Every year I go to the annual HIMSS conference. It is a wonderful learning opportunity and a great opportunity to exchange ideas with friend and colleagues. I look forward to going each year, but recently I have come back wondering what is it we are doing as an industry, and where is the innovation.
I have a habit of spending time with the small vendors. In years past I have found some innovative technology or process which I was able to translate into a solution for a problem my organization was facing. But for the past few years I have come back uninspired. I am not sure if it’s me getting older, a bit more cynical, and a lot more demanding or if the healthcare community vendors are just missing the mark on what we need to do as an industry. I know healthcare is a business and healthcare IT is a huge business but there must be more to it than trying to sell me something. Several large vendors no longer have presence at the convention sighting the large cost and low profit margin in an event like this I understand and am not faulting them. But there must be more too it. How do we harness the enormous energy and effort and translate it to better patient care.
As you can imagine the topic of great discourse this year were HIE’s. Everyone with whom I spoke wanted to be my partner and sell me a platform for a health exchange. I saw some wonderful tools for moving data but no one was able to tell me how that platform could help me or my health system deliver better care. It seemed to me we are all so fascinated dare I say seduced by the prospect of moving data from point A to point B but no one was able to tell me why I should do this and for what purpose. So I ask the question. Where is the value of transporting data for a physician, a health system, and the patient? It is here, at this question, the lack of innovation becomes obvious. Where is the business model to expand and develop this technology? It cannot be just the ARRA dollars or OBAMA BUCKS as I have come to call them. There must be a value proposition that makes this work meaningful.
I think for the physician and the health systems we must find the leverage that makes this work worthy of the time and money. So assuming we move data from A to B what am I going to do with it. For the physician specifically the primary care physician I know I must save them time, help the streamline there practice and help them attain a full basket share of appropriate reimbursement. The healthcare information contained in their electronic record is a strategic asset. We must put in place the tools or service to help them analyze that patient population, improve outcomes and capitalize on reimbursement available in pay for performance and PQRI reporting. How about a tool which reviews a patient record, assembles a summary, identifies potential gaps in treatment and recommends next steps. Would that not make data movement meaningful? Would that not yield better quality? I think so, but I have not seen it yet. It is this type of innovation that is missing in our work. I know the barriers are steep but I think this will yield better care, meaningful care, and a model where all the participants find value. Help me think this through, comment, and offer ideas and let’s see if we can start to change healthcare for the better.
BobColiMD says
Dear Mr. Morreale,
As Institute for Healthcare Innovation founder, Donald Berwick, MD has wisely noted, “The excellence of the status quo is a sentimental illusion.” Most, if not all practicing physicians share your frustration with the lack of innovation by healthcare community vendors that would finally increase the usability of both HIE and EHR platforms, save time, enhance clinical workflow, help them deliver better care and create a business model where all participants find value.
One giant industry-wide opportunity for collaborative IT innovation that is still being completely overlooked is the persistence in HIE and EHR platforms of archaic and inefficient processes to report the cumulative results of all 6,000 different diagnostic tests for viewing and sharing by physicians and patients.
The problem is fragmented, incomplete test results data displayed in variable reporting formats. The clinically logical solution is an intuitive, standard format that displays only complete, integrated information of high quality.
I’d be happy to discuss this specific opportunity to change healthcare delivery for the better with you at any convenient time.
Sincerely,
Bob Coli, MD