The Holy Grail of Healthcare

The Triple Aim never went away—it’s still here, and it’s still the right directive

The healthcare industry is rich with buzzwords and acronyms. In recent years, we’ve seen extensive focus on Meaningful Use and interoperability, on the ACA and ACOs, on EHRs and HIT.

What do all of these trending terms have in common? Underneath the snappy letters and terms is a desire to do better. There’s a desire to create and adopt new technology to provide better care and to charge patients fairly for the care they receive. There’s a desire to innovate on the existing, limping model.

The cost-to-value equation of the United States healthcare system has been historically misaligned. We spend more money on healthcare than any other developed nation and yet our rankings in life expectancy and infant mortality are dismal. (This NPR graph makes that reality very clear.) In fact, the Commonwealth Fund Commission gave the United States a 66 out of 100 for health system performance.

We’re failing our populations, but we aren’t failing for lack of effort. We’ve been trying for decades to bring costs down and improve patient health. In recent years, as tech has boomed across industries and the Affordable Care Act (ACA) motivated sweeping changes to the healthcare industry in particular, those efforts have accelerated and become increasingly technological.

From connected health devices to telemedicine to data-driven analytics, there has been an outpouring of digital healthcare innovation. According to Rock Health, the Affordable Care Act served as a catalyst for healthcare entrepreneurs, and Fortune Magazine reports that from 2010 to 2014, venture funding deals for healthcare startups grew about 200%.

Meanwhile, thanks to new financial incentives laid down by the Affordable Care Act, we’ve seen the rise of a new structural paradigm. We’re beginning to shift from perverse, fee-for-service incentives that reward excessive or expensive treatments to fee-for-value incentives that penalize readmittance and reward results. We’ve seen the emergence of Accountable Care Organizations (ACOs) that invest in coordinated care and “medical homes” that take a team-based approach to preventing illness. The ACA also established a pool of money for grants and new programs, effectively turning the government into a healthcare technology incubator — or at least investor. 

At the core of all of these new inventions and incentives is a desire to positively transform the industry. To see positive results from that innovation nationwide, however, we need to methodically integrate these innovations into our organizations.

When adopting a new technology or a new financial or organization paradigm, we need to ask:

• Does it improve the quality of care?
• Does it improve the health of the patient population?
• Does it decrease the per capita cost of healthcare?

If you were in the industry before Meaningful Use hit the scene, you’ll recognize these questions as the Triple Aim.*

The Triple Aim lost popularity as an industry buzzword when Meaningful Use appeared in 2009. And yet, while the term may not be used as frequently, the Triple Aim is still here.

It’s present both as a shared end goal and as an unnamed but deeply felt motivation for the fledgling, technology-driven healthcare renaissance

Technology will help us fulfill the Triple Aim if we let it. If we keep the Triple Aim in mind as we support, adopt, and implement new technologies, and if we simultaneously keep the Triple Aim in mind as we create financial incentives and healthcare models, we can realize its goals.

The US healthcare system isn’t failing because we aren’t trying, we just haven’t been trying in the right ways.

The Triple Aim is a good goal, and it’s the right goal. We’ve been working on achieving it throughout the entire Meaningful Use era, with a greater focus on technology to drive innovation. But we’ve failed in how we incorporate the Triple’s aims ethos and objectives consistently and cohesively into our strategic decision making.

I believe that the Triple Aim is the best mental framework to reference when making decisions, and that we need to more overtly embed the Triple Aim into every level of our organization. In future articles, I’ll address ways we can — and are beginning to — achieve the Triple Aim with technological innovation and systematic reorganization.

For now, tell me: How is your company or organization working to achieve the Triple Aim? What’s worked? What hasn’t?

*I believe that half of the special sauce to achieving the Triple Aim is to designate a single person or entity to act as an “integrator” and accept the responsibility for achieving all three of the Triple Aim at an organization. More on that, and the other half of the special sauce, in a future article.