Three Trends Twelve Months Later

Posted on June 28, 2013


Occasionally, I read about healthcare trends and sit on them before validating them by disseminating them or writing about them. If something has staying power, it can be effective in a different way to point back to an origin and the evolution since ‘the story broke’.

Exactly one year ago, BD+C magazine reported ‘3 important trends the Healthcare Giants are watching’.  The three were couched as providing significant efficiencies and lower costs for hospitals, and the three:

  1. Pushing Ambulatory Care Facilities Out
  2. Integrating Medical Systems More Tightly
  3. Unbundling / Bundling of Healthcare Services

It is interesting to see how these ideas have evolved over the last year.

Trend 1.  Ambulatory facilities are definitely moving out.  Clinics are going up all around, and hospitals continue to say they want patients to visit their Emergency Departments less, in favor of primary care outside hospitals.  Where I live, a hospital purchased a regional brand of clinics and re-branded them as the hospital’s.  And last week, I read about an article in an Advisory Board briefing that summarized recent patient survey data confirming patients now prefer to go to these clinics because they are perceived as receiving more personalized, less pressured care at a better price. Wow, that news might almost be too good—to the point of being hurtful to hospitals.  Check mark.

Trend 2.  Integration is a crucial tactic at any hospital attempting to survive in the post-reform era.  Doctors are integrating with hospitals as employees.  Information technology is being integrated, and then integrating everything internally, and sometimes externally.  Mergers and acquisitions continue with independent hospitals integrating with larger healthcare systems.  Departments are integrating better (tear down the silos), and warming up to Lean.  And hospitals are attempting to integrate care before and after admissions, and looking more at ‘cradle-to-grave’ care.  Check.

Trend 3.  Last year, Haskell completed a project for everything “unbundled” from a hospital.  It was a facility built to house most non-essential (non-clinical) functions, and it served a collection of hospitals from a regional location.  Some of those functions included food prep, central sterile, linen services, surgical packing, bulk storage and administrative functions.  A popular analogy for this trend is reducing a sports car down to a lean chassis, leaving only the essentials for high performance; hospital square footage can be an expensive hindrance and hospitals know they, too, can be high-performance (again) if enough ‘soft, non-high-tech’ square footage is put in its right place—off-campus.  Hospitals are on a diet; distribution and support service centers are not novel anymore.  Last week, we interviewed for a similar such facility.  Check.

I prefer trends that are a bit edgy and new; the riskier ideas usually have the potential for the higher payback.  These three ideas are definitely taking off, though trend three’s decentralization of support services, is the most progressive.  We have seen a lot of the first two trends (they were on their way already a year ago), which are somewhat universal and not easily done in a year or two.  As for number three, prepare to see and hear more.