Health, Wellness and Wholeness and the EIP

Today's post is a reflection based on re-reading the book "House of God" and on 25 years of working within the so called "Health Care System" (HCS). The HCS, on the whole (as pointed out by many) is not about health, nor care, nor is it very systematic in anything but capturing charges for reimbursement. A few years ago, I did a purchasing analysis for a 35 hospital system. Hospital size ranged from 50-beds to more than 1000; from rural to inner city; from community-focused to large tertiary, university-affiliated monoliths. What I discovered (what I had assumed to be true) is that there was no coordination in purchasing or use of medications. Using this as a surrogate marker for system health, I saw a 35 hospital organization that ran as 35 separate and distinct entities. I have come to term this part of our "system" the "Episodic Intervention Portal" or EIP. To my knowledge, this is a term I have coined - we'll see if it gets any legs. ;-)

The EIP is accessed by well meaning persons in search of answers to health needs/questions. These well meaning persons (WMP's) get to see a practitioner for approximately 7 minutes, usually no more than twice yearly. Thus, all of their care is episodic, and in large practices where they may see multiple practitioners depending on scheduling, disconnected and uncoordinated. Layering into this the vagaries of what insurance will pay for/allow, one is reduced to a series of interventions per episode, without the benefit of a longitudinal view of the WMP's health trajectory. Health, wellness and wholeness (HW2) are beautiful casualties of this type of approach.

Nowadays, we have empowered patients who are trying to change the landscape of the EIP. Information is much more accessible, though not anymore understandable to the average WMP. Direct-to-Consumer advertising creates a desire to have a certain medication/procedure/conversation without the requisite knowledge of pharmacology or physiology. Law firms suggest that anytime you are injured by a chemical or practitioner that you have the right, nay the obligation, to sue to recoup money for you and the lawyers. But no matter how empowered the WMP's become, they are still stuck with the EIP - and the EIP is not changing. Yes, there is rhetoric about "Medical Homes" and "Accountable Care Organizations", etc, but current legislation and payment models will keep us in the status quo, irrespective of the outcomes of the mid-term elections (my bias and opinion).

So, what is the effect on our HW2 and is there anything that we can do within the current EIP? The answer is that our HW2 is dependant upon us to find ways to empower, enable, ehance and engage ourselves and others in its pursuit. This is what Possibilities Journey Inc (www.possjrny.org) is doing. With our "big picture" view and ability to facilitate relationships, we are helping to improve the WMP interaction with the EIP. Better interactions along with some much needed reforms (tort, structure, perspective) of the EIP will lead to a more just and useful entity in which we can pursue HW2. This is our vision, and we are doing our little part to bring it to fruition.

Come join us in our journey to change the EIP into something that works for everyone.

Peace,
Dan