President John F. Kennedy galvanized the nation’s focus for a cause on Sept. 12, 1962, when he set a course for the moon, and having Americans land there, and safely return by the end of the decade.
In pointing the nation forward, he said these words: “We choose to go to the Moon in this decade and do the other things, not because they are easy, but because they are hard; because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one we intend to win.”
I strongly feel that healthcare needs a moon shot in achieving drastic improvements, with healthcare IT playing a lead or supporting role.
This is a critical moment for healthcare and the nation. The future of Obamacare is in doubt (depending on who gets into the White House), and so is the direction that health reform may take.
Meanwhile, the growth of health spending has slowed a bit, but in 2015 eclipsed $3.2 trillion a year, or 18 percent of the nation’s gross domestic product. It gets worse; CMS projects healthcare spending to reach $4.3 trillion by 2020 (18.5 percent of GDP) and $5.4 trillion by 2024 (19.6 percent of GDP). There are critical competing needs for these funds, and dollars spent on healthcare can’t be spent on other essentials. Thirty years of efforts to devise a way to reduce healthcare spending have largely failed.
Beyond that, there is a crying need to improve the entire healthcare ecosystem so that care is effective and supports the best possible care and optimal health of us all.
Here are nine critical components for a moon shot that would give healthcare a chance to reach the ultimate goals that it needs to achieve. IT isn’t the only answer in many of these, but it can play a powerful supporting role.
Achieve interoperability. The industry needs to reach a point where patient information is easily, seamlessly and automatically exchanged between any and all information systems. Clinicians need to be able to view a patient’s records and be certain that they are seeing all of a patient’s information, in a presentation that they can instantly understand, so that they have a complete picture of all patient data that they need.
Develop usable, intuitive and all-inclusive electronic health records systems. Caregivers should be able to use different EHR systems without having to labor at using them. In addition, records systems need to support all of a patient’s information, structured and unstructured, and also should support analytics efforts by clinicians and researchers.
Solve caregivers’ technology frustrations. Physicians and nurses are already under enough stress, so much so that they’re leaving the professions. Technology needs to solve their problems, facilitate care, increase efficiency and make caregivers’ lives better, resolving enough of their pain points to encourage them to stick with their roles as the industry reinvents itself.
Maximize industry coordination and cooperation. Progress here has been made—providers and payers worked together to smooth the transition to ICD-10, for example. But coordination and cooperation should be pushed as far forward as possible, so that everyone has all available information on a patient, and everyone can work together to wring out as much unnecessary cost as possible from the system. Data sharing between IT systems will play a crucial role in achieving this.
Reduce administrative expenses to the bare minimum. Estimates of administrative expenses in healthcare traditionally have ranged from 20 to 25 percent of all industry expenditures. At the low end, that would mean $600 billion is spent on healthcare that’s not directly related to care delivery. Much of that money needs to be reallocated to areas such as clinical and operational research.
Focus resources on deeply involving consumers in their health. Patient engagement, as encouraged by the Meaningful Use program, is only a baby step toward what’s needed. Patients need to understand the importance of paying attention to self-care, whether that means taking on healthy habits, avoiding habits that are destructive and following care regimens. A restructured healthcare system needs to demonstrate it cares about patient health as much, if not more, than treating sick patients. IT can help, but it’s only a tool, and not a magic bullet for a system that needs to focus on optimizing health.
All these steps call for a reinvention of the industry, and doubtlessly, that will be traumatic. Over the past 30 years, the industry has been hamstrung by efforts to protect turf and avoid financial hardship for constituencies. The reality is that systemic change could be painful and disruptive, but the U.S. has weathered the toughest opponents when all have given a little for the greater good of all. At this time, there must be commitment by all to improve the nation’s system exponentially, not incrementally.
President Kennedy set the end of the decade for his moon shot; how much can the healthcare industry accomplish by Dec. 31, 2019? For the sake of the country, its citizens and providers, we need to find out.
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