Jakob Riis: If you had the possibility to issue three ‘Presidential decrees’ to ensure a strong healthcare system, what would they be?
Elizabeth Teisberg: The first one would be to put more priority into the transformation to value-based health care, improving health and care. Achieving better health outcomes for individuals and families is fundamental to productivity, resilience and growth.
Designing care that achieves better outcomes, and does so more efficiently, must start with understanding the needs of the people being served – defining the citizen as a customer. Most businesses start here, but health care often starts from the perspective of care suppliers or provider organizations. Designing high value services requires starting from the perspective of what the customer needs to succeed in improving health. But health is often vaguely defined, confounding the definition of success. My research, with Scott Wallace, has found that individuals define health (the successful outcome of health care) as three main elements:
1) Capability (the ability to do what’s important to the individual),
2) Comfort (relief from physical and mental suffering --pain and anxiety), and
3) Calm (reducing or eliminating the chaos in health care).
New thinking is required that defines and measures health care success by the improvement citizens and patients experience in capability, comfort and calm. Health care today usually defines success as compliance with process quality metrics that do not measure what matters to patients and families. We ask if the care made a good effort rather than asking if the results of the care were good.
This approach of asking if the care really helps each person will provide powerful impetus for fixing health and care disparities and ensuring solidarity. In our work, transformative solutions often prioritize prevention, mental care as part of the primary care, and creating services that enable relationships and trust. Health care should be relationship-centered ensuring ongoing care and engagement. In that context, telemedicine is used to strengthen the relationship – not to replace it. It is an important part of taking care to people.
Value based health care is not only about thinking “from volume to value” as I sometimes hear. To me, success is actually the other way around “from value to volume”, because value-based health care services need to be scaled up. We need high value care available to everyone, everywhere.
"We should use Covid-19 as an inflection point."
Jakob Riis: The Covid-19 pandemic has led to increased pressure on the healthcare systems all over the world. I guess, we are all discussing how we can “get back to normal” sooner rather than later. What are your perspectives on this?
Elizabeth Teisberg: Yes, that is quite interesting that we are talking about “getting back to normal.” It is clear that we are all eager to get through this tragedy and back to our normal lives. And, in relation to health care, I would like to see us thinking differently – about moving forward, rather than back. This leads me to my second “Presidential decree”: We should use Covid-19 as an inflection point.
We have learned so much during this pandemic: We have learned to pay attention to reported outcomes (in this case deaths and hospitalizations and onset of chronic conditions) to see what is working, and what is not. Also, we have been forced to find new solutions quickly and apply innovation faster. We have dramatic demonstration that allowing health disparities has tragic consequences and simultaneously drives costs skyward. We should use these learnings to develop new services and to set the compass of our efforts on improving meaningful health outcomes. There will be long-term effects of this pandemic, but also hopefully new opportunities by recognizing the urgent priority of transforming health care and better meeting people’s needs.
"When combining this with telemedicine and doctors on call, both the geographical and financial barriers can be greatly reduced."
Jakob Riis: You said earlier that you consider telemedicine as a relationship tightener. This is really interesting. In Falck, we have, based on human centered research, defined four solution spaces for our long(er)-term strategic areas for innovation. One of these are “Enable Equal Access” as we find that too many people receive insufficient care due to barriers like logistics, racial disparities and cultural misunderstandings. Therefore, we are exploring ways to deliver accessible care. How do you see this?
Elizabeth Teisberg: I could not agree more. We need to bring care to people, to individuals and families. We need to rethink our services and make sure, that geography or finances are not defining the level of health care one can get. By ensuring free internet for everyone, no matter where you are, connected communication is secured. When combining this with telemedicine and doctors on call, both the geographical and financial barriers can be greatly reduced.
The point is, that used the right way, this could be a way to tighten engagement and to ensure attention to what is important to the individuals: capability, comfort and calm. That is also why, free internet for everyone would be my third “Presidential decree.”
