Benihana-care? Maybe we do need to know how the sausage is made…
It was often said as I was growing up that if you knew how the food was prepared in a restaurant, you’d never eat there. When the restaurant chain Benihana first came to the United States in the 1960s they pioneered the concept of an “open” and transparent kitchen. You literally watched the chef chop, slice and sauté your food in front of you. You would see everything that goes into what you’re about to consume, and there weren’t any questions as to what’s in your meal. The process was transparent.
Much of the controversy around Obamacare’s website launch snafu had to do with transparency, from the vendor contracts to the source code.
Now that Accenture has taken over the website, I’m much more confident in its success. But what if Healthcare.gov had been originally built and launched with more transparency? We’d know the ins and outs of how the system works, what the issues were, how the code was written, how decisions are made about who gets covered and who doesn’t, and finally, how the care will be delivered.
Perhaps if we had launched the most significant social legislation in decades as Benihana-care, we wouldn’t have faced these same challenges.
There are good lessons in this experience, and not just for website developers. There are inexorable trends in healthcare towards transparency, from the requirement to publish clinical trial data to the tracking of outcomes data to the comparison of hospital pricing.
When I think about transparency across healthcare I also think about the relationship between a physician and patient. That’s a place where relationships are changing and becoming more and more transparent. Long gone are the days when the doctor listened, jotted a few notes down, made a diagnosis and then turned and handed the patient a script. It’s much more of a conversation now, it’s a partnership, it’s a collaborative decision making process between the physician and the patient.
In fact, the best outcomes seems to happen when patients begin to see their physician less as an urgent care provider to call only when sick and more as a wellness trainer to consult on staying healthy. The relationship is open, balanced, and less prone to misdiagnosis or poor compliance. This focus on prevention ultimately leads to a healthier population and less utilization of expensive healthcare facilities. Which is what healthcare reform is ultimately all about anyway.