Josh Ruxin has provided a thoughtful, measured description of how private sector management strategies could improve health care in developing countries. He drives this point home by highlighting the prevalence of dead-simple "institutional failures" such as convoluted daily schedules and bad accounting. How can we address these "cascading problems" and rethink healthcare (acknowledging that this is a universal problem—not just limited to developing countries)?
A little research yielded the above big think video interview where Ruxin outlines his experience directing Rwanda Works. Ruxin elaborates the ideas expressed in his RevMinds response in an extremely straightforward manner. As he states, "additional doctors, nurses and drugs" will not solve institutional shortcomings. He points to QuickBooks, accounting, HR and management training as bottom up actions that increase efficiency and profitability within individual clinics. Ruxin outlines that drug procurement alone is not the answer and instead points to the refining of knowledge-systems and optimization of workflows.
People always want to make malls bigger and harder to manage, which I never understand. The same thing is happening with many hospitals. What matters to me is the management of information, different systems are unifying and we are getting a lot of information - we need to figure out how we design the systems to manage that enormous amount of data.
It is quite interesting that the same fundamental management problems hinder health care in all socioeconomic contexts. I'll dig further into information and management (specifically data) in health care in a post later this week.