HIT Think

How new market forces are aligning to change healthcare IT

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HIMSS can be—and perhaps should be—an overwhelming experience. But in engaging in a couple dozen conversations with folks yesterday, I began to get a sense that we’re looking at a new, somewhat scary, age of healthcare, and thus the use of healthcare IT.

Entering new phases is typically a bit frightening. Many of us are never completely ready, yet they come at us with a sense of inevitability, excitement and dread. Sometimes, it hits us when we are unaware. I think the light is coming upon the healthcare industry, with the brute force of a blazing Las Vegas sunrise.

Yesterday, I could hear new words and new competitors being discussed. I heard the term “micro-hospitals” in three successive conversations. When folks were talking about competitors, they weren’t talking about the crosstown hospital system or feisty payers. They were mentioning CVS, Walgreens, urgent care centers and Amazon.

For IT executives, the world is changing. It’s no longer the world of laying cables and configuring networks. It now involves envisioning a new way of doing business with senior executives, and enabling those changes with technology.

Perspective is useful for the HIT industry. It’s passed through two difficult and challenging ages. I believe it’s entering a third. I’d liken it to the evolution of business economies for our own country.

For many years, healthcare IT was the realm of the pioneer, trying to implement some primitive IT (well, at least by today’s standards) to meet the needs of the existing healthcare world—primarily disconnected hospitals and physician practices trying to use it to improve organization and capture data that would enable maximizing charges in a fee-for-service environment. The HIT pioneers had to focus on installing infrastructures and layering on various applications to meet these early needs for provider organizations.

That all changed about 2004, when the federal government began to prioritize the implementation of electronic health records—akin to an industrial revolution. That support was made real by the HITECH act and the availability of funding for electronic health records. The focus for HIT executives went from the basics of technology installation to the rush to put EHRs in place. Whatever you think about the pace or coordination of these implementations, the results were staggering. In the span of a decade, the industry went from having 10 percent of its hospitals with records systems to more than 90 percent of systems in place.

And the nature of the healthcare industry was changing, too, as the industry consolidation began to take hold. Integrated delivery systems began to form, and in recent years, these consolidations have grown to include combinations of healthcare systems into even larger entities. First seeking to achieve economies of scale and dreaming of better care coordination, these burgeoning entities have recently been working on the rise and challenge of value-based care delivery.

We are now slipping into a third age, where healthcare needs to be delivered to a new breed of consumers, and even as the industry is viewed opportunistically by outsiders who have both the experience and technology to meet consumers’ needs. Technology has shifted platforms and become miniaturized, so that everyone can hold a versatile computing device in the palm of their hands. And consumers are increasingly comfortable with picking and choosing services and applications that will meet very specific needs and schedules.

As consumer expectations grow that technology will meet needs, it’s inevitable that this will impact the healthcare services they want and need. At the same time, they’re paying for a rising share of their care, and they have been acculturated to receive value. And tech companies with years of experience in this arena see healthcare as a ripe field for meeting specific needs.

It doesn’t have to be Amazon to fill these voids. This morning in my inbox, I was reminded of that after receiving a press release from a company focused on providing care and counselling to young post-partem moms who typically don’t receive much care or support in the first six weeks after they give birth. It’s a simple, focused need that your typical burgeoning mega-IDN probably has overlooked. Multiply that by hundreds of focused companies looking to meet specific needs of healthcare consumers, and you get the idea of what’s happening across the healthcare spectrum.

The risk for HIT executives is to get mired in one of the previous two ages of HIT and not recognize that the world is rapidly shifting beneath them. Yes, there are many basic pieces of healthcare IT that still need attention—interoperability, better clinical decision support, workflow support and/or redesign among them—but it’s time for these executives to truly help organizations innovate to create customer-focused care that will personify this scary new age that lies ahead.

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