I was reading this fascinating article written by Robert Pearl, MD the CEO of The Permanente Medical Group on the 5 Megatrends that could Transform U.S Health Care. I completely agree with the major trends Cisco chairman and CEO John Chamber sees:
- The Formation of Accountable Care Organizations (ACO)
- Moving away from Fee-For-Service Payment Models
- Rewarding Better Health Outcomes and Quality
- Health Information technology (HealthIT) Incentives
- A New Generation Of Physicians
I agree that we are at the cusp of a tipping point. I was rather intrigued regarding the fourth megatrend, Health Information Technology Incentives. While I agree with the premise there is some inconsistencies within the details. It is truly unfortunate that healthcare is behind the technology wave that other sectors have adopted decades ago. I feel that there is good reason for that which goes back to the reason physicians choose to dedicate their lives to treating people. While that is easily another blog topic the fact is that we need to change and start to change quickly. Not because of the meaningful use incentives but because it is the right thing to do for our patients. Our patients are more mobile than before and want to access the healthcare system on their own time. We are living is a physician centric system evolving to a patient centered system. That change is going to take a lot of time when the current system has been in existence for almost 50 years. As Mr. Chambers articulates lack of connectivity is the issue. This is where the topic goes awry. There is assumption that every hospital and physician office is on the same system. That is far from the case. Even if they happen to be on the same system that still doesn’t mean that the two systems will connect. They could be on 2 different versions of the same system. Perhaps these two organizations don’t equally value the exchange of clinical information, or are fierce competitors. Please don’t assume I am a proponent of this as an excuse but just current reality. And those scenarios are for organizations that have the same system. The issue compounds when the systems are from different vendors and you may need a HISP for connectivity not to mention developing Query and Trust Frameworks. As you can quickly see that the technology is the minor component and the People and Process areas are what make this successful. While I agree that Meaningful Use Stage 2 will provide the incentives for interoperability I feel that this is just the beginning. I honestly don’t think that the federal incentives will even cover a fraction of the cost required to connect these systems as we need to develop the appropriate trust framework necessary for complete interoperability. What I truly feel is that it is in the best interest of the patient and the communities we serve. A patient should feel safe and well taken care of within the healthcare system whether seeking care in California or New York. As stated before, this is going to transform the health system and we need to understand that meaningful change takes time.