Bringing simplicity to complexity

9 January 2018

Maybe you’ve noticed the same thing that I have when attending national or international research conferences. A speaker starts with a PowerPoint-slide that has a picture or an infographic about the theme of the presentation. The slide might show how everything is connected – the big picture – or it might show which components affect the matter in hand. At that moment, many of the listeners take out their smartphones, lean towards the screen and take a photograph of that slide.

The example shows us that an audience wants to hear it from someone who understands the big picture and can represent it in an understandable way – they want to hear it from someone who is an expert. A good speaker might just rely on this one slide and talk the audience through the theme. What can we learn from this?

“Nobody knew healthcare could be so complicated” stated Donald Trump, the President of the United States in February 2017. Well, health management professionals did. In order for a reform to succeed, someone has to give out a clear picture about where we are coming from, where we are going, and most importantly – why is the change so important. Sounds like a job for a politician, but is it?

When introducing a health reform, the questions of the citizens and residents are usually not technical, although we professionals often try to provide them answers wrapped around professional jargon. Most residents do not care about financial incentives of the health care providers or cost-effectiveness of the hip surgeries. Politicians on the other hand might be interested in questions like how much does it cost and how long does it take to be implemented? We as health management and health policy professionals are usually caught in the cross-fire trying to fill in the blanks with the help of research. When reality is attached to the vision of how things are going to play out, there are difficult and often technical questions to be answered.

In many cases, we health management professionals are keeping the dialogue open between politics, policy and practice. In these situations, we want the audience to again take out their smartphones, not to scroll down Twitter feeds in boredom, but to take a photograph of the big picture we are showing them. Politicians, as well as citizens, want to have an expert at the table with knowledge of how all the pieces of the health care puzzle are linked together. Without understanding the big picture, chances of failure are high whether we are talking about health system reform or redesigning hospital admission procedures.

The challenge comes from the paradox where research focuses on areas of health-related research that can be quite restricted to particular topics, not the whole system. At the same time, connecting the dots is what is quite often asked for. When someone does that in a research conference, the audience is rushing to the front row.

Sir Richard Branson, the British business magnate, has said that complexity is our enemy. We all know that health care can be a highly complex system where turning one knob can have severe effects if not planned properly.  We can and we have to bring simplicity into complexity for the decision makers and for residents so we don’t end up with failed reforms. We can start by improving how we communicate our research findings to each other. So, see you at the EHMA Annual Conference in Budapest!

Kimmo Parhiala – EHMA YAC, January 2018


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I have been active in EHMA since the first years of the '90s and I have seen its evolution from a small association of members interested in sharing knowledge on health management practices to the current status of reference and advisory key player for EU, health systems and organisations, stakeholders associations, industry and universities. EHMA is now a unique knowledge hub, policy advisor, community of practice and network of best in class organisations involved in health policy and management. A place where health managers can build their competences, policy-makers and stakeholder associations envision how to implement and sustain change through health management, industry leaders understand how to engage more effectively with health organisations and systems. The right place to nurture and grow health management capabilities and capacity for every stakeholder of health systems.

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Health workforce has become more essential in operating, managing and maintaining health systems lately, particularly in crisis and emergency situations. European healthcare professions and the workforce need to be high on the agenda of managers and decision makers. The Health Services Management Training Centre, Semmelweis University in Hungary is a longstanding EHMA member, because it connects us with collaborators and experts, with whom we can have complex debates, from whom we can learn and at the end find solutions in various challenging fields of healthcare management.

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