Process innovation for health care

The Booz & Company magazine Strategy+Business has an interesting new article on A Better Model for Health Care which asserts that:

Unlike other industries, in which products and processes tend to be about 80 percent standardized, and a purchaser has a reasonable sense of what to expect, the U.S. health-care industry is full of fragmentation, friction, unnecessary customization, and excessive costs. Reducing those costs would require holistic change in the practices and structures of the industry.
. . .
The health-care industry--in the U.S. and around the world--is the only industry whose products and services are virtually always custom-built, that is, independently engineered for each customer. If reform efforts simply expand coverage and make the system work faster by installing electronic medical records, costs will only climb further.

So while other industries are moving to more customization, their solution is to move to more standardization.

I understand the point (which has been made by others), but I'm not sure this is quite right. Part of the health care delivery problem may be that it needs to be custom build but the current system is closer to a one-size fits all. If you have a common condition, the system processes are fine--in fact, medical centers thrive on high volume standardized procedures (as much of the discussion of the medical tourism sites indicates)--even if these procedures are individually dramatic, such as a heart transplant. But anyone who has had a non-common problem can testify to the frustration of being routinely shunted into the standard protocols. We all either have or know of the all too common complaint of "assembly line" treatment.

I do strongly agree with the article's authors that the solution is organizational--as they put it "structures, relationships, and incentives". The trick here will be to invest the new organizational process based on the emerging collaborative models. Turning back to the Taylorist/Fordist assembly line standardization of the industrial age is likely to fail. A more productive route would be creating better tools kits and components that can be mixed and matched to provide the building block for a customized solution.

Health care has the possibility of being the template for the 21st Century organization. It will be a mix of standardization, customization and collaboration. But just exactly what is the formula for mixing those ingredients is still unclear. Years of evolution and experimentation lie ahead. So look at the current turmoil over health care reform as one step in a very long process.