Leading the Transformation of Health Care Delivery — The Launch of NEJM Catalyst originally appeared as an editorial in The New England Journal of Medicine.
Health care delivery is in a period of historic transition. The pressure for major improvements in quality and efficiency exists everywhere — and thus is not driven by the Affordable Care Act alone. The real driver is the medical progress of recent decades, which has dramatically enhanced what medicine can do but has also increased its potential for creating waste, disappointing quality, and chaos for patients. Even if costs were not an issue, the need to reorganize health care would be compelling. Given economic realities, that need is an imperative.
To support the decision makers and clinical leaders in our health care institutions during this time of change, the NEJM Group, which also includes the Journal, has launched a new resource, NEJM Catalyst. NEJM Catalyst will use a range of formats to provide these leaders with information that can help them redesign patient care, change the structure of their institutions, contemplate new relationships with outside organizations, and reconsider the ways in which incentives are being used. In short, NEJM Catalyst expects to improve the management and strategy of health care — offering a trusted source of needed information just as the Journal offers a trusted source of information on the art and of science of medicine.
NEJM Catalyst grows out of the knowledge that we cannot solve our cost and quality challenges simply by asking the good, hardworking people in health care to work even harder or become even better. Health care organizations have to create social capital — that is, improve the ways in which they work together and thus enable organizations to accomplish goals that would otherwise be out of reach. State-of-the-science medicine must be a team activity, and the teams must work together well and efficiently.
We believe that social capital is likely to be even more important than financial capital in the era ahead. After all, one can go to the bank to borrow money, but there is nowhere one can go to borrow trust, teamwork, reliability, and the desire to innovate and improve.
NEJM Catalyst will help health care organizations accumulate social capital — providing valuable insights on why changes are imperative, what kinds of innovations are proving effective, and how organizations are implementing change. We will use case studies, live and webcast meetings, videos and podcasts of talks and discussions by thought leaders, and other methods to provide insight into the toughest problems health care organizations face today. Leaders will be able to learn firsthand from their peers what works and what doesn’t.
We are grouping articles and other media around four overlapping themes that range from the social context of health care to the front lines of care delivery. The “New Marketplace” theme focuses on health policy and markets, including topics such as the impact of payer and provider consolidation, value-based payment, and the role of competition and consumer choice in driving higher-value health care. Led by Leemore Dafny, an economist and antitrust expert at the Kellogg School of Management at Northwestern University, the New Marketplace has already held its first major webcast meeting, portions of which can be viewed at the NEJM Catalyst website.
The “Care Redesign” theme focuses on how to create and sustain the teamwork needed to provide high-value care, as well as the practical implications of organizing care to enhance health rather than simply provide sick care. Led by Amy Compton-Phillips, chief clinical officer at Providence Health Services, this theme has also already organized its first major meeting, covering topics such as team care for 21st-century medicine, the addressing of social needs in routine care, and bundled payments for chronic disease. Portions of that meeting are also viewable at catalyst.nejm.org.
In February, we will launch the third theme, “Patient Engagement: Behavioral Strategies for Better Health.” Led by Kevin Volpp, a physician and behavioral economist from the University of Pennsylvania, this theme will focus on what is known about the use of incentives (financial and nonfinancial) to engage patients in improving their own health. A free webcast meeting will be held on February 25, 2016; information on how to register will be available shortly at catalyst.nejm.org.
The fourth theme will be “Leadership,” led by Stephen Swensen, medical director for leadership and organization development at the Mayo Clinic College of Medicine. This theme will focus on the strategies and tools for engaging clinicians in enhancing the value of care and will be launched in late spring 2016.
The NEJM Catalyst Insights Council provides another avenue to draw on the expertise of clinicians, clinician leaders, and health care executives from across the country. The NEJM Catalyst Insights Council will select and regularly survey qualified executives, clinician leaders, and clinicians to contribute their perspectives and practical guidance on trends and issues in health care today. Survey results will be summarized and interpreted by NEJM Catalyst contributors and will be available at catalyst.nejm.org.
Like much in health care delivery today, NEJM Catalyst represents a new type of work, aimed at problems that are new to our times. We don’t pretend to have a complete understanding of the best ways to accomplish this work, but we believe that bringing recognized experts together will give us the building blocks. We look forward to your input, and we hope that NEJM Catalyst will play a valuable role in helping the health care community create a higher-value health care system.