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Spirit of Exploration Lives on in HIT Startups

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As part of a recent series of articles, Health Data Management has examined some of the latest technologies that innovative startups are introducing in the quest to lower costs and improve outcomes – and perhaps make the entire process of care a bit more understandable to those who provide it and receive it.

In the research and interviews I've conducted during that time, I have spoken with executives from these startups, mentors from some of the myriad health technology accelerators and incubators springing up across the country, and with analysts who closely follow niches within the HIT world.

A few themes have emerged from that research. Among the most impressive is the spirit of discovery that the folks developing these new technologies display, whether that comes from trying to leverage years' worth of hospital cost data--as the creators of the University of Utah Health System's Value-Driven Outcomes tool have done--or whether inspiration strikes over a serendipitous dinner conversation, as happened to the founder of Kit Check, which has made strong inroads in a short time by simplifying hospitals' medication--and now anesthesia resource--tracking.

Another theme that bodes well is the rich variety of backgrounds that many of these innovators bring to healthcare. The team behind the real-time location system technology from Emanate Wireless, for instance, came from Cisco. Eric Buffkin, president of eTect, which developed an ingestible transmitter to supply medication adherence data, is a veteran of the wireless communications industry, as is much of his team. Ted Spooner, CEO of RespondWell, a company that has developed a tele-rehab platform based on the Microsoft Kinect sensor, pioneered not only computer-based fitness applications, but before that was a ground-floor architect of online banking systems (his first foray into online banking, as CFO of the Microsoft credit union, he said, was done because Microsoft execs wanted to find a way to keep employees at their desks).

This is a good thing, because healthcare has a lot of catching up to do in order to reach the degree of tech-enabled interaction people have come to expect. The results of a recent comparative Scripps Research Institute survey, which tested the mood of both providers and consumers in the use of disruptive medical technologies and the culture around that use, found very stark differences. "Both consumers and healthcare professionals are generally supportive of these technologies, albeit with sizably greater support and enthusiasm among consumers," the researchers found. In short, they concluded that, "As medicine gets increasingly digitized, the forces favoring democratization will likely be intensified."

The observation by Chilmark Research managing partner John Moore, that health system executives need to start thinking about "systems of engagement" as well as "systems of record," summed up the obligation for adopting next-generation technology, whether that engagement is provider-to-provider, provider-to-patient, or even machine-to-machine.

That kind of planning won't be easy: the difference between Meaningful Use of electronic health records and meaningful use of technology in healthcare might be akin to the difference between the definitions of the words Catholic and catholic; Moore estimated that about 80 percent of the typical health system's IT budget is already dedicated to keeping the lights on and feeding the EHR.

Moore likened the situation facing healthcare IT executives to what planners in other industries faced during the dawn of the Internet, in which the tech platforms around enterprise resource planning were originally "bolted on" to complement general ledger and financial applications, gradually including human resources and supply chain data. Add to that the market and policy imperatives mandating better data exchange between healthcare providers, their partners in care – such as long-term care facilities, payers, community agencies, and patients themselves – and it's not hard to see the gargantuan task now faced by the industry.

It's also not hard to see that the market and policy drivers of the new healthcare economy are attracting people who have successfully done this before. RespondWell's Spooner ticked off what he called the "information automation cycles" that have forever changed media, entertainment, financial services and manufacturing. "I think healthcare is the last frontier of the automation cycle," he said.

Buffkin said he's seen no shortage of tech knowledge or savvy among the provider, payer and pharmaceutical executives with whom he's spoken about his company's product. What he has encountered, he said, has been more of a clash of cultures, as well as healthcare's traditionally conservative approach in which strategies take years to change.

That clash is both the product and cause of massive change for which there will be no halt. Just as there will be the "patient engagement" and "big data" analogs of failed technologies like the Betamax, and there will be organizational analogs to the Grants and Woolworths, once titans that couldn't fit into the times, there will also be blockbuster technologies and market-shaping new ways to make people healthier that we will wonder how we ever lived without them. If we are going to live in interesting times, there is no reason not to embrace them.

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