There’s little doubt that IT will play a growing role in how healthcare organizations deliver services, but without buy-in from the business units of the operation, technology alone will be of limited effect, experts warn.
“The future is not defined by the technology people. It’s defined by the business people,” Jon Zimmerman, vice president and general manager of clinical business solutions at GE Healthcare, said at a recent event hosted by the Bipartisan Policy Center, a Washington think tank.
Ideally, the march of technical innovation in the healthcare sector would track and support the broader trend of a shift away from the fee-for-service model and toward a more transparent and value-driven framework that is better equipped to address population health and produce timelier patient interventions.
And supporters of that shift argue that technology will play an essential role in generating real-time data and breaking down barriers between disparate systems.
“Delivery system reform cannot happen without innovation and without information technology. It’s impossible,” says Katherine Hayes, director of the Bipartisan Policy Center’s health project.
But experts also agree that there is no profit in simply throwing new technologies at an industry already struggling to integrate the IT systems currently in place.
EHRs Are Walled Gardens of Data
For instance, electronic health records (EHR) are already in broad use in hospitals and large provider networks, but those systems come with their own share of challenges, including limited interoperability and the absence of analytic tools and applications to produce useful insights from the data they collect.
“Where most health systems are today is they’ve all just spent millions and millions of dollars implementing EHRs of one flavor or another, and are now sort of at the point of discovering that there’s a whole new range of tools that need to sit on top of those EHRs that actually let them get value out of the data that they’ve got,” says Chas Roades, chief research officer at the Advisory Board Company.
Roades notes that while vendors have been gradually improving their systems to better communicate with one another, the utility of EHRs remains limited when they function as “walled gardens of data.”
Another concern arises with the proliferation of health data from a variety of sources, including many applications and devices that might be outside the control of IT, raising questions about the trustworthiness of the data and the value of inferences gleaned from it, as well as the needle-in-the-haystack problem that emerges from the sheer volume of data being collected.
“It’s a lot,” says Rhonda Medows, chief medical officer and executive vice president at UnitedHealthcare. “It’s evolving and it’s changing and it’s just a huge volume. And unless you’ve actually got the capacity to deal with this many different and varied sources of data streams, you end up with just basically a warehouse of stuff that you can’t actually act on.”
Some in the medical community suggest that EHRs and other health IT systems would be most effective if they were to fade into the background and minimize the interaction required with the care provider.
Kavita Patel, managing director of clinical transformation at the Engelberg Center for Healthcare Reform, says that practitioners would welcome technologies like motion-capture gesturing systems that would “do away with the computer in the room.”
“Any of these workarounds or kind of ‘life hacks’ that I think we can do in clinical medicine are probably something that every physician or every clinician who sees patients would want millions of,” she says. “So there’s an entrepreneurial mission waiting to happen.”
Too Much Technology Detracts From Patient Care
Simeon Schwartz, CEO of the WESTMED Medical Group, argues that too many health IT systems have created a distraction for doctors, creating a new set of administrative responsibilities that take them away from patient care.
Schwartz cites industry figures indicating across-the-board declines in physician productivity by between 15 percent and 20 percent since health organizations adopted EHRs. That trend is all the more alarming at a time when observers are worried about reduced access to basic care amid a shortage of primary care doctors.
“My biggest concern really has to do with the integration of the data at the point of care. Physician productivity has gone down in this country with the advent of electronic medical records,” Schwartz says. “Almost every organization has declines in productivity in the 15 to 20 percent range.”
“We’re taking away time from physicians to do really important things and giving them less important tasks of less value and losing access in the process,” he adds. “I thoroughly believe that we can get this right, but we are not there yet.”