A history of our healthcare future

By John Halamka
11:01 AM
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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.