In his hard-charging Shingo Research award-winning book, On the Mend, Dr. John Toussaint introduced readers to the efforts of ThedaCare, a five-hospital system in northeastern Wisconsin, in redesigning healthcare delivery through lean transformation by building a culture of continuous improvement.
Potent Medicine, the compelling follow-up to On the Mend, expands on the healthcare delivery redesign and focuses on all three key components in creating a value-based healthcare system in America:
- Delivery of care is designed using lean methods around the patient. Meaningful care delivery is organized around the needs of the patient, not the convenience of insurance companies or doctors.
- Treatment quality and cost is made transparent. To build a true picture of any healthcare system, we must identify accurate data regarding quality and cost and publish it in a way that people understand.
- Payment is made for health outcomes. Right now we pay for procedures, and we do it more than any other industrialized nation. What we really want is to pay for health.
No one individual or organization can fix healthcare alone. Doctors, patients, payers alike must commit time and energy to the solution. Potent Medicine is more than a book. It is a call to action for leaders across the nation to join ongoing experiments, learn from them, adjust, and do it all over again. This is a dynamic process and Potent Medicine outlines how to stay engaged and involved as the healthcare story unfolds.
This title is also available as an e-book from Amazon.
John Toussaint, MD
John is CEO emeritus of ThedaCare and CEO of the ThedaCare Center for Healthcare Value. He was the founding Chair of the Wisconsin Collaborative for Healthcare Quality and of the Wisconsin Health Information Organization, as well as the non-executive leader of the Partnership for Healthcare Payment Reform in Wisconsin. He has participated in many Institute of Medicine subcommittees, including most recently the Value Incentives Learning Collaborative and the CEO Checklist for High Value Healthcare.
John’s healthcare improvement work using Toyota Production System principles has been well documented in articles published in Health Affairs, the Harvard Business Review Blog, and Frontiers in Health Management. His work on payment reform and the transparency of provider performance data has been featured in The American Journal of Managed Care and the Commonwealth Fund publications, as well as news publications like The Wall Street Journal, the Milwaukee Journal Sentinel, and Healthcare Finance News.
He has been a featured speaker at the Association for Manufacturing Excellence, The Agency for Healthcare Research and Quality, the Center for Medicare and Medicaid Services, The Shingo Prize, the Lean Enterprise Institute, the Institute for Healthcare Improvement and many international conferences. His groundbreaking first book, On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry, shows how healthcare can be fundamentally improved at the point of delivery to patients using the proven principles of lean management.
Emily is an award-winning journalist and writer who has developed an expertise in writing about lean transformations, among other topics. She can be found at byemilyadams.com.
A conversation with ThedaCare Center for Healthcare Value, publisher of Potent Medicine
Download the pdf or read the entire Q&A below.
Q: What is lean healthcare?
A lean approach to healthcare involves the application of lean thinking to the process of care delivery — whether in hospital rooms, clinics, operating rooms, pharmacies, emergency rooms or outpatient centers.
It stems from a belief that the solution to delivering better care isn’t only about having electronic health records, more insurance coverage, or more advanced technology. Instead, lean healthcare focuses on fundamental improvements that systemically identify and eliminate waste, leading to improved quality, cost, and patient value.
Q: Why is Potent Medicine needed now?
Change is bearing down fast on healthcare in the United States. The current system creates more waste and errors than value. More and more U.S. companies find it hard to compete in a global marketplace due to rising healthcare costs.
Potent Medicine offers insights, examples and worthy experiments from innovative leaders in healthcare. We hope it’s a helpful resource that enables readers not only to anticipate and adapt to change, but to lead it.
Q: What makes Potent Medicine different than previous lean books?
Potent Medicine is a candid glimpse into the hard decisions, attitudes and challenges we faced in bringing together health leaders, insurers and employers to implement redesign experiments. You can learn from our mistakes and use them to inform a new roadmap for moving forward. Every example in the book can be replicated elsewhere across the country.
Q: Why Wisconsin?
Wisconsin is a place where innovation in payment and transparency is happening. Average provider systems like ThedaCare and Gunderson Lutheran are achieving above average results thanks to the data and feedback from the Wisconsin Collaborative for Healthcare Quality and the Wisconsin Health Information Organization.
Potent Medicine is not a book of theory. It is the story of what we have done in Wisconsin, what we are still doing here and in other states, and what we must do next across the country. It offers examples of successful in-the-trenches collaboration and experimentation.
Q: What does this mean for healthcare leaders?
To maintain our position as trusted leaders, providers must get out in front on healthcare redesign and become team members instead of independent autocrats. We need to start thinking and talking to colleagues about payment models and quality metrics so that the patient’s health is the central focus. If we don’t take the lead in these changes, they will be dictated to us—and to our patients—by others.
Potent Medicine highlights the importance of physician-patient engagement and what you can do to foster it. It discusses some of patients’ specific concerns about their lack of understanding regarding health data and payment. It also offers ideas for the type of incentives, recruitment and challenges we’ll need to address to avoid additional physician shortages in key areas.
Q: What does this mean for patients?
Potent Medicine empowers you to take action in your own care. It offers recommendations of where to seek out hospital quality and outcomes data, and what type of hard questions you should ask your doctor, your care team and your insurance company. By gaining information and understanding, you enable true patient choice in healthcare.
Q: What does this mean for employers and payers?
Employers, insurance companies and the government have the opportunity to engage in experiments around new payment methodology.
Q: What’s next?
We encourage you to get involved in experiments regarding payment and data transparency. We invite you to keep us updated on your progress and connect with The Center to learn what others are doing as well.