he swearing in of Donald Trump as the 45th president of the United States on Jan. 20 will kick off a shared New Year’s resolution for many industry lobbies: gain access to the new administration and influence it. The health care technology lobby, for one, will begin bending the new president’s ear on subsidies and federal mandates to prop up their businesses. But if Trump creates new bonus programs in 2017 for doctors to do much of anything — let alone buy more software — you’ll be able to knock me over with a feather.
One real fear as the Trump administration takes office is that the political discourse on health care will shift completely to repealing and replacing the Affordable Care Act, and we will lose sight of the very real fight to keep the digital age from bypassing health care entirely.
I do not want to let health care off the hook. 2017 should be the year in which the legacy information technology solutions used by so many health care providers hear their death knell, and health information networks begin their ascendance.
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The health care industry, for which we pay dearly and on which our lives depend, is clinging desperately to expensive and outdated software that doesn’t earn providers or patients much in return. Despite billions of dollars of federal investment to digitize health care, the daily experience of it feels unchanged since the 1980s. Medical science and procedures have advanced, but there has been little progress eliminating the clipboards, faxes, and basement servers that continue to keep the business of health care on life support.
Health care is not really an exceptional business. It is fundamentally no different from other industries, like banking, retail, hospitality, and travel, except that they have run headlong towards the information economy. Disruptors like Uber, Waze, and Airbnb have turned their respective industries on their heads with smart, delightful applications that tap into the power of networks to leverage data for the benefit of their users. Health care can and should embrace the automation, knowledge, and resource orchestration that have defined these innovations.
What is exceptional is the opportunity we now have to conscientiously guide, build, and inform Internet-enabled, networked health care.
We have some early ideas of what this could look like from one of the stodgiest, most unlikely players in the industry: hospitals. One need only look at the beds that routinely go empty in today’s hospitals and academic medical centers to notice that consumption patterns are changing. Patient care is streaming outside hospitals’ walls into urgent care, retail clinics, telemedicine, and outpatient settings.
In response, pioneering hospitals are redefining themselves from organizations that deliver care to organizations that also orchestrate resources. They offer mobile connections; share information between providers and patients; connect to downstream labs, pharmacies, and imaging centers; and close the loop on care not just because it’s the right thing for patients but because it’s good for quality and cost. It will also help them reap big rewards in the transformation to value-based care.
The Uber of health care today is not a sexy Silicon Valley startup. In my estimation, it’s Lost Rivers Medical Center, a 14-bed community hospital in central Idaho near the Sawtooth National Forest. In the US, 35 percent of rural hospitals are currently operating at a loss. Lost Rivers was among them. But when it was on the verge of bankruptcy, it made the audacious decision to scrap its servers and clipboards and to plug into the knowledge, insight, and efficiency of athenahealth’s growing network of 85,000 providers and 83 million patient records.
Tapping into the power of the network has helped the medical center automate work for its providers and organize, scale, and automate its administration to decrease work and limit the potential for error and deviation. It also dramatically lowered the number of claims denied, and shortened the time it takes to get reimbursed, boosting cash flow. That means money gets back into the medical center’s hands quickly, and can be directed where it’s needed most — whether that’s initiating, delivering, and administering clinical care within Lost Rivers’s four walls or orchestrating resources outside them.
Here’s the beauty of the network: Unlike a politician’s promises of progress, a network progresses inexorably. It grows more knowledgeable daily and shares that knowledge, like dividends, with its users. Embracing the network model will influence the way that providers and leaders understand health care today, while they continue to build the health care systems of tomorrow.
Health care practitioners and organizations of all sizes need real-time information and connection to learn from and share information with one another. By embracing the network, the insights made each day by providers and patients and payers will, over time, become the industry’s insights.
The network effect is already taking hold in corners of the health care market. In 2017, I predict that the rest of the industry will finally begin to take note. Not all software lobbies will like it, but providers and their patients will.
Jonathan Bush is CEO and president of athenahealth, a health care technology company based in Watertown, Mass., and author of the New York Times bestseller “Where Does it Hurt? An Entrepreneur’s Guide to Fixing Health Care.”