A recent JAMA article on ACOs is a very common sense, succinct summary of healthcare’s future challenges. As recently described by Francis Crosson, senior fellow at the Kaiser Permanente Institute for Health Policy, and despite the justifiable criticisms of the Affordable Care Act, Accountable Care Organizations cannot fail. They will, in some form, define the future of healthcare, and underlying their success is the collection, measurement and feedback of data to healthcare organizations and patients; and the management of cultural change driven by that data. The title of the JAMA article’s last paragraph sums it up nicely– THE WAY FORWARD: MEASUREMENT AND MANAGEMENT.
As dramatic as the changes feel now, the data ecosystem of healthcare needs to change even more dramatically, but current healthcare IT vendors and systems are saddled with application architectures that simply can’t keep up with the rate of change. It’s like trying to transform an office building in a manner of days that is built of concrete inner walls–we need modular inner walls to meet the needs and deadlines. As one EMR vendor CEO recently bragged (ironically) 60,000 labor hours were required to change their application to meet Meaningful Use requirements – and Meaningful Use is an easy hurdle to clear in comparison to what lies ahead.
If ever there were a ripe market opportunity for disruptive innovation to displace entrenched, concrete walls of old-school thinkers and technology, now is the time.
I enjoy your insights in your many posts on this site. As a software innovator, I would be very interested in hearing your perspective on what specific limitations the “disruptive innovation” should address.
Thanks very much,
Dale Sanders says
Thank you, Aaron. You ask a great question and one that I’ve been thinking about in the background for quite some time. It deserves its own blog, but in short healthcare IT vendors and application developers need to adopt more modern application development– basic stuff like OOP and loose coupling. Most importantly, the vendors need to occasionally plan for total technology refresh– for example, re-engineering their data models; and dropping their VB code in favor of C# and .Net for example. At a higher level, once these vendor applications are more open and more extensible, they need to adopt simple ideas and concepts from banking (financial transactions to healthcare payment), airlines (reminders and healthcare itineraries), Facebook (Check In, easy mix of broad and narrow messaging), and Amazon (clinical orders). Part of the innovation in healthcare needs to occur at the reimbursement and payment levels, which is beyond the scope of change for software– that’s the land of legislature, policy, and culture. But in the meantime, better software can make these changes easier and faster.
Hope that helps!