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Dishman at MGMA: Reform will work if docs change how they practice medicine

October 25, 2011 | Eric Wicklund, Contributing Editor

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LAS VEGAS – Healthcare reform will only be successful if the nation’s physicians change the way they practice medicine.

That’s the argument being put forth by Eric Dishman, director of health innovation and policy for Intel’s Digital Health Group. A popular feature on the healthcare IT speaker circuit, Dishman presented the Tuesday morning keynote speech to a packed audience at the Medical Group Management Association’s 2011 annual conference at the Las Vegas Convention Center.

[See also: Intel introduces new technology aimed at new approach to care]

His message? America has developed a “very specialty-driven paradigm of care” that emphasizes centralized healthcare instead of distributed care. And that, combined with the current standard of fee-for-service payment, is destroying the American healthcare system.

“Business as usual – practice as usual – is not sustainable and not scalable,” he said.

Dishman, who has worked for years on developing alternative models of care, said the nation’s healthcare system needs to move away from a reliance on hospitals and clinics and toward home-based, mobile care delivery that helps patients and doctors wherever they are. He pointed out that when Intel was studying physicians’ habits to develop a new electronic health record product, “none of the physicians we studied was ever in their office.”

[See also: Mostashari to MGMA: Time is right to adopt EHRs, show MU, move to ACOs]

Aside from what he called the “mainframe problem” of centralized care, Dishman said the nation’s healthcare system needs to focus on moving to a fee-for-outcomes-based payment system. In that sense, he said, the federal government should stop targeting hospital readmissions as a quality measure and focus instead on reducing hospital admissions or emphasizing hospital avoidance.

“We have to start possibilizing other models of care,” he said.

Dishman said physicians need to embrace mobile technology as a means of delivering care more quickly to the patient, with better outcomes and care continuity in mind. They have to acquaint themselves with the new tools of the trade that enable them to communicate with patients at any time and place, and to coordinate care – including wellness – with other members of the care team.

“The next-generation pacemakers are going to be sending 24-hour a day physiological data, and are your systems and people ready for that?” he asked.

Finally, Dishman also brought up what he called “the other inconvenient truth” – global aging. As the world’s population grows, gets older and wants to stay in their homes longer, the healthcare challenges will grow, but the world’s supply of healthcare providers won’t.

Building a team-based care system, he said, will move the nation in the right direction.

“Nobody is happy with the status quo,” he pointed out. “So why are we fighting so hard to maintain it?”

[See also: Intel ready to go to market with its new in-home device]
Eric Wicklund
Editor of mHIMSS.org
Follow Eric on Twitter @eriwick
Related Topics:
  • America
  • America
  • Digital Health Group
  • Eric Dishman
  • Intel
  • Las Vegas
  • Las Vegas Convention Center
  • The Intel
  • Electronic Health Records
  • Enterprise Resource Planning
  • Health Information Exchange (HIE)
  • Mobile/Wireless
  • Quality and Safety
  • Telehealth

Reader Comments (2)Login to Post a Comment

dch says: Looking for ...
October 26, 2011 | 2:03PM GMT

Am waiting to find the busy docs out there who can say their EHR systems don't adversely productivity, overhead or their interaction with patients.

HITECH was created to push what was unable to pass market muster.

Docs aren't Luddites, contrary to the gnashing and wailing of non-clinicians. We aren't stupid. If this stuff was so great, we'd already have been using it.

And right ... start up costs are prodigious. Maintenance ain't cheap, either, and can't be performed by the High School graduate who used to put paper charts together and file them. Plenty of hardware to maintain and to refresh periodically. Careful attention must be paid to security(!), backups, uninterruptible power, various upgrades ...

Whatabout blank says: Misinformed
October 26, 2011 | 12:52PM GMT

Hmmm...I guess the new EHR Intel is designing is strictly an inpatient version? I don't know the context of Mr. Dishman's talk but sounds a bit misinformed. A lot of healthcare happens in clinics, not 'on the go'. The model of home based / house call care is not dead, some have even tried to revive it, but is not a desirable route of patient care for primary care providers where volume = revenue. We need to move away from "'very specialty-driven paradigm of care' that emphasizes centralized healthcare instead of distributed care"...from where I sit we already have a very distributed model of care where primary care refers a patient to the dermatologist for their skin, cardiologist for their heart, and the gastroenterologist for their digestive disorder (none of which takes place in a hospital...it's usually in that specialist's office). I'd like for someone to once talk about the costs related to IT planning, deployment, sustainment, upgrade, as well as the cost impact to workflow and productivity of trying to introduce a one-size fits most product to a group of individuals. What's the impact on 'out of control' healthcare costs for those items?? Further, if we reset the clock to say 10 years ago, what is the cost of healthcare in todays dollars if remove the systems put in place to help make physicians jobs 'easier', produce better patient care, reduce errors etc. Finally, where are the evaluations that show IT has done all the wonderful things it's supposed to do for healthcare...baloney!

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