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To a hospital CIO, healthcare technology is both a blessing a curse. HCIT brings the promise of dramatically improved clinical outcomes, personalized treatment plans, increased efficiencies, and decreased expenses. However, more often than not, it also comes with the distraction and high cost of implementation, not to mention the frustration of trying to change workflow.
Saying that there are problems associated with healthcare technology certainly won’t come as a surprise to anyone. That said, it is also worth noting that the problems are rarely, if ever, directly caused by the technology itself. It’s almost always about how that technology fits within the ecosystem of the way healthcare is practiced. Simply put, it is extremely difficult AND complicated to effectively combine the art of medicine with the science of technology. Computers are machines – objective, analytical, and scientific. Whereas, the process of providing actual care for patients, is much more art than science- but should include both. While standards of care exist to ensure that all patients receive care that reflects best practices, every individual is unique, requiring the doctor to blend art and science in order to deliver the very best care for all of their patients.
I’ll provide a bit of background to help explain where my perspective comes from. I am an entrepreneur who has spent the last 16 years in health tech. Back in 2002 I founded the first patient engagement company, Emmi Solutions, which was purchased last year by Wolters Kluwer. I now choose to spend my time working with early-stage healthcare companies because, to me, they represent the best hope for solving the multitude of challenges that plague the industry. I love doing this because as I said upfront, technology has such amazing potential to transform and improve the quality, efficiency, and economics of care. The flipside is that it also creates a host of challenges that need to be acknowledged and addressed in order for it to reach its full potential. Whether it’s problems with security, workflow, integration, or something else, the sooner we can sort this stuff out, the better off we’ll all be. And I mean “we” in the broadest context because I don’t just work in the industry – like all of you, I am also a patient.
"For hospitals and clinicians to fully enjoy all the potential benefits that HCIT can bring, everyone involved will need to have greater understanding of and appreciation for the responsibilities and challenges that others face within the same organization"
Obviously, combining art and science may not be the easiest thing to do, but in this instance its clearly worth the effort. I’m not a clinician, so please take this analogy with a grain of salt, but when I think of things like artificial hips or pacemakers I can only imagine all of the work that went into figuring out how these scientific devices could be implanted and actually function within a living organism. It is interesting to note that one of these was developed by an engineer, the pacemaker, whereas the hip replacement was developed by a surgeon. The reason I point this out is because when it comes to innovation in healthcare, regardless if its driven by clinicians or engineers, it is unlikely to succeed without the support and participation of both. Unfortunately, this is often easier said than done.
For hospitals and health systems, innovation of any kind, often proves to be quite challenging. In a normal, healthy innovation ecosystem the key constituents (entrepreneurs/inventors, potential customers, investors) have a mutually dependent and symbiotic relationship. However, when it comes to healthcare, these same players tend to all follow deeply ingrained patterns of behavior which ends up pushing each another apart. I have begun using the term “Innovation Gap” to describe this unhealthy phenomenon. It’s not than anyone is doing this on purpose or has any nefarious intentions, I look at it as a byproduct of the incredible pressures faced by clinicians and hospital CIO’s. With all of the regulations, quality expectations and potential penalties, when something new is proposed, it’s just easier to say no. Sadly they have lost sight of, or don’t have the time to consider, all the potential benefits of saying yes. For example, on numerous occasions I have heard a hospital CIO say “we are an “Epic shop” (or Cerner, or Meditech, or Allscripts, etc.) and will only look at their approved vendors,” which is a serious problem because technology shouldn’t be dictating standards of care. On the flipside, it’s equally problematic when clinicians are unwilling to consider or utilize any new technology that requires any change in process or workflow
Here is one example where the challenges of innovation are more challenging than necessary. There is a company here in Chicago called Fibroblast (in full disclosure, I am an equity holder and board member) that built an EMR-agnostic scheduling and referral management platform. It was started by a GI doc to solve the problem he had in his practice- getting patients to schedule their routine/recommended screenings. The concept itself is a nobrainer because it addresses a commonly recognized issue and the product is easy to implement. However, even though they had a solution that hospitals were looking for and one that supported cost effective population health and drives near term revenues, it took almost 3 years for them to hit their stride. This story is not at all unique to Fibroblast, for new solutions to get into a hospital or health systems, it can take a Herculean effort to overcome all of the technology questions; not issues, just questions. Innovation is never easy, but do we need to make it this hard?
For hospitals and clinicians to fully enjoy all the potential benefits that HCIT can bring, everyone involved will need to have greater understanding of and appreciation for the responsibilities and challenges that others face within the same organization. Healthcare innovation, especially as it relates to technology, is quickly becoming a key determinant of success. That said, nothing stymies innovation more quickly than people who are not open to change or are unwilling to objectively assess their policies and processes. Entrepreneurs and intrapreneurs are already creating – and will continue to create – innovative solutions to address the most pressing challenges facing the industry. The way in which hospital technological and clinical leaders choose to respond to them may well be the deciding factor of who succeeds in the new world of healthcare.
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