In Part 1 of this pair of blog posts, I suggested that the American Healthcare system prior to 2010 could be compared to the iconic baseball film Field of Dreams, with a “build it and they will come” approach to care. That post was written just as the 2014 Major League Baseball season was getting underway. Today, the Kansas City Royals and San Francisco Giants are preparing to face off in the 2014 World Series. So without further ado (from the “Better late than never” Dept.) here is Part 2 – Moneyball.
Moneyball is the semi-biographical story of Billy Beane (played in the film by Brad Pitt), General Manager of the Oakland Athletics (A’s) baseball team. In 2002 the A’s climbed from last place in the American League to contend for the pennant, including a record breaking 20 consecutive wins in a 22 day period. They accomplished this by rejecting conventional wisdom and the universally accepted methods of evaluating players, and re-imagined what it takes to win games. By applying solid fundamentals, and using sophisticated data analysis (known as Sabermetrics), the A’s fielded a team that competed successfully against franchises with bigger budgets and far greater resources. In the process, Billy Beane and the A’s changed Major League Baseball.
Similar to the 2002 A’s, the U.S. Healthcare system has wallowed in last place for some time (for quality and cost as compared to similar industrialized nations, according to a recent Commonwealth Fund Report). And there is no question that the Affordable Care Act (ACA) has been a game changer.
Like a pitcher telegraphing his fastball, today’s health care dynamics suggest HUGE opportunity for clear and quantifiable solutions that deliver on ACA requirements. I am certainly not the first to observe that the era of Health Information Technology is here, and I would suggest that initiatives focused on harnessing the power of big data & analytics, personal tracking technology, and especially mobile health are the keys to revolutionizing American health care as we currently know it.
So what inspiration can would-be health innovators draw from the story of Billy Beane and the 2002 Oakland A’s? Here are a few quotes from both the book and the film, accompanied by my thoughts on their application:
- “If you challenge conventional wisdom, you will find ways to do things much better than they are currently done”.
There’s a lot of debate about the value and efficacy of Health Information Technology initiatives, largely due to a shortage of large scale empirical data. This is something of a catch-22. Accessing the resources and population required to conduct broad research can only be accomplished with the assistance of leading payer and provider organizations. While most of those organizations like to be seen as innovators, few want to accept the risk associated with being the first to market with new and untested technology.
- “Managers tend to pick a strategy that is the least likely to fail, rather than to pick a strategy that is most efficient,”
Entrenched institutions like health care have been conditioned to resist change, and when forced – go about it slowly and deliberately. The high speed evolution of tech development that is sweeping the field threatens the way that they do things. But shifting from a volume-based, fee-for-service approach to care, to one focused on patient centered, high-quality outcomes will inevitably require this kind of radical culture shift.
- “Your goal shouldn’t be to buy players, your goal should be to buy wins.”
Among the most significant advantages that access to new technology offers is fresh perspective. The data is certainly not a replacement for clinical expertise, but it can inform clinical decision-making and enhanced communications across the continuum of care, and most importantly between patients and providers. Such insight has the potential to reveal completely new and different ways of achieving successful outcomes.
- “People operate with beliefs and biases. To the extent you can eliminate both and replace them with data, you gain a clear advantage.”
The truth of this statement has never been more apparent than it is today in the midst of the global Ebola Virus scare. Despite repeated attempts by the President, the Director of the CDC, and countless other experts, misinformation and rumor regarding the disease and how it is contracted continues to flourish. The same is also true with regard to pre-conceived notions about the influence of technology on society.
HIT developers (or more specifically, marketers promoting developer’s work) must be careful not to get their promotional horse ahead of their empirical cart. There is inherent risk in rushing to market with a compelling marketing message, only to discover that the technology does not perform as promised. To be credible it must be countable.
- “No matter how successful you are, change is always good. There can never be a status quo. You have to always be upgrading.”
Does this one really require an explanation? I didn’t think so…
And to close, here is my favorite quote from the film, delivered by John Henry, Owner of the Boston Red Sox (as portrayed by Arliss Howard):
“Anybody who’s not building a team right and rebuilding it using [the new] model, they’re dinosaurs. They’ll be sitting on their sofa in October, watching the Boston Red Sox win the World Series.”