Friday, February 10, 2017

I Reckon It Is Really Hard To Disagree With This Sentiment!

This appeared last week.

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.
January 30, 2017 12:35 PM
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.
More here:
I wonder what Mr Bush (and yes he is from that famous family) would think about the extreme user hostility of the myHR? I suspect he would want to see some work on that too!
David.

4 comments:

Andrew McIntyre said...

When you set goals (ie Gov $$) the software drifts to those goals, but surely user experience and workability are important. The government goals should be patient safety through compliance with consensus standards and not artificial targets like government created standards that are unproven. Driving systems to comply with government mandated or bankrolled new standards will reduce usability. Currently we have poor compliance with standards actually in use and no government pressure to fix the problems in what is in actual use. Instead vendors are forced to divide their time between government mandated new creations, with unproven value, and usability for users, rather than a requirement to do what they already do safely and make systems usable. I am not sure I can identify one government initiated target in the last 15yrs that has yielded any long term value. They have spent $2 billion achieving zinch to date.

By setting targets that are of unproven value we actually reduce the safety and usability of medical software. Thats the sad story of the last 15 years. More of I'm from the government and I am here to help! Unintended consequences abound.

Bernard Robertson-Dunn said...

I may be naive but, IMHO. the primary goals should be better health outcomes. Preferably more effectively and efficiently, but like any optimisation, you often can't have all three.

Anonymous said...

re: 10:30 am ... with respect .... "better heath outcomes" .. is all well and good, sounds great, used everywhere BUT that more often than not is where proponents stop. They feel comfortable that this nonsensical motherhood is more than sufficient as a goal in itself and does not need to be expanded.

Anonymous said...

Andrew McIntyre - congratulations - please go to the top of the class. Government should be nurturing and supporting vendors; instead Government impedes them with strategies designed to compete with them, undermine their viability and divert them from what they do well. The bureaucracy is destroying our home grown health software industry.

"Vendors are forced to divide their time between government mandated new creations, with unproven value, and (unproven) usability for users, rather than a requirement to do what they already do safely and make systems (increasing more) usable. I am not sure I can identify one government initiated target in the last 15yrs that has yielded any long term value. They have spent $2 billion achieving zinch to date."