We are currently at a crossroads in the healthcare industry. Executives are working overtime to try to figure out how to connect and integrate data to best support clinical practice and patient care management. With health systems concerned about balancing both needs, they now need to figure out how to leverage data to get the best value out of their investment. Improvement and innovation in technology are slowly but surely enhancing the industry, but health systems are constantly being assaulted with software companies trying to sell them something. Thus, healthcare executives are left with the eternal question: Which pieces fit together best to create value and improve patient care?
Innovation in healthcare is critical; it helps enhance quality patient care and improves workflow drastically. However, to encourage the innovation we need in healthcare, a cultural change across the industry is required. Collaborations across the healthcare industry need to occur to improve current processes, and to ensure the patient is the priority in everything we do. The changes we make should encompass this mantra and focus on putting the patient at the center of quality care.
There is a tremendous amount of innovation happening across the country. Startups and innovators are working to tackle these tough challenges in healthcare by brainstorming creative ideas and inspiring new solutions. Interoperability challenges, however, can create bottlenecks that detract from potential breakthroughs and hinder the piloting process. True transformation requires access to data from the entire longitudinal patient record, overcoming the isolation and silos of traditional healthcare.
As a midwife in the Netherlands for more than twenty years, I have personally experienced how technology in obstetrics has transformed how we deliver care to expectant mothers. With more than 2,000 midwives in the Netherlands, many healthy women – those not typically at risk of complications – choose to receive care directly from a midwife in their own communities. By having access to technologies that have traditionally been found only in the hospital, we are able to provide the best care possible and can monitor for any signs of risk to refer patients to an obstetrician if needed.
I was very pleased to see that U.S. Senator Lamar Alexander is recommending the delay for Stage 3 of Meaningful Use, since it would drive the entire system to its knees. We all agree that the industry needed to change. This has been a bi-partisan initiative that started with President Bush and his appointment of David Brailer as the National Health Information Technology Coordinator back in 2004. For the past decade, this effort has been continued by the Meaningful Use program under the ONC.
I am not criticizing the initial goals of Meaningful Use (Stage 1 – Data Aggregation & Data Access; Stage 2 – Healthcare Information Exchange and Care Coordination; and Stage 3 – Outcomes Improvement). Rather, my extreme disappointment is directed to the fact that we did not pay attention to the first pillar – Data Aggregation and Data Access – to achieve outcomes improvement, which cannot be accomplished without clear and aggressive guidelines on interoperability requirements. Instead, the effort was directed to the implementation of EHRs for data entry, which created silos around few vendors. Of course, the consolidation and collaboration of healthcare providers that resulted from the Affordable Care Act (ACA) exposed the failures of Stages 1 and 2 around interoperability.
The Goldman Sachs report I mentioned in the first part of this series mentions that remote patient monitoring (RPM) enables healthcare providers to better manage high risk patients, potentially decreasing healthcare spending through better chronic disease management. Further, the report notes that most chronic disease spending can be attributed to heart disease, asthma, and diabetes-disease states that represent the most fertile ground for digital health.
Last week, I talked about how the digital healthcare revolution has arrived and its potential applications, including telehealth. Another way this digital transformation is changing healthcare is how it affects behavioral modification and adaptation.
Digital healthcare holds the promise of saving a staggering $305 billion, according to a recently published report from Goldman Sachs. The report predicts the technology revolution will come from increasing access to diagnostic, treatment, and preventative care, coupled with dramatic cost reductions. In particular, they see significant opportunities for digitally-enabled telehealth, behavioral modification and remote patient monitoring, while much of the savings will be generated by the elimination of redundant and wasteful spending in the area of chronic disease management.