For more than 50 years, the Boston Ballet entertained audiences around the world with classical dance such as Swan Lake and the Nutcracker. As information technology advanced, the Boston Ballet deployed numerous systems to manage ticketing, payroll and personnel management in an effort to automate processes and lower costs. In spite of these efforts, the budget for the Boston Ballet rose every year leading to progressively higher ticket prices and a greater need for grants and donations. A performance of Swan Lake requires a minimum number of “swans,” soloists and principal dancers. Mikko Nissinen, the current artistic director, cannot progressively reduce the number of dancers to lower costs.
In many ways healthcare is like Mikko’s ballet company. Although information technology can enhance care planning, assist in medication administration and reduce duplicative testing, it cannot replace the people required to deliver care services to patients. Nurses are needed to administer medications, therapists are needed to provide treatments, and physicians are needed to diagnose illnesses and provide treatment plans. On average, hospitals devote close to 70 percent of their budget to labor costs. Until robots replace humans in the delivery of patient care, selection of the proper skill mix and number of nurses remains a significant factor that determines cost in provider organizations.