Information Technology Reference
In-Depth Information
for producing better outcomes at lower cost. The Medicare ACO pilot studies and
the experience at some leading health systems already under an outcome-based
business model strongly suggest that health informatics can help achieve the desired
results. This means that providers have a further incentive to adopt electronic records
and other technologies for improved clinical decision support, care coordination,
information exchange, management against quality metrics and patient empower-
ment. Providers should reasonably be willing to invest in these technologies to the
extent that they can improve care outcomes while lowering costs if those reductions
exceed the cost of the technology.
This federal investment and these new economic models have had at least two
important results so far. The adoption of electronic records capable of Meaningful
Use may have now reached 40% of providers and nearly 50% of hospitals. These
federal programs are widely known and reported. Less widely appreciated is the
impact this investment is having by creating a more favorable environment for
investment in entrepreneurial companies, particularly those developing lighter, sim-
pler, less expensive cloud-based systems. It is tempting to say that this is simply the
health informatics industry finally adopting the technologies that have already revo-
lutionized other industries. It is equally tempting to say that it's happening now
because the needed web, mobile and wireless technologies are now mature and
robust enough for use in healthcare. These statements may well both be true but it's
hard to imagine the huge burst of entrepreneurial activity we are seeing today if the
entrepreneurs could not make a strong case that their innovative products would find
a ready market.
So, what's next? First, in the topic so far, I've done my best to stick to the facts.
What follows is largely my opinion. Please read it in that light.
Dealing with Legacy Systems
The most common objection to the federal deployment effort is that we are baking in
a generation of technologically obsolete and not well designed electronic record sys-
tems that aren't interoperable and that will therefore collectively become an impedi-
ment for achieving the very goals we just listed. It is hard to argue against part of this
premise. Many commercial health informatics products are old and were developed
using very proprietary technologies. This makes interoperability harder to achieve.
Their user interfaces are often poor compared to the best of what is now available.
These design shortcomings can contribute to new forms of error. Poor design is also
an impediment to efficient and effective training, proper use and the ability to accom-
plish many of the desired qualitative and efficiency goals. To make matters even
worse, the largest vendors have typically been around the longest, have the largest
customer bases and revenue streams, so they can afford the largest and most effective
marketing and sales efforts and, therefore, tend to dominate the market.
Here's where my old friend and former health informatics consultant, Steve
Rushing, comes to the rescue. Steve has a saying for every occasion. By now I've
