An afternoon with Michael Porter

Feb 17, 2015 10:00 PM

Earlier this week I had the distinct pleasure of welcoming Harvard Business School professor and strategist, Michael Porter to our campus. Porter delivered a rousing presentation that really captured the challenges and opportunities health organizations face as we embrace the shift from volume to value.

If you missed the talk, I encourage you to watch a recording of the event on Pulse. You can also find a written summary of his talk and a video  of my interview with Porter on our Algorithms for Innovation website.

After his presentation, Porter spent time with different groups to get a better sense of the progress we’ve made with our strategic initiatives. He was generous with praise and encouragement, and made some insightful observations, which I hope will serve as inspiration as we continue to push to realize value for patients and unite our educational, research and clinical missions toward a singular goal: Advancing health.

• Urgency: “Today has proven that the premise I had about University of Utah Health Care was right—you are ahead of the curve,” Porter said. “But you have to keep moving. I guarantee, that if you don’t wait around for payment reform to fully kick in, you will be ready and you will be successful."

• Putting patients first: “We [the U.S. health system] do a lot of indulging, especially of physicians. We can’t do that anymore.”

• Value: Porter defines “value,” as “the outcomes we can achieve for dealing with a patient’s medical condition, whether it’s breast cancer or COPD, over the full cycle of care for that condition.”

• Measure costs: University of Utah Health Care is one of the few health systems that have a handle on their costs, right down the patient and procedure. Knowing your costs is critical if you’re going to thrive in an era of payment reform.

• Measure outcomes: Health centers need to rigorously define outcomes and marry them with patients’ wellness goals. Focus solely upon the five-year survival rate for men treated for prostate cancer, for example, and you might miss variation in other key outcomes, such as erectile dysfunction and incontinence.

• Integrated Practice Units (IPU’s): “We need to move away from organizing around specialties, departments and lines of service to organizing around the patient’s problems.” Porter suggests defining IPU’s broadly. Start as far upstream in the care delivery process as possible. Go upstream to the condition and look downstream to the delivery process—not just heart failure, but heart failure caused by mismanaged diabetes, for example.

• Workspace design: When it comes to collaboration and integration, physical proximity is important.

• Volume: Embracing value doesn’t require us to abandon volume. The old maxim that “practice makes perfect,” holds true in medicine, too. The trick is concentrating volume in fewer locations, choosing the right location for the right service and integrating care across all locations and service lines.

• Economies of connection: Mergers and other alliances, such as affiliation agreements, are a good way to integrate and redistribute care, or keep lower acuity care in the community while directing higher acuity patients to urban health centers.