AMA's Wah on the importance of failure

CHICAGO--"Failure is an important stepping stone to success," said AMA President Robert Wah, MD, delivering the keynote address at the Innovation Symposium at the 2015 HIMSS Annual Conference & Exhibition.

“We all hear about successful startups but there are many more that failed,” he said. In the past, the failure cycle was much longer and people couldn’t risk very much.

Wah cited the Apple Newton which was widely considered a failure. However, the company learned from that experience and eventually created the iPhone.

Organizations can’t look at failure as “an absolute no-no,” he said. “We need to visualize it differently.” Organizations need people focused on looking over the horizon. “That model allows organizations to thrive. You have to find part of your organization that’s comfortable with failure.”

Although the AMA is 170 years old, the group is innovative, Wah said. They hired a new CEO four years ago and spent time evaluating its efforts compared against the impact of those activities. As a result, the association is now focused on accelerating change in medical education; improving health outcomes; and improving professional satisfaction and practice sustainability. “If physicians don’t have sustainable practices they can’t take care of their patients.”

Addressing Meaningful Use, Wah said it had a “laudable goals of using EMRs to improve care” but has moved off that mark. “It’s more about regulatory, administrative burden.” With some 257,000 providers facing penalties this year, he said you have to wonder about the success of a program in which half of the participants are failing. “One has to think that the criteria for success and failure aren’t correct.”

AMA formed a workgroup on the subject and created an action plan. Wah said nearly every industry’s big aha moment for technology comes with the beginning of enterprise resource planning (ERP). In other words, organizations go from separate sales, manufacturing, logistics and more to an enterprise-wide view. “In healthcare, we have begun to believe that the ERP is the EHR. As we have added more and more jobs to the EHR, it has gone beyond a clinical record. It’s not part of scheduling, financing, regulatory, compliance, safety and more. Physicians are now responsible for feeding all those jobs which is one of the reasons they are so dissatisfied with the current crop of EHRs. It doesn’t fit their workflow, the interface isn’t workable and all these jobs they have to feed data for has become a huge burden.”

The EHR shouldn’t be the ERP of healthcare, Wah said. He predicted a layer above that will let the HER go back to serving its original purpose of being a data repository of clinical findings.

Digitization provides a lot of promise, he said. “In analytics, we’re seeing rapid change and exciting developments.” Before digitization, researchers developed a hypothesis and then posed it to the data. Now, we have the ability to combine many sources of data. “I believe we’ll see a whole new area of analytics where the data begins to speak to us. Patterns will emerge from these coalesced datasets. Data will speak to us in ways we never thought to ask the question.”

For example, no one would have thought to see whether credit score correlates to medication adherence but the merge of data has revealed a significant correlation. “The needle will come out of the haystack—we won’t have to look for it as much. That never could have been done on a paper platform.”

CIOs are critical change agents, Wah said. He cited a survey in which 66 percent of CIOs identified modernization as a key priority and half said legacy applications are hindering innovation. “They’re looking for agility and how to be more nimble in their use of technology. The “I” in CIO is becoming innovation.”

New technology holds great promise, Wah said, but “sometimes technology is there for technology’s sake. I’m a huge proponent of more clinical input into health IT. It’s vitally important that physicians take a role in the development of health IT.”

He issued a caution about mobile health apps. “There are a lot of apps out there that are cul-de-sacs. They need connectivity. We need information flowing better to make them richer and more valuable.”

When asked about privacy and security by an audience member, Wah said HIPAA has been “a little bit of a boogeyman. “Many times, HIPAA has nothing to do with it. I would submit that some parts of HIPAA unlock interoperability.” He cited defined data fields in HIPAA. That allowed for construction of a central hub to which people subscribed. “We went from dollars per transaction to pennies. I don’t think HIPAA should be held up as a barrier to interoperability. It’s not perfect but let’s not make it a boogeyman that prevents us from doing things.”