Dreams vs. Reality in Healthcare

Mike McGuire, Chief Sales Officer, G2 Works

“Some men see things as they are and ask, why; I dream things that never were and ask, why not.” Senator Robert F. Kennedy used this famous George Bernard Shaw quote as his Presidential campaign theme in 1968. We could certainly use that depth of thought in today’s world, but I digress.

We’ve made, and continue to make clinical/medical advances that are driving us toward the feasibility of personalized medicine for us all. Diseases that were all but incurable 20 years ago are beginning to become manageable. The speed of these advances is accelerating because technology and its adoption are becoming more pervasive throughout the healthcare continuum.

While we’re making tremendous inroads clinically, we continue to struggle mightily with how to operationalize how we are delivering care throughout that same continuum. Through HITECH we’ve spent billions of dollars deploying sophisticated software solutions that, to some of our clinical brethren, make them feel like data entry clerks. These highly educated and trained resources, who can actually use these clinical advances, become stuck using systems not necessarily designed around the way they want to practice their craft.

Our current reality is that we are not going to replace what we’ve spent billions putting in place. Our dream is that someone figures out how to take what’s there and make it more efficient. Some of the inroads will be built around newer interoperability standards like FHIR (Fast, Healthcare, Interoperability, Resources). While hopeful, I’ve been around long enough to know that the software vendors of this industry do not like standards, as it diminishes points of product differentiation.

Standards, however, will not be enough. With value-based reimbursement as another reality, operational excellence has to occur at a speed we’ve never seen nor experienced before in healthcare. What makes it even more complicated is the change has to be from the ground up, not from the top down. Even though Washington wants to, you can’t just mandate quality. We have to give our people the tools required to eliminate, fix, and reimagine their daily lives around the value-based paradigm.

What we’ve seen over the last several years is the amount of knowledge that company’s like Amazon, Google, and Facebook collect on their users is massive. Analyzing and anticipating someone’s needs based on patterns of purchases has taken all of these company’s to the stratosphere in terms of growth and valuation. While purchasing decisions around clothing versus healthcare are certainly different, the data and the transparency of that data on a retail level, and what’s available in a healthcare setting are worlds apart.

I can get customer reviews on Amazon products and services on the website ad nauseam. I can ping Angies List and other websites to find who provides the best service at the least cost based on reviews. For those healthcare purists who believe this will never happen in our industry, it already is. What makes this different is who actually owns the data. One can argue that if you use the Amazon Platform, then you lost a certain amount of privacy. If I’m buying a pair of jeans that’s one thing, but if I’m hunting for the highest quality, but lowest cost Colonoscopy, that’s something totally different.

My decisions on my health care are between me, my clinical team, and no one else. So how do we cross that chasm between my desire to participate in these decisions with where and who has access to my personal data? Right now, I have three portals to navigate because my clinical team (one Primary Care, Two Specialists) has different EHR’s. The data is a by-product of our collective efforts that is managed by someone (vendor) I have no relationship with at all. Anytime I seek an alternative treatment/opinion, I’m captive to an automated system that has no automated capability to assist me. They print out what’s needed, and fax to the Doctor whose opinion I’m seeking…. Really? Billions, and this is where we find ourselves.

The dream has to be built around the patient owning the data and being able to access from whatever device, they feel comfortable using. An engaged patient, coupled with clinical assets allowed to re-imagine their workflows, and actually help manage their respective patient panel is where the dream will take us. As an entrepreneur, we can make that dream a reality. As a “citizen”, will we ever get the chance?