Taking aim with your bow or gun at just one animal is difficult enough. Aiming at multiple targets is a real challenge.

In business, the goals of quality and low price are often targeted, but many times without success. The health care industry is making it even tougher - aiming for three at once.

It's been labeled the "Triple Aim" of health care. Providers in Idaho and elsewhere want the best of three worlds - high quality care, better health for everyone and lower prices. To reach these goals, health care providers will have to beat the odds.

Perhaps the most foundational principle of economics is that we all face trade-offs. Making decisions requires trading one goal for another.

When a business wants to sell a higher quality product or service, it often has to raise prices in order to cover the increased costs of producing it. Over time we have seen quality rise and prices fall for some goods, like computer technology. But day-to-day, business owners usually have to sacrifice one for the other.

In health care, society demands both high quality and low prices. Additionally, there is the idea that health care providers are supposed to work against their own financial interests and help you stay healthy.

It all makes for a difficult business to run, but many are ready to try.

Dr. David Pate, president and CEO of St Luke's Health System, has made all three goals a strategic focus for the entire enterprise. He says, "St. Luke's is focused on delivering the triple aim of better health, better care and lower costs to our patients and our communities"

Northwest Nazarene University graduate student Virginia Henson is studying the issue and has learned that the triple aim in health care may help improve performance by delivering care that is more patient-centric. Such an approach could overcome what economists call a "tragedy of the commons."

The tragedy occurs when society depletes a shared resource because individuals don't consider the long-term interest of protecting it, such as when fishermen overfish a particular area of the ocean. Nobel Prize-winning economist Elinor Ostrom proposed pooling common resources in health care in order to avoid what she saw as a tragedy of the commons in our use of health care services.

Triple Aim's goal is to get all health care providers and patients alike to coordinate their activities and consider all the possible consequences of actions.

The triple goals, however, are often conflicting and will be difficult to achieve. But just as technology is lowering costs and improving the performance of computers, perhaps it will help meet all three goals in health care.

Henson finds, for example, that while at least two-thirds of physicians in the United States are using electronic health records, more can be done. In addition to improving care, a greater use of electronic systems can increase profitability of health care providers by lowering the direct costs of providing the service and by reducing mistakes or duplication. If electronic records systems lead to the sharing of patient data among specialists, health care providers can take a more community-oriented approach to delivering their service.

The health care industry in the United States has produced amazing feats - overcoming many ailments and extending our life expectancy. If any industry can take aim and hit three targets at once, health care is it.

prcrabb@nnu.edu