The Hub of the Triple Aim: Connecting the Players

TheThe Hub of the Triple AimThe Triple Aim is the concept made famous by Don Berwick and colleagues of the Institute for Healthcare Improvement (IHI) that advances three goals to improve health care:

  • Reduce costs
  • Improve outcomes
  • Increase patient satisfaction

Most people would agree that all three of these goals are valuable and worth pursuing. They also support one another; presumably, care that is more effective will also be less expensive in the long term and lead to happier, healthier patients.

In reality, pursuit of the Triple Aim isn’t easy. In Berwick’s original descriptions of the Triple Aim, one important component was an integrator, an entity or organization that helps coordinate care in order to achieve the goals. That aspect of the Triple Aim is not often given the prominence it likely deserves in discussion of improving health care.  Worse, what coordination does exist may be poorly organized and communicated, exacerbating relationships rather than facilitating them.

That’s too bad: Recent findings in Massachusetts suggest that effective health care coordination can produce massive cost savings. How can we extend these results to other regions and systems?

There are at least two avenues we as an industry can pursue to address the need for better coordination and integration toward the Triple Aim: the technological and the psychological.

Technology: Think Tactical

The first area for improvement is tactical. How can we ensure that the technology systems in place really enable smooth communication between health care stakeholders? How can we staff our organizations to most efficiently and effectively manage outcomes, cost, and satisfaction? How can we design workflows that complement each other without redundancy?

Psychology: Think Relational

The second area for improvement is about building relationships. Trust between patients, providers, and other stakeholders becomes the basis for coordination of care. Not only do genuine relationships enhance the physician’s ability to care for the patient, they also enable different care providers to work more effectively together to care for the patient. Trust can be fostered through institutional means, such as transparent policies and processes. More importantly, organizational cultures that encourage social connections among colleagues can ultimately enhance employee work quality.

Achieving the Triple Aim won’t be easy, and it won’t happen solely because of changes in technology or improvements in how people work together. Both technology and psychology have a pivotal role to play in the health system of the future.