The change we seek

Health IT developers offer their hopes for 2013
By Mike Miliard
12:00 AM

Free the data! Empower the patient! Break down those walls! Collaborate! Innovate!

Those are not revolutionary slogans, say the IT vendors  -  developers of electronic health records (EHRs), real-time location systems, data exchange technology and more  -  polled by Healthcare IT News for our year-ahead issue.

Free the data! Empower the patient! Break down those walls! Collaborate! Innovate!

Those are not revolutionary slogans, say the IT vendors  -  developers of electronic health records (EHRs), real-time location systems, data exchange technology and more  -  polled by Healthcare IT News for our year-ahead issue.

Rather, their wish lists for 2013 simply reflect the necessary steps the healthcare industry must take to truly effect the change we all want to see.

"My greatest hope is that 2013 is the year that hospital IT executives and physicians can link arms and become effective collaborators," says Paul Brient, president and CEO of PatientKeeper. 

He bemoans the fact that the "propagation of physician-facing applications  -  CPOE, medication reconciliation, and all manner of EHRs" in the past several years has "had the unfortunate effect of pitting physicians against IT." Often less-than-optimal user interfaces have led to reduced physician productivity, he points out. "There's no other industry in the world that would accept reduced productivity as an outcome of automation." 

In the year ahead, Brient would like to see docs and developers working together to "initiate a virtuous cycle of increased productivity, cooperation and, ultimately, improvements in delivery of patient care," he says. 

Eric Leader, director of product management and business intelligence at Harris Corp., has similarly high hopes for outside the hospital walls. "The biggest gap I see in the United States is population management in the community  -  that includes not just the traditional disease registries, but providing the tools and supporting the process of collaborative care across the community of affiliated and unaffiliated providers," he says. "We've got bits and pieces, but we don't really have a complete solution."

In the next 12 months, Leader hopes to see some strides made in pulling those bits  -  population management tools, health information exchange, secure communications, master patient and provider indexes, care management technology, business intelligence, reporting and dash boarding  -  together.

"I don't think we'll see the whole integrated package, and there will be some gaps in the workflows," he says. "But I think we will see some vast improvement. We're starting to see a whole lot more interest from ACOs and clinical integration networks in more of a consolidated approach. What we see declining is the expectation that a monolithic EHR is going to be able to do all that."

For Edmund Billings, MD, chief medical officer at Medsphere, developers of the OpenVista EHR, continued progress on reimbursement reform and accountable care organizations  -  whatever it takes to incentivize on quality of care is good to help drive the benefit of health IT.

"Meaningful use has been a nice kind of stimulus and has gotten people moving in the right direction, but it won't really take hold until the reimbursement model shifts to help control costs and control quality," he says.

And, of course, he'd like to see wider adoption of open-source technology. "Healthcare is behind the curve on IT in general, and way behind the curve on open source," says Billings. "Open source is pervasive in other industries. And in healthcare it's negligible. Open source is about collaboration, and healthcare is about collaboration." But too often, he says, "The lack of interoperability has become a business model. Closed systems have become the proprietary model. Healthcare needs the opposite."

Rick Lee, CEO of Healthrageous, hopes 2013 will be a year in which we stop paying lip service to patient empowerment and actually do something about it. 

"We have to become adults about what information the consumer is entitled to and what information can only be obtained through your doctor," says Lee. With physician shortages looming and the emphasis being put on patients managing their own health, "We need to have the tools."

Access to information is key. "If I go to Quest or LabCorp and have a blood test taken to see how my diabetes is doing, I have to go make an appointment with my doctor in order to get those results," he says. "The lab shares them with my doctor, but not with me. How silly is that? It's just insane how we infantilize adult Americans and treat them like they're children that aren't allowed to see certain information. And yet we don't have enough doctors to share the information in a timely way with consumers."

With more than 40 million newly insured patients only exacerbating that physician shortage, Margaret Laub, president and CEO of Intelligent InSites, the developer of real-time locating systems, wants to see more technology being deployed to spur operational efficiencies. 

"For 2013, we look forward to healthcare providers embracing new enterprise platforms with open and flexible designs and innovative operational and clinical quality applications  -  and which are based on automated sensors and real-time data collection, mobile technologies and secure cloud computing solutions," she says. 

Paul Grabscheid, vice president of strategic planning at InterSystems, offered his own provocative hope for the coming year.

"My wish is to banish the term 'health information exchange,'" he says. "While exchanging data is useful, it's not nearly enough to achieve the quantum improvements needed in outcomes and efficiency."

Rather, said Grabscheid, "We need to focus on aggregating, not exchanging, data, in order to provide a complete, holistic picture of each patient. Achieving more accountable care models will take more than messaging. To ensure the best outcomes across all care settings, clinicians need to have the most current and most relevant patient information at their fingertips."

Finally, JaeLynn Williams, senior vice president at 3M Health Information Systems, said she hoped the industry would "free the data and open the workflow" in 2013.

"Clinical data collected by EHRs has tremendous variation, so it can't be easily mined or freely shared between people and institutions," she explains. "Standardizing and normalizing data as it is stored is an essential first step in making it accessible and usable. We know how to do this, but as an industry we haven't made the effort. More importantly, we need to create open access to the vast stores of clinical data that exist within healthcare."

"Right now this data is available to only those who collect it, and is limited in large part to the proprietary systems housing the data," she adds. "We need to free the data to drive better healthcare and better tools and systems. Eliminate barriers to data, and we will unleash an innovation firestorm."