How Moneyball applies to healthcare

The storyline is familiar. An organization is challenged to achieve better results without spending more money.  An executive is committed to obtaining these better outcomes and recognizes that more financial resources aren’t forthcoming .  Faced with the option of near-certain failure if he continues to work within the historic operating framework, he decides that a different approach is necessary.  With the help of a young and visionary analyst, they decide to challenge the way “things have always been done.”  Introducing data and analytics, the two men decide that they can bend the cost curve and still achieve successful outcomes.  This approach is met with derision and resistance by others within the organization and the industry.  Given a thoughtful array of tools and resources to achieve the desired outcomes, end users don’t adopt these tools as they are intended.  The results are predictably poor, which further threatens acceptance of the vision.

You see, this is an industry that is rich in tradition and rife with seasoned, confident individuals who believe fervently in their ability to succeed by leveraging their experience and intuition.  The data-driven approach threatens their autonomy, their wisdom and indeed their professional identity.  Some of the conclusions reached by the analytics approach are in direct conflict with what their professional judgement would have them believe.  Their  individual artistry is challenged by the promise of a data-driven, team-based approach.  Some  senior professionals decide that this transformation is more than they can stand, and abandon the enterprise while publicly decrying the new paradigm.  Others remain with the organization but passively resist the movement.

By now, healthcare executives and physician leaders recognize this story.  Healthcare reform.  Quality.  Patient safety.  EMR implementation.   Right?

Actually,  no.  The industry is professional baseball.  The organization is the Oakland Athletics.  The visionary executives are GMs Billy Beane and Peter Brand.  The story is Moneyball , a 2011 biographical sports drama based on Michael Lewis‘ 2003 book of the same name.

If you’ve not read Moneyball or seen the film, I don’t want to spoil it for you.  But here’s the punchline:  the transformation envisioned by Beane and Brand ultimately resulted in an American League record 20 game winning streak and a 103-win season for the A’s in 2002.  Applying the approach that Beane and Brand pioneered the Boston Red Sox won a World Series soon after in 2004.  The data-driven approach to evaluating and deploying players (Sabermetrics) has become a part of the fabric of baseball, that most traditional of American games.   It’s  evidence-based baseball, if you will.   And it supplements and enhances, rather than replacing, the wisdom and experience of seasoned baseball executives, scouts, managers and players.  The Legacy of Moneyball has also penetrated other sports and businesses as well.

Actor  Brad Pitt plays Billy Beane in the film.  Here’s how he summarizes the plight of his character and team:  “It’s a tough wall to get over, but they had to by necessity in order to survive. They knew if they fought the other guys’ fight, they were just not going to compete, and I think that takes incredible realism and incredible smarts to figure your way out of the box. It changes the way we look at things, and I think that’s one of the big points of the story.”

So the story is a familiar one.   But it’s about baseball, not healthcare.  Right?

Gregory R. Weidner is an internal medicine physician and Medical Director, Canopy Electronic Medical Records, Carolinas Healthcare System.

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