A history of our healthcare future

January 20, 2010 | John Halamka, Life as a Healthcare CIO

When Stage III of Meaningful Use is fully implemented in 2015, what will our healthcare system look like? Here's my future forward look at the changes in the provider, patient, payer, and researcher experience five years from now:

*Clinicians will become healthcare coordinators, working in partnership with patients to manage wellness using a shared lifetime electronic health record.

*Clinicians will produce a record that is designed to be shared with the patient, instead of just supporting the billing process.

*Hospitals will compete based on the results they achieve rather than the grandeur of their buildings. Transparency in the reporting of quality and outcomes will transform the healthcare marketplace. Patients will have a much better understanding of quality, cost, and outcomes.

*Patients will undergo fewer tests and take fewer medications because redundant and inappropriate care will be reduced. Healthcare value will improve - higher quality for less costs, since less care is often the right answer.

*Patients will have much more choice as consumers. Access to the electronic records including their genomes will enable personalized medicine - selecting the treatments that best align with their care preferences, risk taking thresholds, and physiology.

*Payers will reimburse providers for quality rather than quantity since electronic health records will document the care given and not given.

*Researchers will have access to novel data sources (with patient consent) and be able to discover which treatments are the most effective. This knowledge will be integrated into electronic health records and personal health records so that providers and patients can make the optimal care decisions. Today, there is more literature published every year than a clinician can read in a lifetime, so best current evidence is not rapidly incorporated into practice.

Change is hard, technology is easy. As we navigate the stages of meaningful use in the years ahead, be prepared for amazing shifts in workflow, process, and behavior that will accompany them. Let's hope we can tell our children the history of how we did it!

John Halamka, MD, blogs regularly at Life As a Healthcare CIO.

Reader Comments (2)Login to Post a Comment

Dr Medtech says: A history of our healthcare future - Bravo!

January 25, 2010 | 7:52PM GMT

Thank you so much Dr. Halamka for your futurist and very insightful perspective.

As you so aptly highlight and what seems to be a missing element from today’s dialogue on health care reform, is how enabling health information technologies (HIT) can have an important impact on opportunities to embolden existing stakeholders, create new jobs, and stimulate the grow of small businesses to reduce costs and improve quality of care.

A key will be the "Chutzpah" or courage to continually adopt incentives and test new models that help drive innovation at the state or local levels. These new models can help break the chain of established "practices and habits" that create inefficiencies, drive up costs, and provide disincentive for quality improvement. These seeds of innovation can be planted in a range of activities that include prevention programs, chronic disease management, and long-term care.

Having the frameworks in place at the state, community, or organizational levels to reward new ideas, reject broken parts, and adopt the most innovative practices is a critical component of sustaining and driving your bold vision for 2015 and beyond.

As our friend Machiavelli has said the hardest thing to do is create a new order of things!

........or thinking more optimistically and emphatically, Dr. Seuss would say, "Oh, the places we will go....!!!

Best regards,

JMB

ronpionmd says: virtual practice will be common

January 25, 2010 | 5:28PM GMT

As a fan of yours, permit me to add the following to your scenario. In the coming months and years more emphasis will be directed to servicing' patients' and their caregivers' needs wherever they are. Once relationships have been developed, continuity of care will take on a more expansive role without the necessity of being in the physician's presence. Realtime expertise will be available as needed via a secure internet connection.....conducted by teams of providers. A physician can be the 'team' leader in instances wherein he/she is needed. Other members of the team i.e. nurses, social workers, dieticians, technicians, wellness coaches etc. will be given more responsibility. Once folks recognize that we are all creatures of habit and that habits can be changed with practice, motivation and guidance....we will come to a conclusion that change need not be 'hard' if one wishes to change (purpose) and has learned how. Respectfully submitted.