Fresh perspectives in health care | AccountingWEB

Fresh perspectives in health care

The topic of the 8th annual Connected Health Symposium was timely: Driving Quality Up and Costs Down:  New Technologies for an Era of Accountability.  Nevertheless, what made it a great conference were the fresh perspectives it brought to the fore.

Measurement, analysis, and communication are imperative

Brent James, the Chief Quality Officer at Intermountain Health Care, set the stage by describing how he and his employer, Intermountain, have succeeded in simultaneously improving health care quality and decreasing costs.  He credits this achievement to the incorporation of baseline protocols into the clinical workflow, followed by continuous improvement.

According to James, despite the explosion of knowledge and technology over the last 200 years, modern medicine has continued to rely on individual's judgment rather than measurement.  James observes that this ongoing dependence on subjective recall has led to tremendous variation in the practice of medicine, a paucity of valid clinical knowledge about best treatments, long lags between identification of best practice and its dissemination (more than 15 years), and a "striking inability to do what works".

The solution, James argued, is building standard baseline protocols into clinical workflows, which individual physicians are then free to override.  James says that this methodology is effective because standardization allows clinicians to spot what works-something they can't do when everyone practices medicine a different way.

Then, it's a matter of iteration.  Over time, employment of this process has helped Intermountain achieve better quality and lower costs than many of its larger, better-funded peers.

Better health depends on reducing income disparities

Next up was Kate Pickett, co-author of The Spirit Level: Why Greater Equality Makes Societies Stronger.  Her perspective is a macroeconomic one.

Drawing on a number of statistics, Pickett argued that income disparity is the most powerful predictor of health at a societal level.  Displaying chart after chart, she demonstrated that citizens of countries such as Denmark and Japan have better health, and life expectancies, than citizens of wealthier countries such as the US and the UK where the income gap, from richest to poorest, is greater.

In a follow up interview, she offered possible explanations.  Among these are that inequality erodes trust-and that people in lower strata of society experience anxiety and stress when they believe there is no hope of upward mobility.

Many more perspectives covered

This post summarizes some of the insights from the first two keynotes.  Over the course of two days, each presentation added a different way of looking at the issues related to improving health care quality and cost.

The business of health care

There were sessions about reimbursement, medication adherence, accountable care, and financing health care.  And, there were lots of demos on innovative technology.

The psychology of motivating change

In addition, however, there were a number of talks about motivating desirable behavior.  Examples included sessions on using games to promote better health, biofeedback, self-quantification, and even tips for effectively communicating health information to the distractible multi-tasking consumers of health information that make up the next generation.

Connecting the dots

I found that I spent much of the conference thinking about not just the topic at hand, but about the implications of each talk for other topics discussed at the conference.  Luckily, the event producers recorded many of the panels, and presentations, as there was a lot to absorb in just two short days.

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Steve Knowles has spent 25 years in business and practice in the UK, but he also worked in the states and the years haven't dulled his way of seeing an alternative view to everyone else, and every day is a new adventure.


Joel M. Ungar, CPA is a lifelong resident of the Detroit area and a graduate of The University of Michigan. He is a principal with Silberstein Ungar, PLLC, a Top 15 auditor of SEC public reporting companies.


Allan Boress, CPA, with over 25 years as a practitioner and consultant to the accounting profession. Mr. Boress is the author of 12 published books in 6 different languages, including a best-seller, The "I-Hate-Selling" Book.


Larry Perry, CPA, CPA Firm Support Services, LLC, is the author of accounting and auditing manuals, author and presenter of live staff training seminars, and author of webcast and self-study CPE programs. He blogs about small audits, reviews, and compilations.

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Maria Calabrese, CIR, Human Resources manager for Fazio, Mannuzza, Roche, Tankel, LaPilusa, LLC in Cranford, New Jersey, Maria's topics revolve around the world of: Mentoring, Performance management, and The "Y Generation," a.k.a. "The whY generation".


William Brighenti is a CPA, Certified QuickBooks ProAdvisor, and Certified [Business] Valuation Analyst, operating an accounting, tax, and QuickBooks consulting firm in Hartford, Connecticut, Accountants CPA Hartford.


Ken Garen, CPA, is the co-founder and President of Universal Business Computing Company (, a software development firm of high-volume, high-productivity accounting and payroll technology.


Eva Rosenberg, MBA, EA, is the publisher of, and author of the weekly syndicated Ask TaxMama column. She provides answers to tax questions from taxpayers and tax professionals worldwide.


Amy Vetter, CPA, CITP is the CPA Programs Leader for Intacct Corporation responsible for leading the CPA/BPO Partners nationally.

Brian Strahle is the owner of LEVERAGE SALT, LLC where he provides state and local tax technical services to accounting firms, law firms and tax research organizations across the United States. He also writes a weekly column in Tax Analysts State tax Notes entitled, "The SALT Effect." For more info, visit his website:
Scott H. Cytron, ABC, is president of Cytron and Company, known for helping companies and organizations improve their bottom line through a hybrid of strategic public relations, communications, marketing programs and top-notch client service. An accredited consultant, Scott works with companies, organizations and individuals in professional services (accounting, finance, medical, legal, engineering), high-tech and B2B/B2C product/service sales.

Rita Keller is a nationally known CPA firm management consultant, speaker, author, mentor and blogger. She has over 30 years hands-on experience in CPA firm management, marketing, technology and administrative operations.

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Sally Glick, CMO, Principal, Marketer of the Year in 2003 and AAM Hall of Famer in 2007, leads a lively discussion of the constantly expanding roles of marketing and the professional marketers that drive this initiative in accounting firms of all sizes.


The IMA Young Professionals Blog features the insights of IMA’s Young Professionals Committee. Committee members share advice and experiences on careers, continuing education, work/life balance, and other issues affecting young accounting and finance professionals.


FEI Financial Reporting Blog provides highlights from SEC, PCAOB, FASB, IASB, and other regulatory news, including reporting under Sarbanes-Oxley Sect 404. It is written by Edith Orenstein, Director of Technical Policy Analysis at FEI.


Sue Anderson has 30 years of experience in continuing education for accountants. Currently she is the program director for online CPE provider CPE Link.


Jim Fahey is COO of Apple Growth Partners, a regional CPA firm in Ohio. His focus is on the effective and efficient use of technology within the firm by all team members.

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Leita Hart-Fanta, CPA, CGFM, and CGAP is the author of "The Yellow Book Interpreted" and owner of a website devoted to training for governmental auditors.


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