Former Utah Governor and Health and Human Services Secretary Michael Leavitt at HIMSS17 in Orlando on Tuesday.

Jonathan Bush: Time for a health IT arms race

athenahealth’s CEO said that hospital executives should stop tolerating software that users hate and, instead, demand a new set of core competencies from their technology vendors. And he pointed to Waze, Google and Kayak as examples to emulate.
By Jonathan Bush
12:35 PM
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Jonathan Bush athenahealth

New technologies in consumer markets (travel, shopping, social/networking with friends, etc…) are continually drawing in people, creating new demand curves, while healthcare – with its faxes, beepers, legacy system software – remains comfortably and obstinately entrenched in its frozen time bubble. In short, we haven't seen any 'break all the laws' bids in healthcare – like what Uber did with ride sharing or Amazon for shopping. 

That said, I'm an optimist. Despite the glacial-like pace of groundbreaking health information technology to date, I predict that in 4 to 6 years we'll see an explosion of networked-backed health services that come with a loyal commitment and proven ability to chip away at our industry's massive cost overrun and inefficiency issues. If they're going to stick, however, they'll need the right adoption incentives and network from which to grow. 

Back in the day, health IT vendors were king if they could convince potential buyers that they had mastered the meaningful use game. With MACRA and MIPS, not much has changed; vendors still remain on the hook for helping provider organizations report against government programs. This is the easy stuff, as evidenced by the massive glut of government certified solutions.

But as reimbursement models, both public and private, shift to demand quality beyond just reporting, so too does the job of health IT. I find it satisfying that the playing field will no longer be defined just by "check the regulatory box" systems, but will become an arms race to determine which health IT partners will play the most meaningful role in driving actual performance. A definite sorting of the wheat from chaff. 

As such, it's time for health IT buyers to start the arms race, to demand a new set of core competencies from health IT systems and the vendors who sell them that work in service to the organizations that use them. Some of the most successful companies in their respective industries like Waze, Google and Kayak, tap into the power of networks to deliver valued results to their users. Shouldn't health IT systems follow suit?

If healthcare operated off of a networked infrastructure, data would be stored holistically, rather than trapped in silos at individual organizations. Data could be viewed comparatively so insight into clinical, financial, and operational performance is not limited to a single site, but could be benchmarked across an entire network of peers. Bright spots could be found. Best practices identified. Inefficiencies corrected at scale.

Data put to use in this way means greater connectedness to care happening outside a health system, too. Transparency like this would mean better planning against priorities such as keeping schedules full; providing value to affiliated groups; managing at-risk populations; and gaining better visibility into the behaviors of providers across multiple medical groups and systems.

The brilliance of "the network" is that it sits on an open API-enabled platform from which innovation can not only be introduced, but can be introduced quickly and broadly. Legacy servers in basements (software) can't do this. Just as downloading a "must-have" app from the app store is second nature, health organizations should be able to shop for the best solutions to plug into their EHR and practice management service – and be up and running in quick order.

With networked healthcare, access to the latest innovation becomes the norm – from the 400-bed academic medical center seeking to cut costs by integrating telepharmacy tools to the suburban three-doc practice looking to maximize clinical staff time with digital check-in.

Stop tolerating what you have. If your system, your software, doesn't drive clinical and financial performance, demand that it does. If your vendor doesn't coach you to perform, or doesn't have a business model that hinges on you doing well, ask why. The shine of being government-certified is wearing off, and the days of implementing health IT systems to collect a subsidy are over.

Health IT needs to jumpstart smarter, better and more efficient healthcare – which in my humble estimation – can only happen when purchasers demand change and embrace a networked platform. To compete, you should be asking more of your system as success more than ever isn't about being digital, it's about setting out a path for performance. 


This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.


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