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12/5/2003

Health Care Governance Expert to Speak at Midyear Opening Meeting

Donna Young

Genomics is one of the most "interesting" but "disruptive" challenges that will force the health care industry "to move 180 degrees away" from standardized practice to customized patient care, said James E. Orlikoff, president of Orlikoff & Associates Inc., a Chicago, Ill., consulting firm specializing in health care strategy, leadership, and governance.

Because quality of care has been defined as an "industrial model of elimination of variations" with "consistent practices, parameters, pathways, and protocols," he said, the instituting of genomics in health care will test the abilities and resources of health systems.

"You may have pharmacists . . . [dispensing] medications to 10 patients with exactly the same disease, but [the patients] will get 10 completely different medications because they have different genetic profiles, and that is really going to be an interesting and challenging concept, and kind of disruptive innovation, which is going to impact in the near future," Orlikoff said.

Orlikoff, executive director of the American Governance & Leadership Group, an organization that provides education, publications, and consulting services to health care organizations, is the featured speaker at ASHP's Midyear Clinical Meeting Opening General Session on Monday, December 8, in New Orleans.

He has worked in the health care industry for 25 years and is the author of 15 books, including Board Work: Governing Health Care Organizations, which won the American College of Healthcare Executives 2000 Book of the Year award.

One reason health systems are facing rising costs, he said, is because "health care creates its own demand."

"It's a classic example of Jean [Baptiste] Say's law of economics, which is supply creates its own demand," Orlikoff said. "Every time we come up with a new pharmaceutical, or a new medical device, or new imaging technique, the demand for it is created because of the existence of the service."

Another factor contributing to rising health care costs, Orlikoff contended, is that, the United States is "promising more health care services than society can pay for," he said.

"All human needs are insatiable, and when it comes to health care there is infinite demand for health care, but there are only finite resources to meet that demand."

The United States will spend $1.7 trillion on health care this year, Orlikoff said.

"If you look at United States health care as its own country it would be the fourth largest economy in the world," he said. "And the problem is, we are coming to a point where health care spending is destabilizing the economy because health care does not add economic value to the goods and services we produce on a global basis. It consumes economic value."