Healing Michigan's health care system together

April 26, 2010
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When I first came to Michigan from Indiana just under a year ago, I knew I was coming to a special state for health care.

Impressively, hospitals across Michigan — from Ann Arbor to Grand Rapids to Traverse City — have topped the national charts for years when it comes to providing high-quality health care. And compared with most states, Michigan has a long history of innovative pharmaceutical and medical research, excellent private insurance coverage for workers and a strong medical safety net for the poor.

Now, as we face the known and unknown implications of federal health care reform, an increasingly competitive statewide environment and ongoing economic challenges, we also stand at an important fork in the road, where the path we choose will determine the future of our health care institutions, and the very health of our citizens and of our broader state economy.

One direction will take us down an open road, wide enough for healthy industry competition to co-exist with collaboration and partnerships that leverage the extraordinary knowledge and expertise of Michigan’s health care community. This direction has the potential to lead to financial health and cost containment while preserving our ability to serve Michiganders with the excellent care they deserve.

The other direction is down a road possibly so narrow that it will force our hospitals and other providers into intense competition that, in the end, benefits very few and compromises our ability to reinvent and reinvigorate Michigan. This direction moves us away from why most of us entered health care in the first place — to create and implement the science and practices that make people and communities healthier.

In many important ways, we’ve already started down the open road.

Hospitals and doctors’ groups across the state are working together to improve the efficiency, quality and safety of the care they provide, while containing the growth of health care costs. In addition, they are finding ways to make sure patients have access to as much care as possible closer to home so they only need to travel to receive the most specialized care.

For instance, dozens of hospitals across the state — including Spectrum Health and its Meijer Heart Center, Metro Health, Saint Mary's Health Care and the University of Michigan Health System — have united in the shared interest of improving the care of patients with clogged arteries through the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. By sharing data and best practices — together — we’ve prevented needless complications in thousands of patients and saved millions of dollars. We’re engaged in the same type of statewide collaborative work with initiatives that focus on everything from stroke to cancer to surgery.

Similar collaborations and sharing of best practices are happening in doctors’ offices statewide. Thousands of physicians, including hundreds in West Michigan, are taking part in the Physician Group Incentive Program, a cooperative effort to improve the quality of the care they provide through their group practices. One example of the power of these partnerships is the savings of $29 million realized through specific steps to increase the use of generic drugs.

In support of this effort, University of Michigan teams have been training participating physicians in the “lean thinking” approach that many industries have used to streamline their manufacturing processes. We’re using a “lean” approach at the U-M Health System with great results and are excited to share this methodology with our partners across the state so that they can implement systematic changes that benefit their practices and organization.

Even in the field of medical research, where competition to be “first” is intense, cooperation between the east and west sides of the state is increasing. From sickle cell anemia to cancer, U-M researchers have teamed with Van Andel Institute researchers to jointly tackle scientific puzzles.

But for all of this progress, there are also signs that we may be straying off of the path of cooperation, collaboration and overall improvement of health care delivery in Michigan and moving to a climate that could significantly undermine the collective good. While it remains important to preserve healthy competition, we cannot lose site of the benefits of collaboration and cooperation, especially as the forces of health care shift and as our citizens continue to need and deserve the best care.

Hospitals, health systems and physician groups have a choice to make about which path we take. Let’s make the right one.

Dr. Ora Hirsch Pescovitz is the executive vice president for medical affairs at the University of Michigan, and CEO of the U-M Health System.

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