Book Review - Reengineering Health Care by Nur.Faidah02x


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									Book Review: Reengineering Health Care: A Manifesto for Radically
Rethinking Health Care Delivery by James Champy and Harry Greenspun, MD.

 Jim Champy has become well known within the business world for his books
and leadership in business transformation. His first book with the late
Michael Hammer, Reengineering the Corporation: A Manifesto for Business
Revolution, released in 1993, sold three million copies. He has since
written seven additional books including Reengineering Management.

 Reengineering Health Care, which he wrote with Harry Greenspun, MD
starts out with the simple question as the title of chapter one: Why
Reengineer Health Care? In this chapter, they point out that while health
care has kept pace with science and technology for diagnosis and
treatment, it has not kept pace in its delivery. They state that
computers arent the problem, but rather the application of technology and
how work is organized around it.

 While I read this book, it rekindled some memories of Champys first book
with Hammer. I went back and reread my highlighting and margin notes from
that first book. The prevailing and consistent theme was the focus on the
components of the "three-legged stool": People, Process and Technology.

 In fact, there are chapters in Reengineering Health Care dedicated to
each of these components. In each of these chapters, they offer case
studies in which they exemplify real people who have combined the three
legs to improve health care for better results from a financial, patient
care or procedural perspective. Lessons learned are provided with
detailed explanations for each, explaining the why and the how. For
instance, in the chapter on technology, one of the tips is to protect
physician productivity. They go on to explain that one of biggest
concerns physicians have with IT systems is a poorly defined system that
distracts them from patient interaction, slowing their productivity. They
described a real-world case in which they involved physicians, nurses and
other clinical staff in the design of the process around the technology,
which gave them both buy-in on the process, and an efficient system
designed around how they need to get their jobs done.

 There are two additional chapters that each showcase a successful
reengineer that they have encountered in their research and the path
theyve followed to improve healthcare and some of their long-term

 As with Champys first reengineering book, a chapter is included titled
"The Hunt for Reengineering Opportunities". This provides a primer on how
to get started and some tips on how to identify the "burning platform" or
the greatest pain-point as a place to begin. Do you start by focusing on
better quality delivery of health care? Improved financial results?
Improving the process to make the physician and staff more efficient?
Each medical facility must decide for itself.

 There was an opportunity for Champy and Greenspun to make this a dry,
process laden tome as a how-to on process improvement methodologies
within the health care industry. To their credit, theyve created a very
readable, yet informational book that provides excellent examples of
leadership and descriptions of methodology that both informs and
motivates health care providers to take the plunge into their own
internal health care reform. Can one read this book and know everything
there is to know about reengineering health care within their own medical
facility? Certainly not; and thats not the intent of this book. It does
provide an excellent overview of the benefits that can be gained and some
high-level lessons learned on the considerations to be made in such an
endeavor. A medical facility that is seriously considering a
reengineering project should probably partner with an experienced
consulting organization with the appropriate experience to help them
implement it correctly.

 Health care reform is one of the hottest topics in the news. Government
incentives and eventual penalties - are driving many health care
organizations to implement electronic medical records systems to gain
compliance with government mandates. Reengineering Health Care comments
that the result of recent legislation was essentially health insurance
reform. Stating that "up to 40 percent of the insurers operating costs is
spent on administrative processes...some hospitals write off up to 30
percent of what they bill because of the complexity of approval and
collection procedures", Champy and Greenspun make an excellent point that
a reengineering effort is worth implementing for the benefit it provides
regardless of government incentives and penalties. The time is right for
those in the medical industry commit their organizations to the provision
of better health care, improved efficiency and better financial results.
Reengineering Health Care is the first step that a health care
organization should take to making that commitment.

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