basic construct of the book. This is about changing people, process and technology in healthcare.