A HIMSS Event | SANTA CLARA, CA | SEPT. 16-18, 2019
By John Sharp, Director, Thought Advisory, HIMSS
Many have suggested healthcare is broken and radical changes are needed. But physicians, nurses and other providers feel a sense of burnout over changes in healthcare and daily pressures of caregiving and administrative tasks. Entrepreneurs who want to “fix” healthcare can put off providers. Others call for deep change and changing incentives to promote change, such as, the shift to value-based care. Most in healthcare and most patients would agree that healthcare is overly complex with misaligned incentives due to fee-for-service; until incentives shift, will providers embrace change?
Can digital health facilitate this shift? A Techcrunch author recently emphasized how early digital health companies pushed for outcomes from real-world data. He stated that those from outside healthcare “were aiming for disruption, not integration, and in doing so were ignoring the vast set of protections and people that have been put in place to ensure public safety.” Others have recommended that innovators spend a day or a week with a provider to begin to understand the complexity of healthcare.
This brings us to question if digital solutions only look for ways to integrate with the current physician workflow. Now that the workflow is embedded in the EMR, do any new solutions require deep integration into the current system? How do we create sustainable business models in either context?
In my mind, the answers to these questions vary. Providers have difficulty knowing which apps and devices to recommend to patients. New solutions now integrate the recommendation into the prescription workflow so that providers have the option of prescribing an evidence-based app which will help the patient manage their condition. Another example are apps which enable providers to give cost information about drugs to the patient at the point of care in real time, improving efficiency by avoiding calls from the pharmacy saying the drug is not covered and making it more likely that the patient will fill the prescription. On the negative side, innovative solutions may add to the workload and make the provider less efficient. Even if they have some evidence of improving outcomes, these options are less likely to be adopted. This is especially true for patient generated health data which providers are concerned will take too much time to interpret; but good dashboards and a team approach may enable them to use the data to improve outcomes.
Healthcare does need disruption, but entrepreneurs need to take into account all stakeholders in healthcare, the shift to value-based care and where they can impact care processes. The move from innovation, to evidence, to digital transformation requires an understanding of the current system, but also a vision for the potential of disruption.