Remaking Healthcare In America

Over the course of the last two decades, the healthcare system in the United States has undergone dramatic changes. While many of these changes can be directly attributed to the need to balance the quality of care the is provided with cost issues overall, As Shortell, Gillies, Anderson, Erickson and Mitchell note in their text Remaking Health Care in America, some of the changes that have occurred in the healthcare system are much more subtle and are based primarily on paradigm shifts in the very context of the healthcare organization. Theses authors further contend that the future of healthcare will not be based on the development of technology; rather it will be based on a consumer drive culture that demands service, value and accountability.

To illustrate this point, one only needs to consider what Shortell and coworkers note about the value of healthcare in the United States. According to these authors, in the past, value in healthcare was created through the proliferation and development of new hospitals, clinics and services. Today, however, value is created in a much more intrinsic manner: "We believe that in the future, value will be created through greater investment in intangible assets: assessing customer needs and preferences, investing in one's employees and professional staff (the knowledge makers), and developing the knowledge-building capability of the organization". What this effectively suggests is that the healthcare is become more consumer driven. As such, the healthcare organization of the future will have to develop and market its service and amenities as opposed to its specific clinical capabilities.

With the realization that healthcare organizations must reorient themselves to a consumer culture, Shortell goes on to argue that this means resources for the organization will have to be reallocated. Bricks and mortar development will have to be put aside in lieu of the development of human capital, knowledge networks and technology to manage information and knowledge within the organization. This overall shift represents a huge paradigm shift in the way that the healthcare organization currently works. However, as the authors clearly note this change is necessary if healthcare organizations are to distinguish themselves from one another.