The Forest for the Trees

Day 2 of Value Based Health care. 
Today was a particularly enlightening day as it focused on a big success story in primary care and another in employer based health care.  I also had some foreknowledge of the organizations which helped enrich the cases for me.  One thing that I did notice is that we as health professionals might have a tendency to hold the delivery of health care to the same standards as our actual therapies.  While high standards in and of themselves are a good thing to have, working with humans in a complex social, medical, business, regulatory and legal environment is tricky to do and even trickier to study.  It is important to remember the current state of health care delivery innovation.

Infancy.

Current research projects, ideas and companies in changing the way health care is delivered are remarkably young.  Given the restrictions placed by government regulating practices, insurance, payment, and their own involvement via Medicare/Medicaid, that there is any innovation at all amazes me.  The key takeaway here for me was to celebrate what is actually being done, and what it can lead to, rather than lament the shortcomings of the research methods used to validate the success of innovations. 

It actually strikes me that perhaps our current research methods to "prove" that medicines are effective, are themselves the problem.  We are using the wrong tool for the wrong job, and the implicit suggestion is that reality must be broken down and remade so that it fits within our current research methods.  Perhaps innovation of research methods are actually required to deal with the chaotic business of health care delivery. 

This class is quite exciting, and the level of debate is quite sophisticated.  I am very fortunate for the stars to have aligned so that I may be a part.
More tomorrow!