Whether to utopian or dystopian ends (e.g., a new survey finds 69% of healthcare professionals believe the Affordable Care Act increases or significantly increases risk to patient security and privacy), Obamacare and other healthcare regulation in the U.S. are forcing healthcare IT investment to unprecedented levels. From this Petri dish of experimentation are emerging clues for other industry sectors as to how sufficient levels of automation enable more applications and utility from the data and networks that have been formed.
Regulation forces and encourages IT investment
The Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the 2009 stimulus bill, offers incentives through 2015 for adopting ‘meaningful use’ of electronic health records. After 2015, those incentives change to penalties for failure to adopt ‘meaningful use’—although those requirements are still being tweaked. And there’s more coming. Just this month, the FCC announced the formation of the Connect2Health Task Force to encourage wifi use in healthcare. As FCC chairman Tom Wheeler explained, “We must leverage all available technologies to ensure that advanced healthcare solutions are readily available to all Americans, from rural and remote areas to underserved inner cities. By identifying regulatory barriers and incentives and building stronger partnerships with stakeholders in the areas of telehealth, mobile applications, and telemedicine, we can expedite this vital shift.”
Patterns in the impact of heavy investment
Recent announcements in a range of areas demonstrate how healthcare is becoming a bellwether of next-stage technology applications:
- Since its launch just over a year ago, the CommonWell Health Alliance, a health information exchange among a growing number of health IT providers has found burgeoning demand. CommonWell started a rollout to initial healthcare providers in December; and by one report, nearly half of the physicians groups planned to join an HIE. Somewhat akin to the associations that banks have long had to support credit card networks, healthcare providers are finding business and consumer benefit to the coordinated sharing of certain patient data.
- A new meaningful use requirement to automate laboratory findings of notifiable diseases to public health authorities will go into effect in 2015, with a predicted, immediate doubling of cases reported. Thus, regulatory compliance can be expanded, becoming more pervasive and absolute, once certain levels of automation are common or required within an industry.
- Increased video consultations and other new means for patients to access the healthcare system. One healthcare IT study predicts a 25-fold increase patient use of in-home video consultations with their doctors in the next four years. Last week, an industry group in Australia called upon the Australian government to adopt a formal teleheath strategy. After its IPO this week, Castlight Health, which offers an enterprise cloud healthcare cost tracking and savings solution for employees, saw its already generous $16 offering price soar to $40, bringing a company with $13 million in 2013 revenues to a $3 billion valuation. We can marvel at social media today, but the surface has barely been scratched on the levels of communication and data analysis that will become commonplace for customers of all types.
- A Rhode Island hospital is experimenting with the use of Google Glass in emergency rooms, and a new study shows that ER doctors with access to such information—and therefore a better understanding of the patient’s situation—are 30% less likely to admit them for presumably unneeded hospitalization. Already the cost savings in this informed reduction of caution have worked out to an overall savings of approximately $20 per emergency room visit. The implications of expanded levels of employee access to information are still emerging.
- Epic, a major IT provider to large healthcare providers, has enabled its customers to share access to their systems via their Community Connect program. (E.g., the Singing River Health System’s offering.) A study finds mixed results for those smaller, indirect customers who gain new technical capabilities leading to more regional sharing of patient data, but also lose critical control over some system-imposed processes as well. This model was also pioneered by banks in the early days of automated bank operations, and it became a precursor to subsequent, massive bank consolidation. Additional rounds of efficiency and, yes, consolidation, may be expected in other industries as their business becomes more technology based.
- The challenge in measuring value as ROI. Not only is quality treatment a challenge to measure, but a healthcare IT consultancy that tracks value according to how advanced a provider is on the eight-step EMR Adoption Model finds that significant quality improvement does not occur until the sixth step is reached. Thus, IT ROI must be considered more broadly than it has typically been calculated in the past, and many benefits of automation will only emerge once a critical mass has been achieved. Yet, the ongoing cost of such broadly implemented systems may itself fuel mergers and consolidation.
CIOs and CTOs should be leading their firms’ anticipation and understanding of both incremental and disruptive patterns of technology-driven change. (As much, of course, as such change can be foreseen.) Patterns of adoption tend to see-saw between industries for specific applications, but new applications emerge from systems implemented for more limited purposes—and many companies can find likely examples of coming change in other sectors.