Healthcare Needs To Know What Shoe Size We Wear

Last night after participating in the Lung Cancer Social Media Chat (#lcsm) I was thinking about several of the topics that were raised about what are the things to look forward to in 2014 related to Lung Cancer.

In the discussion there were items mentioned from new treatments, surgical procedures, low dose CT screening, to genetics and molecular diagnostics.

It made me think of a recent post from Seth Godin entitled, “different people differently…” (click here to read)

One of the inherent things that healthcare is trying to do is to limit the variability in caring for patients. Whether it is a patient that is admitted to the ER, a patient that comes for a routine annual check up with their primary care physician, the workup of a patient with congestive heart failure, or a newly diagnosed cancer patient, healthcare is trying to limit the way patients are worked up, followed, and cared for within the system.

Part of this comes from a need to reduce cost. Systems thinking from manufacturing has proven that the more we reduce the variation the better the quality produced and the more we can reduce the cost in manufacturing a good or product.

In the United States most healthcare organizations have seen almost a  9 point reduction in the operational revenue of their businesses. In order to combat this, most healthcare has pulled on the internal levers that they have the most control, costs. The topic of cost tend to focus on how they care for patients and the employees within the organization.

ASCO, NCCN, ASTRO, ACR all have care pathways for how patients should ideally be worked up based on their diagnosis and presentation to physicians. The positive side is that when healthcare organizations and their respective physicians adopt these type of pathways patients have access to the same care. It doesn’t matter the type of insurance, if you have a job or not, or your race or creed, people are all treated equal.

However, as was brought up in last nights conversation during #lcsm by John Humphreys (@johnpharmd) we are moving towards precision medicine. As we begin to understand and identify more genetic markers that give rise to more personalized treatment options, how will this impact all of the care modeling and work that healthcare has done to this point in time?

Will our work on limiting the variability in care to reduce cost actually begin to increase cost?

Simply stated by Seth Godin in his post, ” Today, the people you serve are coming to realize that like their shoe size, their needs are different, regardless of what your urgent agenda might be.”

How will healthcare adjust in the realization that not everyone wears a size 10 shoe? Not everyone wants a high heel made by Jimmy Choo. Some people wear a size 8.5 and prefer a shoe made by Sperry Topsider.

Healthcare needs to prepare for understanding each patients story. What shoe size is the right fit for each patient based on the type of shoe they need at that specific moment.

Healthcare needs to understand the needs their consumers have, at various stages of their lives, and ensure that they are prepared to deliver the appropriate “shoe” when it is needed or wanted.

What “shoe” size does your patient wear?

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek


#PtExp #PX #cancer #hcldr #hccosts #hcsm #stories #storytelling #lcsm #bcsm #hcmktg #mktg #storyteller #hcpt #consumerism #hcbiz #CX #UX

3 responses to “Healthcare Needs To Know What Shoe Size We Wear

  1. There must be a middle ground somewhere between a one-size-fits-all approach to reduce costs and a personalized plan that meets the needs of each individual patient. If cost ends up being the only factor, what happens to the patients that don’t fit into that one size?

  2. Hi Andy – good topic! There are two sources do variability in patient care: 1) the patient and 2) the physician. Evidenced-based medicine attempts to remove the variability introduced by the physician. Personalized (or precision) medicine attempts to reduce patient variability. Decision support tools will be required to help physicians deal with all this information and understand which information is appropriate for patients.

  3. Thanks for this post Andy. As usual you pick wonderful topics.
    In my opinion, individualized care does not mean the actual system/standard of care or process needs to be different. For example; a lung cancer diagnosis. Assume each person’s lung cancer tumor is totally heterogeneous. The approach to assess and diagnose can use the same decision tree with different pathways depending on the staging and genetic tumor characteristics. Looking to the future; each tumor would have full genetic and epigenetic sequencing and then a drug cocktail would be matched to the results and the patient treated per the protocol for the drug. The process is the same, it’s just the cocktail that is different. The problem we have now is we don’t have a process and full decision tree defined and distributed to every center/physician who diagnoses and treats lung cancer. Not all cancer centers approach diagnosis the same way — some take fine needle aspirate biopsies, some take core biopsies, some use navigational bronchoscopy to sample the tumor, some test for EGFR and ALK, some do a bigger Foundation Medicine type panel. Not every patient needs the same treatment but every patient needs the same process/decision tree to have access to the best path for his/her individual situation

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