Our path to better health at lower cost requires a comprehensive solution as described in the last post. Let’s dig a little deeper into the components of that solution. Every industrial employer knows that variation in a product increases rework and cost. American manufacturers regularly deploy six sigma programs to improve quality and reduce variation in their products. Variation has a similar effect in chronic illness management. It produces worse clinical and financial outcomes. Brent James said it this way.
#1: Variation in Care
“Variation, the first opportunity area above, has been such a common problem in healthcare that it’s more or less impossible for all patients, even those with full access to the best care, to be getting good care. Addressing variation alone can drive down costs by about 30 percent while improving clinical outcomes.”
Let’s just look at high blood pressure as an example. There are 63 drugs approved to treat hypertension. A single medication may control the pressure but it usually takes 3 or 4 medications to get it under 140/90. All of these medications will reduce the blood pressure, but specific combinations reduce side effects and increase protection of cells and organs. Those are the medications you should include in your protocol.
Look at the top three red boxes in the diagram above. New scientific discoveries tell us the genes involved here are switched on in middle-aged patients with extra abdominal fat. When aldosterone and angiotensin II activity are increased it raises the blood pressure and damages the vessels, heart, and kidney. With losartan and eplerenone we can block those effects very precisely. Combining losartan, hydrochlorothiazide, amlodipine, and eplerenone in your hypertension protocol produces the best and most durable hypertension control with the fewest side effects and the greatest protection for cells and organs. Using this protocol makes it possible to systematize, replicate, and scale your approach to hypertension across hundreds of providers. It has been proven to dramatically reduce heart attacks, strokes, and the need for dialysis as part of an optimal medical therapy protocol. If your organization does not manage chronic illnesses like hypertension using a protocol, you can never squeeze out variation and explain how you improved your clinical and financial outcomes. Optimal medical therapy is a product like a screw or a hamburger. It is time to squeeze out the variation. Let’s get started.
Bill, Curious as to your thoughts about the role of remote patient monitoring devices to help manage adherence to OMT and also to create accountability that limits variation?