Most of you have watched Peter Jackson’s epic saga Lord of the Rings. It’s been almost 16 years since the first Lord of the Rings movie was released, bringing J.R.R. Tolkien’s mesmerizing world of hobbits, elves, dwarves, and orcs to life. I was rewatching it recently and couldn’t help but see parallels to healthcare’s present conundrums.
Lord of the Rings is more than just a book and movies. It has become one of the most influential pieces of fictional literature- inspiring and impacting several spheres. And healthcare hasn’t gone untouched!
A common vision- A Fellowship
Who would you say is the ‘hero’ of this series? Frodo? After all, wasn’t he was the one who bore the Ring all the way to Mount Doom? Or is it Gandalf? Surely, the Fellowship couldn’t have succeeded without his wisdom and guidance. Or Eowyn? Or Aragorn? There are many characters you could pick, but they all had one thing in common: a single vision, a vision to destroy the ring and restore peace to Middle-Earth.
The same way, I find it heartening to see providers, insurance companies, the government, care teams, and every responsible person working towards shaping U.S. healthcare. From a system that was relatively unresponsive, volume-based system to a highly transparent and an accountable one, healthcare in the U.S. has come a long way. And indeed, for many healthcare leaders, it has become a mission- working towards transforming healthcare, together.
They, much like the Fellowship, are committed to finding a solution that is crucial to their world. And just like the Fellowship, they will strive till they succeed.
Perseverance- because there is always hope
This one probably goes without saying- after all, Lord of the Rings is a story of perseverance and staying focused. There’s hardly a character who hasn’t endured hardships to attain something great- Gandalf, to my mind, is the best example of all. He saw the worst, died, and lived to tell the tale. Why? Because, one, he believed in his mission. And second, he believed there was still hope, even if- to quote the grey wizard – it was “only a fool’s hope.”
Likewise, healthcare with its numerous complexities needs perseverance too.
An inefficient healthcare infrastructure doesn’t just affect patients- it affects physicians, nurses, and all those who work within it. The quest for success, high-quality care, better patient engagement, enhanced population health may be just as daunting as Gandalf’s, but these too require a great amount of fortitude, diligence, ingenuity and yes… perseverance.
The hobbits in the series stood just a bit over three feet tall. They were soft, walked dusty roads without shoes, and were used to regular meals and soft beds. And they were thrust into situations to save the world. Tolkien and then Jackson invested in his little heroes a sense of mission, vision, and heroism- despite their size. And despite overwhelming odds, the hobbits summoned up all their courage and took on a challenge way bigger than they were.
According to a survey conducted in mid-2017, only 47% of accountable care organizations in the U.S. planned to be a part of a risk-based shared savings model. Even if ACOs figure out the ‘how’ of population health management, there is a good number that is apprehensive of taking on risk. The bigger the problem, the bigger the reward when it’s tackled! So, ACOs too should be thinking about the challenges they want to answer.
“One does not simply…”
This quote by Boromir is only in the movie, and not in the book, and yet it holds different meanings for different people. Perhaps it means that the things worth pursuing in life are not simple. Or maybe, it means that you don’t just launch yourself into a mission- you spend time, you ask questions, you prepare, and then you jump into it.
In healthcare, both these interpretations could not be more true. Healthcare requires planning, forethought, and more than anything- efficiency. Among industrialized nations, the United States spends well over twice the per capita average. Transformation of a system like healthcare- whether you give care, receive care, manage it, or pay for care- it all requires actionable strategies to drive impactful results. True, there has been a lot of progress in this direction with new regulations centered at achieving the maximum value and eliminating fragments. And yet, delivering the high-quality, coordinated care that we aim for requires further more efficiency, accuracy, and quality.
“Even the smallest person can change the course of the future…”
I ask you to change perspective here and zoom in to a micro level view of healthcare. Healthcare is not just driven by providers today. As we step into the era of evidence-based healthcare, it has become critical for providers to embrace an element they never once thought could be critical- data.
Even a single bit of data can enable clinicians to analyze their patient population, understand which of their patients need help, and develop a strategy to proactively reach out to the patients who need care. Back in the day, we never realized the potential data-powered strategies had. Today, be it EMRs, or claims data- the ones that have the lion’s share in healthcare data, or be it social determinants of health or behavioral data- even the tiniest of data element can transform our understanding of a single patient’s care and can deliver better clinical and financial outcome for that patient.
And when each and every one of us take that approach, we too, can change the course of the future!
At the end of the day, Lord of the Ring teaches us to embrace the challenge, remain focused, and do our best to make the world a better place. I suppose healthcare shares the same motto and the same commitment. In the final battle sequence, Aragorn charges into battle by saying, “A day may come,” and finishes with, “But it is not this day.” Healthcare in my opinion has the weapons it needs to deliver true value. With teamwork, with focus on mission, and with all the weapons available, we will step forward to transform healthcare and make it efficient, affordable, and equitable.
A day may come, when the challenges are too many, but it is not this day and we are more than equal to it.
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