Compass Point – Healthcare: Cayman’s health care capable of change

Change is not always an easy thing to accomplish but it is sometimes extremely important for the betterment of all. When it comes to healthcare, the Cayman Islands Government recognises that change is a vital component of achieving the best quality healthcare for Cayman residents at the lowest possible cost.  

Keith Allred, who is the president and managing partner of HB Strategy Group, will be assisting the Islands in their on-going quest for change and improvement when he presents an address at this year’s Healthcare 20/20 conference, titled Conflict Resolution and Change Management.  

He received his PhD from the University of California, Los Angeles, and served on the faculties of Columbia University and Harvard University, the latter as a professor in the John F. Kennedy School of Government. 

Mr. Allred has helped leaders at hundreds of government and private organisations adopt needed change, working closely with the management teams at portfolio companies and consulting clients.  

He is also the founder and director of The Common Interest, a citizens’ group of more than 1,700 Republicans, Democrats, and Independents. The organisation identifies and champions solutions in the Idaho Legislature that are so obviously in everyday citizens’ interests that they attract support across all political lines that usually divide people. This track record of legislative accomplishments at The Common Interest led the Democratic Party to ask him, as an independent, to be their nominee for governor of Idaho in 2010. 

It was while he was standing in this election that his interest in health care was suddenly sparked when he announced at a press conference that he would be finding a better route for the state of Utah to provide healthcare for its residents. After that press conference, Mr. Allred realised the magnitude of his decision but found the solution employing a data driven system.  

It is therefore his background as a senior advisor to Healthcare Quality Catalyst that will be the backdrop to his presentation at the conference, to be held at The Ritz-Carlton from 17–20 November. Healthcare Quality Catalyst assists hospital systems improve their quality and decrease costs through a combination of its adaptive data warehouse software applications and organisational change methodologies, both of which, Mr. Allred said, can be applied to smaller health-care systems, such as that within the Cayman Islands. “The US system of health care has faced many challenges in dealing with the issues of high costs and low quality,” Mr. Allred explained. “In the end, the issue has been made far more complicated than it really is. The Cayman Islands has the opportunity to do much better, at a national level.”  

He pointed to the methods of health-care service provision offered by Intermountain Healthcare in the state of Utah, which he said, is a leader in its field and helps health-care providers to save up to a third of their costs while simultaneously significantly improving the quality of patient care. Coincidentally, a former colleague of Mr. Allred’s, Dale Sanders, is the chief information officer for the Cayman Islands Health Services Authority and was an executive for nearly a decade at Intermountain Healthcare. 

“At Intermountain Healthcare, they are much more data-driven by virtue of their enterprise data warehouse, which permits them to gain information from a wide range of patients and how they have been treated,” Mr. Allred said.  

He explained further that the data can then be analysed and the best quality health care can be highlighted. “Often, it is not the highest cost health care that provides the best outcome for the patient,” he said. 

However, Mr. Allred conceded that although the United States might have the best scientific literature on the subject of healthcare, it might not always put this into practice and follow the science consistently. An enterprise data warehouse system can measure exactly what doctors are doing and how they are treating patients. 

“It is difficult to get doctors and nurses to change,” he said. “They may have the empirical answer to a specific issue but the major challenge is in getting them to change their practices, remove the variability in treatment, and follow evidence based protocols.” 

Mr. Allred said he has the key to helping health-care professionals overcome their aversion to change by making them personally the agents for change. “There are ways to implement effective organisational and behavioural change,” he said. “We draw on their sense of professionalism and put the empirical data into their hands.”  

He said it is important not to treat this as just an IT project and to really get the health-care practitioners involved in the data from the onset. “You need to have them drive the design of the metrics,” he says. “For example, Intermountain Healthcare started with one specific area within the hospital group, the cardiovascular unit. The doctors within the unit drive the critical measures. We find that when they are so closely involved they take the findings a good deal more seriously and become self-monitoring and make changes to the system themselves.” 

Intermountain Healthcare saw substantial financial gains from cost savings once the data driven system had been implemented and, at the same time, the quality of health care delivered to patients also increased in tandem, Dr. Allred said. 

The Intermountain Healthcare model is now being pushed out to other hospital groups within the United States and they are already seeing care improving and costs reducing. 

“It took Intermountain Healthcare a number of years before the system had been fully implemented throughout the hospitals. They started with one area and then worked through each division,” he said. 

Mr. Allred believes that a similar system could easily be rolled out to Cayman’s own health-care system, saying that, although the initial outlay to purchase the system might not be as easy to absorb in a small country such as the Cayman Islands as in a large hospital complex, the return on investment would be tremendous. 

The Healthcare 20/20 conference is open to all and there is no cost to attend. Mr. Allred will be joined by a stellar line-up of international and local experts on the subject of affordable, quality healthcare. Premium sponsors for the conference are BritCay, Tenet Healthcare, the Health Services Authority, AIS and Tower Marketing.  

To register, go to www.healthcareconference.ky and click on the Registration tab.