Why the Amazon, Berkshire and JPMorgan plans should inspire hospital IT shops to act fast

The entire ecosystem is changing, forcing smart CIOs to keep pace or face significant disruption.
By Tom Sullivan
10:00 AM
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Yes, Amazon rattled the healthcare market on Tuesday when it announced a partnership with Berkshire Hathaway and JPMorgan Chase to create a nonprofit healthcare company focusing on cost reduction, increased transparency and user satisfaction. And, no, the trio did not reveal much in the way of details.

Even still, there are strategies hospital IT executives can embrace immediately because it’s safe to say some kind of change is coming — though we don’t know exactly what it will look like just yet.

“We’re starting to see a disruption model take place,” HIMSS CEO Hal Wolf said. “This is not a one-and-done. All hospital systems have to figure out how to catch up.”

While there is a reason to be skeptical that Amazon, Berkshire and JPMorgan can radically overhaul the industry in short order — and, bluntly, at this point questions outweigh answers — more than just one deal with gigantic disruption potential is happening right now.

Wolf pointed specifically to CVS announcing its intent to acquire Aetna for $69 billion and DaVita selling its managed care group to Optum in a $5 billion deal as two recent examples. Apple revealing its plans to add medical records to the iPhone is another.

“This is going to be a challenge to the medical model. It’s about thinking through the whole ecosystem, which is changing,” Wolf said. “This could, and I emphasize could, be notice that change will be faster and larger than what people would have liked.”  

Rasu Shrestha, MD, Chief Innovation Officer at UPMC, said that hanging on to today’s ways of doing business only makes hospitals vulnerable to failure and, ultimately, being rendered irrelevant.

“I'm excited about the waves of possible disruption. I just hope these waves will be based on substance, and not just hype. Therein lies the opportunity for forward-thinking health systems,” Shrestha said. “Health systems must be proactive in their approach to not just tackle the everyday challenges of what we know as health and care today, but to redefine the very notion of ‘healthcare’ in the bold new world ahead.”

Palmetto Health-USC Medical Group Executive Director of Clinical Informatics Nick Patel, MD, agreed that disruptors such as Amazon, Berkshire and JP Morgan should inspire large healthcare organizations to think differently about care delivery, quality improvements and patient experience.

“Amazon is going to be very innovative on how their employees receive care by likely providing apps and IoT devices to monitor health,” Patel said. “They will also likely use gamification to reward employees for better health. Amazon gift cards anyone? How about only buying healthy foods from the Amazon Pantry at a discount?” 


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It’s not just Amazon, either. Patel said JPMorgan and Berkshire Hathaway have the potential to advance transparency, leverage economies of scale and bring expenses down to revolutionize cost-savings. 

“With Apple improving how patients records are accessed and shared, duplication of labs and other tests will hopefully be reduced,” Patel added. “Companies are fed up with rising costs and lack of improvements in patient care and safety to show for it. I am looking forward to learning more about their strategy on tackling these challenges, so we can mirror them at our organization.”

But how, exactly, can hospital and IT executives actually make all that happen?

Wolf recommended focusing on three action items: craft a strategic plan for unknown connectivity, think on a network basis, and train your workforce for an outside-in approach to exchanging health information.

Strategic connectivity. CIOs who have not already done so should be thinking strategically about connectivity with unknown services, features, institutions with different information feeds, Wolf said, and that includes understanding what you want to accomplish and knowing how to partner accordingly.

Think on a network basis. “I don’t know a single CIO that isn’t slammed now with change management, implementing new systems, cybersecurity, designing networks,” Wolf added. “The design of that architecture has to include an outside-in approach to care and exchange of data and information versus an inside-out approach, more so now than ever.”

Workforce training. Wolf said the need to train staff in terms of information for that outside-in approach is an increasingly common issue and hospitals should be creating a working platform to address both network and human standpoints.

That means hospitals have to start cultivating the necessary skills for the rise of consumerism in healthcare, according to Bill Russell, CEO of Health Lyrics and former CIO of St. Joseph Health.

“Health systems may want to take this moment to sit across the table with the largest employers in their community to develop services that address their specific needs,” Russell said.

That tectonic shift should also include making it easier for patients to do business with you, said Will Weider, a long-time healthcare CIO. 

“We need to recognize that our customers don't want to be restricted to business hours that don't fit their schedule, or having to make phone calls to conduct business,” Weider said.

Weider added that, for the most part, even seemingly simple tasks, such as registering to use or resetting portal passwords and scheduling are often difficult in healthcare.

“Amazon isn't the leading retailer because of price or selection, it is because it is so damn easy to buy things from them,” Weider said. “When it becomes easier to do business with someone else, there will be no loyalty to a healthcare provider.” 

All of this is not to say that hospital executives should fear Amazon, CVS and Apple. Rather, they do have advantages in terms of know-how and real-world experience, UPMC’s Shrestha said.

“These attributes should not be excuses to hold us back, but rather fuel to propel us to reimagine new care models, embrace what's worked, and rethink products, services, and culture across healthcare in ways that have never been done before,” Shrestha explained. “We must be bold, we must be steadfast, and we must be intelligent in our approach.”

Regardless of what Amazon, Berkshire and JPMorgan ultimately create, whether it’s called Healthcare 3.0 or something else, Wolf said it will inevitably have to connect back into the medical model.

“Whatever sits on the outside has to reach into hospitals, clinics, it has to play in a space where the two are connected, it has to be an intersection back to the medical model for whatever virtual idea they come up with,” Wolf said. “There’s a huge play in interoperability that gets a big refresh almost immediately. CIOs need to be really thinking about how to bring this all to bear and be able to connect to whatever comes down the line in a secure model.”

Twitter: SullyHIT
Email the writer: tom.sullivan@himssmedia.com