ZachEvans

Believer. Husband. Dad. Coach. Healthcare Thought-Leader. All-Around Good Guy.

Responsibility

Motivating the Right Party

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Patient engagement is a popular buzz word in healthcare circles right now. Motivation to increase the engagement of a healthcare provider’s patients vary  but most–if not all–center on the idea that an engaged patient will be a healthier patient. Employers want engaged patients because employers want to speed-up the role out of consumer driven health plans. Insurance companies want engaged patients because they want to keep down medical expenses (so do employers and the patients themselves). Doctors and hospitals want engaged patients because engaged patients can be marketed to directly regarding one doctor’s or hospital’s strengths compared to another.

CMS has even expanded its focus on the engaged patient with the requirements to meet Meaningful Use Stage 2. As part of MU/S2, patients are required to be given expanded electronic access to their medical records, access I strongly support as this data is owned by the patient, not by the doctor or hospital that provided the care.

The Core Measure relating to Patient Electronic Access has as its objective to “provide patients the ability to view online, download, and transmit information about a hospital admission” and is broken down in to two parts:

  1. More than 50 percent of all unique patients discharged from the inpatient or emergency departments during the EHR reporting period have their information available online withing 36 hours of discharge.
  2. More than 5 percent of all patients (or their authorized representatives) who are discharged from the inpatient or emergency department during the EHR reporting period view, download or transmit to a third party their information.

I appreciate and agree with the first requirement. Given the technology of today and the general acceptance of consumer portals, hospitals should be required to give patients access to their healthcare data and it should be available in a timely fashion. The first incarnation of HIPAA provided a common framework for patients to request copies of their data, but the process was sorely outdated and expensive to both parties involved.

It is the second requirement that I take issue with. I am proud to work in healthcare and for a hospital company. I firmly believe that we have a near-sacred responsibility to provide the highest quality of care to the greatest number of patients. We see patients at their weakest and most vulnerable moments. We have a responsibility to give them the necessary care to help them get better. We do not, however, have a responsibility to ensure that they are engaged in their care.

Yes, we have a responsibility to educate them about all of the care options and resources available to them. Yes, we have a responsibility to remove as many barriers as possible when it comes to accessing those care options and resources (see the first part of the requirement above). I fail to see, however, why a hospital should be held accountable for a patient that refuses to actively engaged in their own healthcare.

Where is the personal accountability for ones on health? Why are we not motivating the right party to become more engaged in their own health?

Why Vulnerability Matters

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There has been no shortage of articles written on the value of transparency in business. Drivers behind transparency include increased trust, higher employee engagement and buy-in, realized brand authenticity, and improved loyalty. As a leader, I am a big believer in being as transparent with my team, customers, business partners, and stakeholders as possible. I believe in transparency for all of the reasons mentioned previously and for one additional simple fact: It is the right thing to do. When I am asked to lead a new team or my existing team adds a new teammate, there are four promises I make to them:

  1. I promise to give you a truthful answer when asked a question (aka: transparency). I may not always be able to give you all of the details at the present time but I will not lie to you.
  2. I promise to wear the black hat and tell people “no” on your behalf so that you can maintain as positive of a relationship as possible.
  3. I promise to remove as many barriers as possible that are keeping you from being as productive and as happy as you can be.
  4. I promise to help you find a healthy balance between your responsibilities both inside and outside the office.

I am considering adding a fifth question to my list: I promise to be vulnerable to you when appropriate.

Vulnerability is different than transparency in that, while transparency allows those around you to look inside your operations, vulnerability allows those around you to look inside you. It allows co-workers, team members, and stakeholders to see the less-than-perfect you. The you that, if you only make three mistakes before lunch, considers the day a success. The human you. The personal you.

Leaders understand the need for both transparency and vulnerability. Both engender loyalty from your team and can lead to greater passion and productivity. With transparency comes buy-in but with vulnerability comes connection.

I have, on more than one occasion, been given the opportunity to admit mistakes I have made in my career and I have never regretted doing just that. When a leader admits a mistake, it frees their team to try their hardest, safe in the knowledge that calculated risks–and the inevitable mistakes that come about because of taking them–are acceptable to the organization.

Note: For a more detailed discussion on vulnerability and its power, please view this excellent TEDxHouston talk by Brene Brown.

What to Do When You Mess Up

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A recent article that I read offered up three somewhat trite examples of how to “impress people with how you handle it when you’ve given them a bad experience.” The author advised readers to:

  1. Throw a parade (What does being boring have to do with being wrong?)
  2. Great error pages (Online only, I guess.)
  3. Give a refund (Money doesn’t solve everything.)

While I may be less-than-impressed by the examples given, I can at least applaud the sentiment behind them: Taking responsibility.

Put another way: Own your messes.

A colleague recently submitted a request for some summary data from a project I was leading. I was in a hurry and responded with a spreadsheet we used on the project team to track the un-summarized data requested. While this response met the letter of the request it didn’t meet the spirit of the request.

Do you know what happened? My boss (who had been copied on the email thread as a courtesy) called me on it. My response? I agreed, followed-up with my colleague, made it right, and I’ll try to not make the same mistake again.

Could I have responded with a litany of excuses about how busy I am or how my colleague could have just as easily summarized the data? Sure, but I don’t think that’s how you demonstrate leadership to those around you. Also, you (usually) end up looking bad by making excuses.

Everyone makes mistakes from the entry-level analyst right up to the CEO. It’s going to happen and denying that fact just makes you look like someone who likes to put their head in the sand. The key to it all is how you respond when you mess up.

Own your messes.