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Should We Be Worried About Our Field?

What is “Healthcare At Home”?  Why should we as home health care professionals be concerned about our sector of the health care continuum?  What can we do about it?

Our long time friend and respected colleague, Bob Fazzi, PhD, has just published a manifesto about “Healthcare at Home”, and how we should take charge of our industry.  Take a look at Bob’s essay, and then engage in the conversation.

 Should We Be Worried About Our Field    Bob Fazzi

by Bob Fazzi, Ph.D   

Let me start by saying I love this field. Home Care and Hospice is a critical sector of health care and a social pillar of our society. I am awed by the leaders I work with and indebted to the hundreds of thousands of caregivers and support staff who make our agencies what they are today. And I am humbled and grateful that I have had the good fortune of being involved in a field I consider sacred and so important.

At the same time, I feel I have a responsibility, one garnered from nearly forty years in this field, to honestly express what I see and feel related to how we as an industry are approaching our future. From this perspective, I want to respectfully say I believe that, as an industry and as leaders, we are not doing enough. We are not coming together to aggressively take responsibility for redefining, reshaping and re-energizing our field. As an industry, we seem to be passively watching while others define us.

The fact is that the community will inevitably be the focus of healthcare in this country and world-wide. There is no choice! The aging of the population, the exponential growing numbers of seniors, and the spiraling cost of health care make it imperative that the future of healthcare be provided in the sector that can provide the highest quality healthcare services for the highest number of patients at the lowest cost.

Thought leaders at our major educational institutions, international practitioners like Eric Coleman at Intel, researchers from international companies — like KPMG, who just completed a one year international study of all health care and national leaders from the “Future of Home Health Project,” sponsored by the Institute of Medicine, National Research Council and the Alliance for Home Health Quality and Innovation — all have it right: healthcare at home will be the world-wide default (Eric Coleman’s term) for the future of health care.

The future of health care in this country and world-wide will be one where there are three sectors:

  • health care provided by hospitals and systems (the most expensive and highest tech)
  • health care provided by physicians (the ultimate gatekeepers)
  • health care provided at home

There are three sectors and we are the Third Sector – Healthcare at Home.

Unfortunately, I believe we are not stepping up and taking responsibility for our future. We are reluctant, some would say afraid or entrenched, to leave “how we have always done it” and embrace the new realities of health care that are inevitable. We all know it will happen but we fear making the changes.

Here is the worst part.  We are falling into the same fear of change trap that other major entities have fallen into. Kodak didn’t change. Wang computers didn’t change. The railroad industry didn’t change. Blockbuster didn’t change. So…what about home care?

I believe it is critical that we break away from the silos of the past and embrace the new reality that, if care is provided in the home, our sector – Healthcare at Home – owns it.  Change your vision of who you are and you automatically change what you do.

Agencies will begin developing a full range of services – some certified and some not – that respond to any health related issue where the patient can be better served in the home.  Private or non-certified services will be a standard part of all agencies.  More agencies will join the ranks of their competitors who have already recognized that EMTs can provide an expanded range of non-certified services.  Not all of our services require more costly disciplines.

State and national associations will gain by having an expanded definition of their membership and services. EMTs will be part of state and national associations, not competitors. If Healthcare at Home agencies are seen as key players in the new health environment, vendors who provide services and products to patients will want to be at our state and national conferences.  Look to see Walgreens and CVS, Home Depot and Lowes playing major roles, setting up booths at trade shows and increasing non-dues revenues for associations.

Even more important, when our leaders go to our state legislatures or Congress, it will be much easier for politicians to understand who we are. We are the Third Force – Healthcare at Home. Legislators will more easily recognize that we represent a powerful and expanding block of voters – patients and their families. Legislators will listen more intently and be more receptive to supporting initiatives that help us better serve our patients.

So yes, I am worried but I am also hopeful. I know I must seem like a “Chicken Little” but please know I am an astute researcher and follower of trends. This is either an incredible time and opportunity for home care and hospice agencies and for state and national associations or a time when home care will join the ranks of Blockbuster. We have to step up and not be passive or sullen.I believe that the time is now and the dialogue and action must begin.

About the Author:  Bob Fazzi, PhD, is the Founder and Managing Partner of Fazzi Associates, based in Northampton, Massachusetts.

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