Brad Pitt has an approach to data and performance that could save health care. That's right: Brad Pitt. Yes, the same Brad Pitt that started his career on the daytime soap opera Another World; played the cool thief in the Oceans series of films; then the goofy fitness trainer in Burn After Reading and topped it off by marrying Hollywood femme fatale, Angelina Jolie. Handsome, charming, master of self-deprecating humour, and now saviour of the health care system; Is there nothing he can’t do? You see, Brad Pitt has the opportunity to teach us the tools needed to fix the Canadian health care system. Where did he get these magic tools to fix health care? Pitt is featured in the role of Billy Beane in the recently released Hollywood film Moneyball. Truthfully it is actually Billy Beane that has the tools to fix healthcare. Brad Pitt will just show us how to use them. However had I said, “Billy Beane will show us how to fix health care,” you would have quit reading. Because unless you follow baseball you’ve most likely never heard of Billy Beane. Brad Pitt you’ve heard of. And while Billy Beane is quite the hunk himself, he’s not quite in Pitt’s league. In fact he’s in the American League. Based on the book of the same name, Moneyball tells the story of Major League Baseball's Oakland Athletics in the early 2000s. As Oakland’s general manager, Beane’s job was to create a winning team with a severely constrained payroll at the same time as the competition were doubling theirs. Essentially the new owners asked him to do “a lot more with a lot less”. Sound familiar? I’m an emergency physician. In healthcare we are asked to do more with less almost daily. “See more patients in the emergency department; but with fewer beds.” “Do more surgeries; but with the same number of operating room hours.” “Take care of sicker and more patients; but with the same number of staff.” To be clear, baseball isn't the health care system. In health care we can close on the weekend. We can make people wait. We can put patients in beds in the hallway. Pressed to save money, we buy cheaper IV cannulas although the staff don’t like them. Maybe we don’t open all the beds on a ward to save on nursing costs. We used to be able to run a deficit, but increasingly those days are over. Baseball is different. It plays by a different set of rules. They can’t tell ticket holders, “Stadium’s full. You’ll have to wait in the hallway.” They can’t buy lower quality bats and gloves just to save money. They can’t say, “We don’t have enough money to pay all the players for tonight’s game. Let’s leave right field open.” And they definitely can’t say, “We’re not going to play on weekends. Or this summer for that matter”. Forced to compete with the major league - literally and figuratively - payrolls of the New York Yankees and Boston Red Sox, Beane needs to figure out a new way to do business. What does he do with his team and its paltry budget? He takes The A’s, with their lowest or next to lowest payroll in the league, to winning the most games than any other team but one. They make the playoffs 3 years in a row. The A’s set the American League record for most consecutive wins in a season. And along the way they almost eliminate from the playoffs the richest team in baseball, the Yankees. How does he do it? He uses data: a lot of data. First he scans the data for any indicators of performance others in the league aren’t looking at. He determines which player attributes add value (runs for his side, prevented runs for opponents) to his team; and which do not. He looks at the traditional way of how the scouts identify excellence, and obsesses over how to turn the art of player selection and development into more of a science. He takes age-old problems and examines them from a different perspective. All of this analysis derives from the enormous amount of data available in baseball. Beane demonstrates that using the available data to arrive at new insights about the ideal players at the least cost creates a competitive advantage. In short, Beane takes his small budget team and turns it into a big-ticket winner. We can do the same in health care. And some high-performing organizations already have: Group Health Cooperative in Seattle and environs; Intermountain Health headquartered in Utah; the Geisinger Health System in Pennsylvania; Kaiser Permanente. Many factors account for their overall excellence, but a common feature is using data to drive improvement. Health care in Canada has more than enough money. Throwing more money at our problems won’t fix them. We need to move away from the old business model. We need to ask different questions of the data to discover why some health systems are performing at a higher level given the same set of circumstances. What is working? What isn’t? What changes do we have to make to maximize the human and financial resources to ensure better health for our population? What are we doing that doesn’t contribute to better health? If what we’re currently doing isn’t working, let’s try something different. You don't have to like baseball to relate to Moneyball. You don’t even have to like sports. All you need is to work in a system that is asking for more with fewer resources. Or work in a system that you believe could be doing a better job than it currently is. Then you'll be hooked. Go out and see Moneyball in the movie theatre. It’s a great film and an even greater story. Almost as good as the book on which it's based. And if you don’t like it, and you don’t see a connection between sports and health care? At least you get to see Brad Pitt.
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