As Health Data Management wraps up 27 years of reporting on the healthcare information technology industry today, it gives me a chance to pause and reflect, and to look hopefully toward the future for the industry.
Much has been accomplished. I recall an early HIMSS conference at which an exhibit featured a one terabyte database of images of the globe. It was powered by rack upon rack of networked individual computers. It was a marvel. Now, 20-plus years later, you can hold a terabyte of data in a USB memory stick.
So, too, has technology adoption accelerated at a breathtaking pace. Twenty years ago, electronic health records were in the domain of pioneers. Now, the vast majority of medical care providers have an electronic means for storing medical information.
And it’s not just health information that’s been digitized. Medical and pathology images, lab results, genomic profiles and more are on computers. Medical data, and the information that is derived from it, is growing at exponential rates.
But more does not necessarily mean better. More medical knowledge has made care delivery complex. Information is squirreled away in siloed systems. Clinicians often face the task of finding information in parallel systems and integrating it in their heads. Worse, patients sometimes are forced to be the de facto health information exchanges to transport their data from one provider to the next. Worse yet, we demote clinicians to clerics who click on boxes and type in notes, rather than arming them with the intelligence they need to make wiser decisions for patients.
The next, essential frontier is to facilitate the access to information that serves the provider, the doctor, the patient. Data needs to be seamlessly integrated so that it’s easy to find, easy to digest and easy to manipulate in one place. Technology must serve the most valuable commodity in the healthcare equation—the hands-on care provider—while serving the most important customer—the patient.
Think of this simple illustration. You can buy admission tickets for a sporting event or opera from a phone app. It will show you what’s available; it will show you the view from a particular seat; it will compare prices to show you a ticket that’s a relatively good buy, compared with a ticket that’s overpriced. As a consumer of data and information, you instinctively know that this is a combination of technology that’s making your life easier.
That’s where healthcare IT needs to get to. At every turn, it needs to make things easier. The byproduct of that will be increased efficiency, which at least offers the opportunity to save time, money, patients’ lives and physicians from burnout.
Then, in addition as a society, we need to come to a consensus on what constitutes good, cost-effective care. Much of the debate around healthcare boils down to on whose ledger a cost will appear. Insurers don’t want it as their cost; some federal legislators don’t want it paid as part of a federal program; and providers don’t want to deliver care when there are questions about who will pay.
This results in a reimbursement system that plays hot potato with the bill. As a result, chronic conditions that benefit from regular, ongoing, preventive care gets worse, so instead of a dozen $ 50 physician office visits over the cost of a year, treatments are delayed until a $ 100,000 emergency department visit is required—and the patient may not survive.
Value-based care is a step in the right direction, but only a minimal step. True healthcare delivery improvement that has the potential to actually make major strides has to get every component singing off the same sheet of music. The song is the optimized health of the consumer; the pieces of the orchestra are the components of the global system that have historically warred and now must work in harmony; and as a society, we must agree on a composer/conductor who we vest with the responsibility to bring it all together.
Finally, as a country, the current paralysis from polarization must end. Resolving crises such as healthcare, income inequality, immigration and more can only be solved by compromise, in the classic definition of what politics is meant to achieve. The process has been bastardized and rendered useless by those continue to stoke divisions, above all else.
Solving healthcare—or any of the other vexing issues we face—is not impossible. For the common good, citizens rationed goods and bought war bonds to win World War II. We put a man on the moon with less information technology that is now contained in a Speak & Spell electronic game. If national unity is perceived to be the crisis that it truly is, surely we could surmount our differences.
We have a variety of tools in our hands. Healthcare IT is an enabling component that can provide part of the solution. We need the will to use it for the greater good. Whether it’s healthcare or our future as a country, let’s coalesce around the greater good of the greatest number of people.