Regina E. Herzlinger is the Nancy R. McPherson Professor of Business Administration Chair at the Harvard Business School. She was the first woman to be tenured and chaired at Harvard Business School and the first to serve on a number of corporate boards. She is widely recognized for her innovative research in health care, including her early predictions of the unraveling of managed care and the rise of consumer-driven health care and health care focused factories, two terms that she coined.
Her book, Who Killed Health Care? (NY: McGraw-Hill, 2007), was selected by the U.S. Chamber of Commerce as one of the ten books that changed the debate in 2008.
Her book, Consumer-Driven Health Care: Implications for Providers, Payers, and Policymakers (San Francisco: Jossey-Bass 2004) received the 2004 American Journal of Nursing Book of the Year award for History and Public Policy.
She has won the Consumers’ for Health Care Choices Pioneer in Health Economics award, the American College of Heatlhcare Executives’ Hamilton Book of the Year award twice, the Healthcare Financial Management Association’s Board f Directors award, and Management College of Physician Executive. Modern Healthcare’s readers regularly selected her as among the “100 Most Powerful People in Healthcare” and Managed Healthcare named her one of health care’s top ten thinkers. In recognition of her work in nonprofit accounting and control, she was named the first Chartered Institute of Management Accountants Visiting Professor at the University of Edinburgh. In addition, she has delivered many keynote addresses at annual meetings of large health care and business groups and been selected as one of the outstanding instructors of the Harvard Business School MBA Program.
She has served on the Scientific Advisory Group to the U.S. Secretary of the Air Force and as a board member of many private and publicly-traded firms, mostly in the consumer-driven health care space, often as chair of the Governance and Audit subcommittees.
Question: In what way should health care be focused on outcomes?
Regina Herzlinger: What do we know about outcomes in health care? Well let's say you needed a mastectomy. How much would you know about the surgeon who's going to perform that mastectomy on you? About her mortality rates? How many people like you died when they got this surgery? About her morbidity rates? How many people became infirm? How many people got a deadly clot? How many people had a sponge left inside their body? How many people got an infection that they absolutely could not shake? How many people were readmitted 30 days, 60 days, 90 days, to keep repairing what's going wrong with that surgery? Do you know where you could find that information? I don't either.
Clearly what we need is much more transparency in health care.
I have long proposed the health care equivalent of the SEC [Securities Exchange Commission]. The SEC has been a miserable failure in its regulatory functions, but transparency--it's incredible. Countries all over the world emulate the transparency functions of the SEC. I can go to the SEC's website and within three seconds I can find most of what I would want to know about any publicly traded corporation.
What can I know about my doctor, my hospital, my insurer, my dialysis center? Zero.
We need a federal agency that forces disclosure of outcomes. And by outcomes I mean, real outcomes. How many people died? How many people get a clot? How many people get an infection? How many people can function well after whatever is done to them? That's one thing of what we need.
Once we measure outcomes, the health care system will reorganize itself so that it can deliver outcomes. Right now, it can't make you better for your diabetes, your AIDS, your heart disease. All it can do is optimize the hospital part of that, optimize the doctor part of it, optimize the laboratory part of it.
Anybody who studied systems analysis knows if you optimize all the many little pieces of the system, that's not the same as optimizing the whole system. A system that measures outcomes will force a change in how health care is delivered. That will make it simultaneously better and cheaper.
Recorded on: May 27, 2009.