Organizational Models Behind Healthcare Delivery

In a review of the China Study, I wrote about how Healthcare discussions often revolve around insurance, treatments, technology, operational excellence, etc. but not as often on driving factors like lifestyles, choices, etc. As a product manager, I'm often confronted by similar questions on strategy; for example, can organizational culture be a source of sustainable advantage? Are we overly focused on business models, technology leadership, incumbency  when we should also think about how are teams operate and how members relate with each other?

Today's HISTalk mentions how Epic, the leader of the EMR vendor market if you measure momentum, focuses not on hiring candidates with the best experience but instead selects those with the right traits, qualities, and skills. HISTalk states:

"Epic emphasizes that many hospitals can staff their projects internally, choosing people who know the organization. However, they emphasize choosing the best and brightest, not those with time to spare. Epic advocates the same approach it takes in its own hiring: don’t worry about relevant experience, choose people with the right traits, qualities, and skills, they say."

Top-tier management consulting firms like BCG, Bain, and McKinsey have always known this. As a result, these firms test candidates on scenarios (or "cases") to evaluate how a candidate would think in a particular situation rather than evaluating the candidate on behavioral questions (that can generally be memorized). Other companies in other industries are catching on. Netflix famously released it's Freedom and Responsibility Culture reference guide that emphasizes context over control.

How much time do you spend on your organization's team dynamics? What methods do you use to select candidates?

The China Study

One of my good friends who is a senior-level executive at a major national Payer (and sometimes an industry source for this blog) recommended The China Study. It sounded like an odd title for a book on health and nutrition so I was eager to find out what it said.

The book is authored by T. Colin Campbell, who has spent his career in science. This book isn't an opinion piece, it's a fact-based reporting of the correlation of several lifestyle factors on health outcomes. The book criticizes the "scientific reductionism"--the practice that assigns outcomes to single variables rather than considering the systemic nature of influencing factors.

The author shows, for example, how the presence of carcinogens themselves do not lead to as many cancers as carcinogens in combination with complex proteins (such as found in non-plant sources like red meat). The China Study itself is the analysis of relationship between diet and disease for about 100 communities in China that were relatively isolated and with differing diets and disease outcomes. This provides a snapshot of the effect of varying amounts of diet components in a manner that was not possible before.

The conclusion I have drawn from this research is that there's a large unexplored theme of modifying diets to improve patient outcomes. Much of the debate in Healthcare revolves around insurance, Healthcare IT, cost-reduction, technology innovations. So little time is devoted to the source: the foods we eat and the lifestyles we lead.