What we're thinking about

April, 2015

Detour Sign

A few months ago, I wrote about the frustration of the HealthcareIT community with the lack of interoperability in the industry thwarting the promise of seamless care for patients. As if on cue, the Office of National Coordinator (ONC) came out with a draft interoperability plan on Jan 15th. Yet again, the ONC’s tactic was to emphasize better standards being key to achieving interoperability. However, I was glad to see that they did go beyond that, highlighting the need for governance as a key ingredient in achieving interoperability.

As part of this mandate, ONC chief Dr. Karen DeSalvo’s opening letter calls for continued work on standards, along with motivating these standards through appropriate incentives. Desalvo’s inclusion of motivating through incentives is an admittance that even if we had best-in-class infrastructure and standards to support interoperability, there are still extrinsic forces and motivators holding us from achieving true interoperability. This is an important point to highlight. It explains why the promise of interoperability is yet to be delivered, despite spending billions of tax dollars.

While this is progress, DeSalvo's prescription still falls short in my opinion. I am not convinced of the ONC’s hands-off approach. Simply calling for a public-private partnership and relying on “non-governmental governance” (also known as market-based approaches in the policy circles) would not be enough. The incentives that woke this industry up from its slumber came from Meaningful Use and while it has not given us exactly what we wanted (yet), MU does show that the government has taken an active role. It is essential to realize the natural progression here before trying to reach for bigger goals such as risk management and population health management. Only after incentives and payment models pave the path will utilization and committed adoption of healthcare IT solutions follow.

The 21st Century Cures initiative, a sweeping bipartisan effort to address an accelerating world that requires faster adoption of technological advances, could prove to be a harbinger. It assumes the existence of the flow of data, quality reporting, and value-based payments as a pre-condition. While that is certainly admirable as the “long game”, a firm foundation needs to be laid by the government first.

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HIMSS 2015 Sign

Last week, from April 12-15, I had the opportunity to attend and showcase Klio’s product at HIMSS, the healthcare IT industry’s largest annual conference. With over 43,000 attendees, hundreds of exhibitors, and four days of programming, the event provided countless avenues for making connections, obtaining feedback, and hearing the key concerns and interests of the moment. So what did I hear?

Between sessions and through the questions my colleague and I fielded at the Klio Health booth, my key takeaway was that healthcare organizations are beginning to truly embrace the Triple Aim, which includes these key objectives:

1. Improve the patient experience of care
2. Improve the health of populations
3. Reduce the per capita cost of care

In fact, during the conference, HIMSS published the results of a leadership survey in which they found that respondents indicated that implementation of health IT systems had improved patient experience (68%), population health (53%), or the cost of care (51%).

My conversations with providers, systems integrations consultants and journalists seemed to also reflect this trend. Fundamentally, it seems to be understood that health IT can help extend the reach of the clinical staff, and drive workflow efficiencies which will reduce the costs of care. But I also heard that providers truly do feel that by improving the patient experience through tools that engage and involve the patient more fully in managing health, they will also in turn improve the health of their patient populations at large. Then, if data analytics tools can help providers stratify patient populations such that they can focus limited resources on those patients needing the most intensive care, they will further be able to reduce the costs of care.

Sounds simple right? I was surprised to repeatedly hear this refrain.The virtuous cycle outlined here sounds a bit romantic, but in an industry which has been plagued by much doom and gloom, I was encouraged to see that even those scarred by the slings and arrows of tragic IT implementations past are optimistically embracing the promise of new solutions.

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