Why Can’t Healthcare Planning Be As Easy As Vacation Planning?
Travel agents. Ticket counters. Maps. Travel books. In the past, we would have to spend time in person with all of them in order to plan a vacation. And it was all pretty static – make your decision, then live with it. Today, we don’t have to leave the couch to plan travel: we have the world in our hands (or, more literally, in our smartphones). And should something change last-minute, we can change course in real time (for a fee, of course). We can reserve a hotel room from our phone after seeing photos and reading reviews from other people who have stayed there. We can book or rebook a flight, see a seat map of the plane, and choose a seat based on reviews of that very same seat. Technology has fundamentally transformed how we approach travel, enabling more real-time decision-making ability as well as long-term planning. Why should our approach to healthcare planning not be just as easy and intuitive?
The key to the ease and flexibility of travel planning today is the pervasive adoption of digital technologies (“SMAC” – Social, Mobility, Analytics, and Cloud). Of course, health information technology has been around for a long time and has modernized many areas (e.g., doctor’s appointment, access to medical information, digital medical records, and video consultations) of healthcare management. However, except in isolated pockets (such as radiology), core healthcare has been a laggard in systematically leveraging information technology. The lag has many reasons: the healthcare industry is mature and highly regulated; it requires high-trust human interactions between patients and physicians in matters of life and death; and reimbursement models are labyrinthine. However, despite this delay in the healthcare industry to embrace digital transformation, there are many areas where technology is leaving an impact. Here are three examples.
Next-Generation EHRs: Electronic Health Records (EHR) are a classic example of the application of information technology in healthcare. Even as their benefits are being debated, change is already afoot. Recently, Partners Healthcare launched an EHR system at a cost of $1.2 billion in order to create a consolidated system to service its network of 10 hospitals and 6,000 doctors. The goal of this consolidation is to ensure that all the patient data captured at various hospitals in its network is available to the treating physicians in a single place. Moreover, patients who are actively seeking greater participation in managing their health will also have greater access to their medical records. While the aim of enforcing adoption of EHR systems in healthcare was to have a consolidated data access system, most existing systems fail at delivering interoperability (often between different healthcare providers even if they use the same EHR vendor, and almost always if they use different vendors). Lack of interoperability makes for clunky and inefficient systems that people just don’t want to use. API standards such asFHIR (pronounced “fire”, short for “Fast Healthcare Interoperability Resources”) help federate first-generation EHRs and cater to patients’ demand for just-in-time and at-their-fingertips access to medical information. While there are numerous problems still to be solved (technical, legal, privacy-related, …) and the holy grail of the untethered and patient-owned EHR is still years away, interoperable cloud-based EHRs are the way to go.
Wearables: Wearable devices are being increasingly adopted by individuals for tracking personal health information. What makes them really exciting in the present context is a slew of highly innovative products already available (e.g., Thync, FreeStyle Libre) or being developed (e.g., SmartStop,QardioCore), and the level of exemption from regulations and approvals that the FDA is considering for low-risk general wellness products. The data that such devices generate can potentially be combined with patient medical history to derive meaningful insights that could be used to better manage situations such as chronic disease and geriatric care. Additionally, consumers’ willingness to adopt wearable technology to monitor vital health indicators presents a unique opportunity for delivering follow-up care. Patient monitoring data streamed to a provider would enable healthcare professionals to reach out to patients for remedial actions if their health indicators are abnormal, possibly even pro-actively. This can actually create a next-generation model of patient care where potentially critical situations are caught upfront, thereby reducing hospitalization and associated costs.
Prescriptions: Traditional pharmacies place the onus of prescription filling, refilling, and compliance (i.e., accurately taking the medications) on patients. Having to deal with sorting medications based on the time they need to be taken and keeping track of multiple medications that need to be taken together can be a significant burden for, for example, older patients on multiple medications. PillPack (featured this past weekend on NBC Nightly News) tackles this problem by delivering pre-packaged, pre-sorted medications customized for an individual patient. In addition, it handles pharmacy support functions such as processing insurance copayments, handling prescription refills, and providing round-the-clock support from pharmacy staff.
The examples above show the impact of digital and consumer technologies on very fundamental aspects of healthcare. Further afield, there is a whole world of personalized healthcare derived mostly from the ever increasing push for using genomics in medicine. Of course, the transformation of an industry as complex as healthcare depends on much more than technology; but as the examples show, there is no dearth of IT innovation to propel the journey when the non-technological pieces fall in place.
And while you are on that digitally-facilitated vacation, check out the book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age by Robert Wachter. It is a highly readable account of the forces and players shaping the future of healthcare. Don’t miss Chapter 27.
Dr. Siddhartha Chatterjee is Chief Technology Officer at Persistent Systems. Dr. Aarti Desai, Senior Domain Specialist at Persistent Systems and leader of the Genomics and Systems Biology teams at Persistent LABS, co-authored this post.