December 10, 2017 By sadiya
With all of the new “smart” information and communications technology (ICT) available today, it’s easy to make the wrong strategic decisions. To achieve sustainable, high quality, cost-efficient healthcare, leaders must understand when and where to invest. Here, Dr. Peter Edelstein, Chief Medical Officer for Clinical Solutions at Elsevier, gives his recommendations, followed by the winners and finalists of the 2016 HIMSS-Elsevier Digital Healthcare Awards competition.
Healthcare reform is spreading across the globe. And while “reform” differs depending on the city, country and region, the foundational realities driving reform are similar throughout the world: the spiraling costs of care; our aging and growing populations; and the emergence of worldwide epidemic conditions, such as obesity, diabetes, heart disease, Alzheimer’s disease, and cancer.
Wherever in the world I travel, I find a deep belief and intuitive sense that the incorporation into our evolving healthcare models of “smart” information and communications technology (ICT) will support our global drive to achieve consistent, sustainable, high quality, cost-efficient healthcare. However, the initial attempts at healthcare reform in the United States should serve as acautionary tale to health leaders in Asia, Europe, the Middle East, Latin America and elsewhere; the US-legislated ICT-based reform – guided by visions of rapid advancement to high value care – has violently collided with operational realities. Learning from “what is going right” and “what is going wrong” in the American reform process may allow health leaders around the world to select realistic, impactful ICT investments in 2017 and beyond.
We are already living in the age of big data. The retail, advertising, insurance, legal and travel industries are just a few examples of the dozens of economic sectors that not only collect vast quantities of customer data but utilize data analytics to identify opportunities, trends and challenges. It seems obvious that immediately investing in big data and clinical analytics solutions to identify meaningful, actionable information (regarding both patients and providers) should be a major 2017 ICT trend – that such ICT investments can successfully increase the quality and cost-efficiency of healthcare across the world. Thus it is not surprising that when asked to project 2017 ICT trends, several healthcare leader participants in the 2016 HIMSS-Elsevier Digital Healthcare Awards competition cited “big data” and “analytics.”
However, this may risk the same dangers that resulted from similar beliefs held by many healthcare leaders (and several big data and clinical analytics vendors) in the US soon after the Affordable Care Act, also known as “ObamaCare,” was signed into law. Because focusing on big data and analytics as early ICT investments when initiating healthcare reform is risky, a classic example of “putting the cart before the horse.” For those not familiar with this phrase, a simple analogy will clarify my warning:
Your country is preparing to build a massive, integrated, railway system to serve every city, town and community across the nation. This will take years and require massive amounts of money and human capital to complete. In order to avoid wasting money, time and labor, it is critical that you adopt an intelligent, informed construction strategy. So before you spend money buying a train, you should spend money, time and labor building train stations and laying down train tracks connecting those train stations.
Creating and building a better healthcare system anywhere in the world is a massive undertaking requiring years, enormous amounts of money, and significant human resources to complete (and then maintain). In our railway analogy, big data and clinical analytics are the train. The time will come when investing in these powerful ICT systems and tools will allow for a great leap forward in delivering high value healthcare. But before spending valuable, limited resources on this healthcare ICT train, government and healthcare leaders s
- Trend #1. Electronic health records (EHRs) are the health ICT train stations that must be built in 2017. So major 2017 ICT trend #1 must be investment in EHRs.
- Trend #2. At the same time as governments and healthcare systems are investing in EHR health train stations, they must invest in ICT allowing those systems to communicate across the networks. ICT hardware, software and transformational care service are the ICT health train tracks connecting the EHR train stations. Thus, the second major 2017 ICT trend must be investing in technology and services that drive broad, deep, rapid integration of the EHRs across cities, states, territories and nations.
Now, another word of warning based on the US healthcare reform experience: buying EHRs from a variety of commercial vendors makes affordable, successful communication across cities, states and countries much less likely, as differing EHRs are often unable to adequately
hould first invest in building “health ICT train stations” and connecting these stations by laying down “health ICT train tracks” across their cities, states, territories and nations. It is these “health ICT train stations” and “health ICT train tracks” that must be the major ICT trends beginning in 2017.
The US experience has shown us that it takes years to build our ICT health train stations and ICT health tracks. Investing too early in trains (big data and clinical analytics) is costly and inefficient. Fortunately, there is one significant and favorable difference between healthcare systems and railway systems: simply implementing an EHR in a single hospital can improve the quality, safety and cost-of-care for thousands of patients; next, integrating even a limited number of EHRs can dramatically expand that high-value care. In other words, unlike a railway system, investing in EHRs and integration ICT in 2017 will immediately deliver value to patients, providers and payers. … We don’t have to wait for the trains.