CEO Report: Future in the Making

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July 1, 2013 Volume 77, Number 7
CEO Report: Future in the Making Paul Pomerantz

The best way to predict the future is to invent it. – Alan Kay

Alan Kay is one of the great visionaries of computing technology, a pioneer in many of the graphic interface elements we take for granted on our PCs every day.

Despite working with early computers in the 1960s that were profoundly abstract and unprecedented in their complexity, Kay saw little value in them if they weren’t useful to everyone. If a user had to memorize a series of complex commands, which were out of the reach of most people, such technology was not achieving its full potential.

Early computers were operated through string after string of command lines. Kay radically altered this dynamic by allowing a user to interact with objects everyone understood – a mouse pointer, file folders and trash cans. It seems simple now, but the idea at the time was absolutely visionary. Kay knew computers, but more importantly, he knew people. He knew a complete paradigm shift was needed to unlock the potential in both.

Today, we wouldn’t recognize computing as it was then, with computing power ever present, reliable, affordable and usable.

Contrast the progress in computer technology with that in health care. While health care technology has certainly advanced in so many ways, the system is still challenged by cost, access and increasing complexity. While I have served in health care for several decades and have worked with many specialties, the pace of change buffeting anesthesiology is truly remarkable. Perhaps because of the ubiquity of the specialty, you are affected by all the pressures of cost, restructuring and reimbursement, corporatization, scope of practice and the impact of new technology.

We are in the midst of a transformation from a system based on service to one based on the value provided and outcomes. We need a new paradigm that will make health care change as accessible and user-friendly as a modern computer, for both physicians and their patients. Anesthesiology is poised to play a major role in the creation and implementation of this new paradigm.

This issue of the NEWSLETTER is about government relations. ASA excels in this area – and is getting stronger. However, “Government Relations” is just one part of a change process that also includes public and member education, standard setting, and quality measurement and improvement. Our goal in advocacy is to create a public policy environment that is sensitive to our members and their patients. The most essential element in this process is you, the member. It is your work to support advocacy at the local, state and federal levels that assures our impact. Just as important is the work you do every day to innovate and implement improvement in your practice setting.

The practice of advocacy is evolving. It is a continuous process linked to strong data and evidence, coalition building and sophisticated communications. Moreover, policymakers are increasingly looking to their constituents and organizations such as ours to provide solutions to vexing problems. ASA is well positioned in this respect. Here are three key ways we’re doing it:

Performance Measures and Standards: ASA has no peer in the art of developing measures and standards. Our Physical Status classification is the gold standard for patient fitness assessment. We were the first to recognize patient safety as a specific perioperative concern, culminating in the creation of the Anesthesia Patient Safety Foundation. Our standards, guidelines and practice parameters continue to shape how medical care is delivered. Valid measures are going to be critically important when working with Medicare and reforming the sustainable growth rate formula, for example.

Data and Evidence: As of this writing, the Anesthesia Quality Institute (AQI) has amassed nearly 10 million cases in its registries. The AQI is perhaps the most important initiative ever undertaken by ASA. Its unparalleled storehouse of data is already offering insights into performance and quality that legislators and policymakers cannot ignore.

Perioperative Surgical Home (PSH) Model: Initiated in 2011, the PSH is a model of care developed by ASA that positions anesthesiologists as perioperative leaders who coordinate the surgical care of patients from start to finish throughout the health care system. Its aim is patient-centered care enabled by robust partnerships between physicians, non-physicians, facilities, and patients and their families. Its success will be measured by quantifiable cost-savings, efficient care delivery and patient satisfaction.

Effective advocacy is a team sport, involving science, communications and intertwining coalitions. It’s important that every ASA member be equipped with the ability to actively and knowledgably participate in a dynamic, ever-changing health care environment.

This is the future. ASA will continue to help you create it.

Paul Pomerantz is ASA’s Chief Executive Officer.