Earlier this week, I addressed a great group of thought leaders and visionaries during a panel on the transformation of healthcare through technology at Infocast’s 6th Annual Healthcare Deal Making Summit in Nashville. During my time there, I heard stories about the dozens of ACOs already in operation and business model innovations in healthcare delivery.
However, when asked how far along healthcare transformation is in the United States, many attendees thought we are already quite advanced. Of course, they’re under the assumption that we’ve built the technological infrastructure required to capture, store and share data seamlessly across places of service with providers, who in turn are ready to embrace new business models and master the IT systems in question. This optimism is what I’m referring to as the ‘Wonk View’ of healthcare – an aspirational healthcare system with well-adjusted patients, providers, and lots of solved problems. The problem is this system doesn’t exist yet.
I later attended the AAFP meeting in San Diego, where the scene was a little less idealistic. I heard the physician perspective on measures like ICD-10 (“You mean all this happens on October 1st, 2014?”) and Meaningful Use Stage 2 (“You mean we have to get our patients to use computers, too?”), which more accurately reflects our current system and starkly contrasts the Wonk View. Here, physicians bear the brunt of an increasingly complex and frustrated healthcare system. Patients themselves aren’t far behind, either.
In the span of just three days, it became very clear to me that 2014 will be a particularly challenging year in healthcare IT.
Is 2014 the Make or Break Year in Healthcare IT?
I’ve been in healthcare IT a long time. Ten years ago, attending a physician clinical meeting meant listening to providers express curiosity about the future of healthcare IT. Doctors grasped its inevitability and looked forward to innovation.
Better technology represented a number of possibilities, including faster charting, better decision support, accessibility of research at the point of care, better management of patient populations and perhaps most alluringly, the promise of simplifying non-value-added tasks of medical practice in favor of an increased focus on patient care. In short, there was a perceived return-on-investment to the adoption of clinical software systems.
Sadly, however, the landscape today is much different. There is a noticeable lack of excitement – doctors have lived through Meaningful Use Stage 1 and dealt with dysfunctional vendor relationships, poorly designed products and frustrated staffs. Physicians live in a world that can’t be described or solved inside of a corporate office, resulting in a division between the ‘wonky’ possibilities of technology and the reality physicians deal with. The promise of health IT is scarce – the return-on-investment is harder for doctors to forecast, which breaks my heart.
Let’s look ahead to 2014. Medical practices are now attesting to Stage 2 Meaningful Use, where they have to demonstrate interoperability of their EHRs and somehow engage their patients to use patient portals when it’s already hard enough to get them to follow medication regimens. On October 1st, the entire U.S. healthcare system – nearly 6,000 hospitals, more than 600,000 doctors, hundreds of software vendors, claims clearinghouses, pharmacies, long-term care facilities, etc. – will have moved over to ICD-10 on the same day.
Health IT vendors will feel pressure, too. Only 80 of the 400+ vendors in the market are currently certified for the 2014 criteria, and recent data from this year’s Physician Profitability Index (PPI) indicates that 20-25% of physicians are also dissatisfied with their current systems and plan to undergo a system change in the next twelve months.
By December 31st 2014, the day before the ACA’s individual insurance requirement penalties go into effect, millions of newly insured patients will have been absorbed into the healthcare system, seeking access to services that were previously deferred due to lack of coverage. With all these stressors taken into account, it’s very possible that 2014 could be the straw that broke a very fatigued camel’s back.
Healthcare IT Vendors Need to Step It Up
Meaningful Use Stage 2 creates a healthcare infrastructure that patients, government, and payers could potentially benefit from, but its ROI and clinical benefits are not yet clear. ICD-10 does not help doctors treat patients more effectively in the near term, nor does it boost profits. Plus, the nationwide influx of 30 million patients into the healthcare system after the ACA kicks into gear isn’t making things any easier. So how do physicians get through the next year?
In short, vendors have to step up their games and help physicians out to make the Wonk View of healthcare a reality. With great challenge comes great opportunity, meaning 2014 could result in significant innovation across several dimensions:
- Hiding the complexity of ICD-10 in well designed, user-friendly tools, ensuring uninterrupted reimbursement
- Developing EHR technology that is actually smart, fast, and usable
- Cloud-based innovation to support seamless interoperability across care domains
- Innovating socially driven technologies to engage patients.
The method to accomplishing these goals is simple, even if the task is arduous. We need to bring our best and brightest ideas to the table, using the latest technology delivery models in ways we never thought possible. Only by leveraging innovations in software delivery developed in the last few years is the Wonk View of healthcare transformation even conceivable.
With that said, I believe it’s very possible to build the technological infrastructure we spoke about in Nashville – where providers can capture and share data, embrace new business models, and master useful health IT systems – so we can equip physicians to handle the regulatory and systemic pressures discussed in San Diego. Maybe the Wonk View of healthcare isn’t as idealistic as it seems.
Edwin Miller is Vice President of Product Management at CareCloud, where he is responsible for the ongoing development of CareCloud’s complete product suite for the physician practice market. An industry veteran, Mr. Miller has over twenty years of experience in product development and engineering for healthcare technology. Follow Edwin on Twitter: @EdwinMillerHCIT
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