Friday, December 16, 2011


Enterprise Architecture: Ways to make healthcare more affordable...

If citizens of the United States want to ensure that healthcare remains affordable, it has to look at the problem space through the lens of enterprise architecture...

Why am I not surprised to note that no one has studied the supply chain of healthcare? Today, I will share a few ideas that each are guaranteed to save billions...

1. Optimize the pharmacy process: Consider the simple fact that many people have diseases such as diabetes that are long term in nature. People with diabetes typically take the same drug for pretty much all of their life. When does it ever make sense for you to get a thirty day prescription for something you will have for at least the next thirty years? Think about the overhead checking with a pharmacist so frequently costs? Some have extended this out to ninety days but this too misses the point. How much could we save if we could get all our drugs in one shot as an annual event?

2. Change how drugs are dispensed: I frequently purchase prescription medication for family members whenever I travel outside of the United States. My last purchase was in Sangre Grande, Trinidad where I simply handed the pharmacist my money and he handed me a sealed jar. Don't you think this process is much safer than what you witness in your local CVS where the pharmacist is doing extreme and potentially error-prone multitasking in talking to customers, moving pills from one jar to another, disputing with health insurers all at the same time?

3. Make doctor fees transparent: Healthcare is one of the few industries where a consumer learns what it costs only after he has used the service. It doesn't have to be this way. What prevents a health insurer such as Aetna, Cigna or United Healthcare from creating a mobile application that allows a consumer to see list pricing for a given service along with what they could be expected to pay for a procedure out of their own pocket? Imagine a mobile application that could provide a predictive diagnosis and then tell the consumer how much that doctor visit may actually cost upfront?

4. Encourage more volunteerism: I live in a town with a volunteer ambulance system which is much cheaper to run than a for-profit entity. Why can't more municipalities leverage the finer aspects of volunteerism in this regard? Imagine a scenario where a nurse attended a state school such as University of Connecticut and has amassed some debt. Couldn't he/she work off this debt through volunteerism?

5. Make more drugs available over the counter: I, like many other IT employees work in a stress-filled environment and have developed high blood pressure. I take my daily dose of Atenolol. What would happen if they made this a drug that is available behind the counter where you needed to ask for it? It is not a drug that even the most deranged would be interested in taking. It doesn't make you feel good, doesn't introduce any form of psychosis and doesn't even taste good. Why involve the doctor to write a formal prescription, a pharmacist to fill the prescription, etc. Can't we leave these well-trained medical practitioners to do something of higher importance?

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