eHealth Innovation: HIT leaders ponder needs for population, economic health
CAMBRIDGE, Mass.—A panel of healthcare technology leaders discussed innovation for population and economic health during the inaugural eHealth Innovation conference.
David Cochran, MD, president and CEO of the Vermont Information Technology Leaders, said the state is basically a loosely organized integrated delivery network. He described the various health IT tools, including health information exchange, EMRs and registries, as pretty generic. Rather, it’s the communication, documentation, workflow and analytics that will help organizations improve patient outcomes and lower costs.
Cochran said he is seeking ways to optimize care for chronic diseases. For example, diabetes patients spend about four hours a year with their physician, which means they spend the other 364 days and 20 hours caring for themselves. That means they need to be engaged in their own care and have the resources necessary to monitor their condition.
He also said that healthcare is light in analytics and its data systems are “brittle and fragile.” Since it takes years to develop a quality, thorough dataset, by the time users are ready to perform analytics, the data are outdated. “We need to extract knowledge from the money stream. Don’t tell me it can’t be done because it’s being done in other industries.”
Leon Barzin, MA, director of health IT for the Massachusetts Medical Society (MMS), said the organization primarily works with physicians who are EHR veterans. While trying to stay vendor-neutral, “we look out for smaller organizations and practices.” MMS occasionally comarkets products and services.
He is concerned about the lack of innovation in EHRs because the newest generation “look and act like Windows 95.” MMS is calling for a new generation of EHR systems that include technologies such as single sign-on, Direct network and the Simple Object Access Protocol [SOAP]. Without innovation, he said the end result will be another round of proprietary products that don’t communicate with each other. “We desperately need transportability. I can’t overemphasize the current and growing level of frustration.” Without flexible innovation, the $25 billion being spent on health IT will just create a new generation of proprietary systems, he said. The healthcare community won’t get another chance for this level of investment so we can’t let this opportunity go to waste.
“Our highest priority is to make quality healthcare affordable,” said Gregory LeGrow, director of eHealth innovation for Blue Cross Blue Shield of Massachusetts, who discussed the organization’s three-prong approach to that goal. One is reducing administrative spending both internally and externally. That includes automating and improving the infrastructure and using those channels to spur innovation. The second prong is member engagement. One method for that engagement is innovation payment plans where, for example, patients who opt for a high-value hospital have a lower cost-sharing responsibility.
The panel members were asked about the fragility of existing data systems. Barzin said vendors and providers need to distinguish between identifiable and nonidentifiable patient data. Meanwhile, small and medium physician practices are starting to aggregate enough data to put into practical use.
Cochran said that most providers use a research mindset rather than a business intelligence mindset. For example, they will assemble a dataset to answer a particular question. “That’s a losing battle,” he said. “We can’t anticipate the questions. We need to extract knowledge around the money stream.”
Another change in thinking comes with the shift to accountable care. In the past, providers would eliminate mental health services because they don’t generate enough revenue. With accountable care, “we make sure we’re doing first-rate work in mental health services.”
Looking ahead to further changes in the healthcare landscape, Cochran said “disruptive technology doesn’t happen because we tell it to. It happens because it bubbles up and happens.”
David Cochran, MD, president and CEO of the Vermont Information Technology Leaders, said the state is basically a loosely organized integrated delivery network. He described the various health IT tools, including health information exchange, EMRs and registries, as pretty generic. Rather, it’s the communication, documentation, workflow and analytics that will help organizations improve patient outcomes and lower costs.
Cochran said he is seeking ways to optimize care for chronic diseases. For example, diabetes patients spend about four hours a year with their physician, which means they spend the other 364 days and 20 hours caring for themselves. That means they need to be engaged in their own care and have the resources necessary to monitor their condition.
He also said that healthcare is light in analytics and its data systems are “brittle and fragile.” Since it takes years to develop a quality, thorough dataset, by the time users are ready to perform analytics, the data are outdated. “We need to extract knowledge from the money stream. Don’t tell me it can’t be done because it’s being done in other industries.”
Leon Barzin, MA, director of health IT for the Massachusetts Medical Society (MMS), said the organization primarily works with physicians who are EHR veterans. While trying to stay vendor-neutral, “we look out for smaller organizations and practices.” MMS occasionally comarkets products and services.
He is concerned about the lack of innovation in EHRs because the newest generation “look and act like Windows 95.” MMS is calling for a new generation of EHR systems that include technologies such as single sign-on, Direct network and the Simple Object Access Protocol [SOAP]. Without innovation, he said the end result will be another round of proprietary products that don’t communicate with each other. “We desperately need transportability. I can’t overemphasize the current and growing level of frustration.” Without flexible innovation, the $25 billion being spent on health IT will just create a new generation of proprietary systems, he said. The healthcare community won’t get another chance for this level of investment so we can’t let this opportunity go to waste.
“Our highest priority is to make quality healthcare affordable,” said Gregory LeGrow, director of eHealth innovation for Blue Cross Blue Shield of Massachusetts, who discussed the organization’s three-prong approach to that goal. One is reducing administrative spending both internally and externally. That includes automating and improving the infrastructure and using those channels to spur innovation. The second prong is member engagement. One method for that engagement is innovation payment plans where, for example, patients who opt for a high-value hospital have a lower cost-sharing responsibility.
The panel members were asked about the fragility of existing data systems. Barzin said vendors and providers need to distinguish between identifiable and nonidentifiable patient data. Meanwhile, small and medium physician practices are starting to aggregate enough data to put into practical use.
Cochran said that most providers use a research mindset rather than a business intelligence mindset. For example, they will assemble a dataset to answer a particular question. “That’s a losing battle,” he said. “We can’t anticipate the questions. We need to extract knowledge around the money stream.”
Another change in thinking comes with the shift to accountable care. In the past, providers would eliminate mental health services because they don’t generate enough revenue. With accountable care, “we make sure we’re doing first-rate work in mental health services.”
Looking ahead to further changes in the healthcare landscape, Cochran said “disruptive technology doesn’t happen because we tell it to. It happens because it bubbles up and happens.”
Beth Walsh,
Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.