Spring In Sonoma County
Group Walk
Santa Rosa, CA April 2016
Continuous Innovation In Health Care: Implications Of The Geisinger Experience
"FOR DECADES, OBSERVERS OF THE U.S. health care system have watched a struggle against seemingly intractable problems: incomplete and unequal access to care; perverse payment incentives that fail to reward good outcomes; fragmented, uncoordinated, and highly variable care that results in safety risks and waste; a disconnect between quality and price; rising costs; consumer dissatisfaction; and the absence of productivity and efficiency gains common in other industries. These problems have resulted in a loss of value within the health system and have generated various reform proposals, with most focusing on providing greater access to or controlling the costs of care. Although laudable, this focus ignores the fundamental problem: health care value (defined here as outcomes relative to input costs) simply must increase to achieve these diverse goals."
"Enhancing value requires both explicit delivery system reform strategies and the associated organizational capacity to execute change. Sustainable health care value is created only when care process steps are eliminated, automated, appropriately delegated to lower-cost but capable staff, or otherwise improved (that is, when there is innovation). Innovative care-process change occurs when (1) consumers are actively engaged in behavior that mitigates disease or improves purchasing; (2) safer and more effective drugs or devices are developed and adopted; (3) clinicians deliver more rapid, appropriate, and reliable care; (4) unnecessary tests and therapies are eliminated; or (5) supply-chain costs are systematically lowered. These changes are most sustainable within a care system that measures innovation returns, focuses on value creation, and is appropriately rewarded in the market. But how can this kind of innovation occur?"
Read more http://content.healthaffairs.org/content/27/5/1235.full
Why Social Media Not?
By Fareed Zakaria Opinion writer January 14
"Thomas Jefferson often argued that an educated public was crucial for the survival of self-government. We now live in an age in which that education takes place mostly through relatively new platforms. Social networks — Facebook, Twitter, Instagram, etc. — are the main mechanisms by which people receive and share facts, ideas and opinions. But what if they encourage misinformation, rumors and lies?"
"In a comprehensive new study of Facebook that analyzed posts made between 2010 and 2014, a group of scholars found that people mainly shared information that confirmed their prejudices, paying little attention to facts and veracity. (Hat tip to Cass Sunstein, the leading expert on this topic.) The result, the report says, is the “proliferation of biased narratives fomented by unsubstantiated rumors, mistrust and paranoia.” The authors specifically studied trolling — the creation of highly provocative, often false information, with the hope of spreading it widely. The report says that “many mechanisms cause false information to gain acceptance, which in turn generate false beliefs that, once adopted by an individual, are highly resistant to correction.”