The Triple Aim…The Ultimate Challenge

Robert W. Yokl, Vice President/COO, SVAH Solutions

I have a love-hate relationship with the newest mantra of our healthcare supply chain industry which is Cost, Quality, and Outcomes. I love that we have a mantra to work toward and it has been accepted as the “Triple Aim” of our industry. But what I don’t like about it is how vague and unfocused it has become. This leaves the interpretation of these three areas open to just about anything that will fit into the box or fit the bill for the white papers that are issued every so often on this “Triple Aim.” So, what were we doing before this – chop sui?

Before I started working in the healthcare supply chain over 25 years ago I worked for ADP which is and at that time was the largest payroll processor in the country. One month, out of the blue, we got a roll-out of a new program (it was rare that ADP ever did anything fancy) and this program was unique in that it was “Totally Guaranteed Correct Payroll – Or Your Money Back.” They had fancy shirts, buttons, stickers, etc. This was a national roll-out of this program for the sales and customer service team to use to establish more business, and we were excited. But in less than 2 weeks it was canned and totally disappeared. But why?

The Chairman/CEO was away on vacation when this program was conceived and rolled out by the national marketing team at the organization. When he returned and found out about this program, he immediately had the program shut down and his reason was incredibly simple: “Payroll is supposed to be correct every time. It is a given!” Why are we guaranteeing something that we are paid to get correct every time? 

How does a story from another industry from a long-time past relate to healthcare? First, what do our patients care about most? Their health, family, and their paychecks (not always in that order). I see a similar parallel in that we are rallying to the “Triple Aim” but that is our job to perform every single day before, during, and after the Triple Aim appeared. As one of my well experienced management engineers used to say when he heard the latest management process/mantra, “We have already been doing this for years, it’s just got another fancy name.” It’s time for the Triple Aim to have a formal process!

As a long-time member of AHRMM, I fully support the lead that they have taken with establishing and maintaining the Cost, Quality, and Outcomes program. But we need more substance, not more sponsors. Perhaps the next step for this mantra is to define a process further or adopt pieces or modules from areas such as Value Analysis with the Functional Approach, Lean Management with Voice of the Customer, Six Sigma with Standard Deviation Reporting, etc. Regardless of my views, the Triple Aim is starting to make its mark on our industry. We now need to clarify further specifics so that supply chain managers can set better goals and benefit further from the program, process, mantra, or whatever it is supposed to really be.