IBM Business Consulting Services. The IBM Center for Healthcare Management. Innovative ideas for healthcare payers and providers.

Transcription

1 IBM Business Consulting Services The IBM Center for Healthcare Management Innovative ideas for healthcare payers and providers deeper

2 About the Center Seeking answers to crucial questions It s no secret that healthcare is under enormous pressure worldwide. Among other issues, healthcare payers and providers face sharply rising delivery costs, burdensome administrative structures, a troubling incidence of preventable medical errors and chronic patient and provider fraud. Governmental regulation, including privacy restrictions, is intensifying as are security threats such as computer hacking and bioterrorism. Diseases meanwhile are increasingly drug-resistant and cross national borders with the ease of an airline flight. Public expectations are spiraling as the Internet fuels greater consumer sophistication, along with proliferating care and coverage choices. Information systems frequently are unable to support the massive data and complex integration necessary to optimize patient care, processes and payments across multiple, diverse organizations, providers, delivery sites and types of care. The result: a system that generates conflicting mandates, supports systemic inefficiencies and produces inflated costs. In certain situations, systems even can encourage suboptimal care. The IBM Center for Healthcare Management was created to provide insight into these and other critical healthcare issues. Its mandate is to promote the development of innovative ideas, research and best practices that enable academic, governmental and industry leaders to develop highly strategic management solutions. Quality Patient Safety Life Sciences Management Strategies Cost Reduction Healthcare Standards Regulatory Demands IBM is committed to helping healthcare entities improve organization-wide performance, level of patient safety and caliber of patient care. Clearly, novel even revolutionary approaches are vital to upgrading delivery and payment systems worldwide. The IBM Center for Healthcare Management (CHM) begins with fundamental questions, such as: How can healthcare quality and cost-effectiveness be improved continuously while expanding services to individuals who now are underserved? And how can those fundamental goals be achieved while meeting increasing governmental requirements for patient safety and other regulatory compliance? By stimulating research, disseminating information and promoting dialogue within and across organizations, disciplines and nations the CHM seeks to share promising approaches and proven solutions with healthcare professionals worldwide.

3 The IBM Center for Healthcare Management: Awards stipends to researchers exploring healthcare management, leadership and information technology dilemmas. Publishes research reports, case studies and white papers, and Hosts discussion forums for university faculty, healthcare organization executives and industry consultants to identify, explore and devise responses to current and projected issues. System, heal thyself The IBM Center for Healthcare Management encourages cross-disciplinary exchange among management and information technology strategists, healthcare payers and providers, diverse academic specialties and disparate geographies. In particular, we seek to understand how the fusion of business and technology innovation can create new, effective healthcare industry solutions. By supporting fresh approaches and shared vision, the CHM seeks to catalyze ongoing dialogue and innovation. Such processes can yield viable, balanced solutions that advance both healthcare quality and cost-effectiveness. Given the near-critical state of healthcare in many regions, the CHM is committed to fostering new ways to solve worsening, long-term problems. The research stipend program The CHM actively promotes research to advance healthcare effectiveness. These 30- to 40-page reports are insightful, offer new solutions or perspectives, and explore a dimension of one or several of the CHM s five areas of focus for Research is funded through stipends, which are awarded on a competitive basis. Recipients may be involved in healthcare research, education, practice or management at universities and nonprofit organizations, or in healthcare journalism for print, online or television media. In 2004, the CHM anticipates awarding 10 stipends of US $15,000 each. Stipends are awarded to individuals, not the corporations, institutions or clients with whom those individuals are employed. Final reports are published and disseminated by The IBM Center for Healthcare Management.

4 Research topics The CHM is interested in funding research that addresses the following issues: Healthcare quality and patient safety Recent studies such as those by the U.S. Agency for Healthcare Research and Quality, the U.S.-based Institute of Medicine and the Leapfrog Group coalition of healthcare payers highlighted serious challenges in healthcare quality and patient safety. These reports also pointed out that government, corporations, healthcare insurers, and providers are deeply interested in solving these issues. While U.S. government and private-sector entities have been aggressive in highlighting these issues, payers and providers worldwide are bringing new attention and increasingly quantifiable approaches to healthcare quality and patient safety. Which systemic approaches are creating lasting improvements in healthcare quality, and/or patient safety, by addressing shared issues? In particular, which approaches are highly integrated that is, span the payer-provider continuum and/or multiple healthcare-delivery sites? Optimizing clinical, administrative and financial processes Governmental, corporate and individual customers increasingly are resisting insurers attempts to pass on rising healthcare costs. Insurers simultaneously must offer a broader range of innovative, competitively priced products and services to draw and retain more sophisticated, less loyal clients. Healthcare providers costs meanwhile are escalating in the face of an aging population, expensive technologies and therapies, and worsening staff shortages. And healthcare clinical practices are poised to evolve from current, episodic treatment to translational medicine using clinical genomics and molecular medicine and eventually to personalized medicine. Payers and providers must determine their true competencies and find ways to remain profitable despite leaner margins. Which business models or process improvement approaches are providing sustainable, above-average productivity increases for organizations in either, or both, categories?

5 Connectivity and healthcare standards Few industries have seen faster advances In technoloogy over the past decade than healthcare. While those advances are highly visible in patient treatments, information system gains are less evident. Which trajectories are leveraging advances in information technology to address regulatory and/or industry data standards? How effectively is data integration generating return on investment? In particular, what is the financial impact of using integrated clinical and/or administrative data to improve healthcare processes, quality and/or patient safety? Human capital Human capital consists of two elements: the knowledge, skills, abilities and experience necessary to accomplish an organization s mission, and an organization s ability to recruit and retain employees with those strengths. Yet, healthcare systems worldwide are facing serious shortages of medical personnel as increasing life expectancies and burgeoning populations drive the need for ever more medical care worldwide. Innovation and transformation Healthcare services delivery is a continually evolving, and often surprising, process. Among the more recent entrants: single-specialty hospitals, unique home care approaches, and rapidly expanding medical services such as ambulatory surgery. Healthcare payers also are rolling out innovative products, including defined contribution plans and three- or four-tier co-pay plans. And relatively new business models, such as outsourcing claims processing and contact center services, are gaining converts and momentum. Which leading-edge business process transformation and/or business process outsourcing approaches are being tried and used effectively? How far-reaching are changes and results? Which current, innovative approaches to healthcare human capital issues are succeeding most notably? Which have failed, and why?

6 Application process Interested individuals should submit a three-page, single-spaced proposal that includes: Project description Research method and source types Statement about what makes the project unique and what its contribution to the relevant healthcare discipline and/or its impact on insightful business strategy will be Applications should be accompanied by a detailed resume and relevant publications list. Grants are awarded twice annually, on March 1st and November 1st. Applications must be postmarked by the respective dates. Submission Submission may be done in hard copy to: Richard Brousseau Executive Director, IBM Center for Healthcare Management 1301 K Street, NW 4th Floor, West Tower Washington, DC IBM Center for Healthcare Management Executive Advisory Board Carol Belmont, R.N. Thomas Burlin Neil de Crescenzo Sietze Dijkstra Michael Dixon Gail Gulinson Roland Harris Caroline Kovac, Ph.D. John Nyland Felix Palacio Sandip Patel Alfred Spector, Ph.D. Curtis Tearte

7 About IBM Business Consulting Services With consultants and professional staff in more than 160 countries globally, IBM Business Consulting Services is one of the world s largest consulting services organization. IBM Business Consulting Services provides clients with business process and industry expertise, a deep understanding of technology solutions that address specific industry issues, and the ability to design, build and run those solutions in a way that has the potential to deliver bottom-line business value. For more information To learn more about IBM Business Consulting Services, please visit: ibm.com/bcs

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