“The Wizard of Oz” (Healthcare)
Observations;
There seems to be a divide in the Healthcare Technology World in the U S between those that are proactively pursuing technology because it is necessary, improves quality and a necessary component of compliance and those who are “Capital” challenged and waiting for the “Wizard” to grant them the permission ($) to proceed. The ARRA HIT stimulus bill is effecting Healthcare Executives in different ways. George Halverson, CEO of Kaiser Permanente, one of the largest Healthcare Provider organizations in the world, declared at HIMSS, 2009 in Chicago during his keynote address that it was time to “Fix it Dammit”. While it is obvious that this is one approach there are still those that want the money first.
Reality for the Market;
Compliance still matters! Does it really? Quality still matters! Oh yeah? There is a contingent of CIOs that are being told to “Fix it Dammit” by their Executive Teams and are exploring otherwise forbidden fruit for many Regional and National Health Systems. Value Propositions for cost efficiencies, improving quality, competing in a patient competitive market space (for now) with the provision of EHR/PHR and closely tracking revenue winners/losers (P4P) for patient referral data is paramount for those companies that will ultimately win out. How about Utilization, Enterprise Performance Management and utilization, CXO Dashboards?
How about “Shovel Ready”? What does that really mean? Is it going to mean those that are proactive will get the ($) first with their strategically planned and developing projects or is it going to be beneficial for those that wait?
I am told by prospective customers that are closely following Washington legislators and assisting with the development of the Obama Health Stimulus Plan that the lack of expertise on the political panels sitting on the other side of the table is much like “The Wizard of Oz “(Healthcare). Who needs a heart, courage or a brain? Will the Wizard tell us? Will we “Fix it Dammit” or will this be another exercise in “Community Health Information Networks” (CHINS) that arose in 1993 out of the Hillary plan? (a failed effort)
There are many possibilities according to which way the political winds blow but just maybe we can control this proactively before the government steps in and tells us what to do and how to do it. If the latter happens, quality of patient care in the U S will surely diminish.
Comments
I think the need for a national healthcare policy is so obvious that it will happen and with it, a great deal of IT to introduce needed efficiency.
That said, the current state of affairs is so far beyond absurd that it will take much effort to pull it all together. What other country could afford to do it this badly?
Mistakes will be made. It's inevitable with something this needed, something that was that wrong and something so essential. So, people who respond early will get funds but people who have a better idea later will get funds. I think healthcare will have a very positive benefit for the IT industry for years and years.
This is different from the Clinton period. Even if it goes off the rails, it will get put back on. It must. This has gone beyond some progressive agenda to take care of everybody (though that is reason enough), it is now a matter of economic security.
I also think there is a tendency for IT people to think of this as all about them. The IT part will be small. We need more schools for more doctors and more nurses. Those schools and more students will also drive IT spending.
Posted by: Geoff Feldman | June 12, 2009 09:59 PM
Hi Gary;
All that I can really say is USA with its healthcare system including policy “makers” is 1 million years behind in helping their people.
All that nonsense as P4P, productivity etc. are only steps on maintaining a system when it exists while at this time USA has no healthcare system!
Somewhere in other underdeveloped countries there are similar issues, only difference there are less people looking to make a profit as its means for an earthly existence.
I am advocating for technology to be implemented across healthcare system because it provides faster solutions to healthcare issues.
What I will not agree with is when there are breaches in patient data privacy or when IT is outsourced to countries for cost savings purposes which in return are weakening the entire system.
We all are behind technology implementation in majority areas of our lives mostly because of political influences that are "more important' than people's wealth and wellbeing.
A proper healthcare system shows how well people are living in that country rather than how well some companies are performing.
Posted by: Donna Grossu | June 14, 2009 06:39 PM
Please consider all stakeholders in your wonderful and thought provoking post Gary. Getting a complete picture of the patient is not just the result of physicians or hospitals entering info into a system. Pharmacists, labs and others will need to be involved. It is going to take much more than implementing technology to make this work, and there are still many unanswered questions, including which stakeholders will be required to participate (can't just be docs to be effective), who should see what, who will ultimately own the data and as a result of use who will own the patient?
Posted by: Susan Dorfman | June 19, 2009 05:37 PM
I've been watching other stimulus funding and it hasn't flowed exactly as expected. I don't think 'shovel ready' will be the criteria. It will be more along the lines of having a proven track record and a lower potential for fraud, abuse and waste according to some internal calculations.
Change is needed. How can we help our leaders to overhaul our existing system, keeping the strong aspects and addressing the problems?
Posted by: Heidi Titchenal | June 24, 2009 09:01 PM
I appreciate the input for this posting and look forward to more thought provoking reponses. It is obvious that Healthcare Reform as it relates to technology is a hot topic. I am getting comments and e-mails that are Global in scope. They indicate also the opinions of those in various healthcare settings and models.
Keep the postings and opinions coming.
Gary Claytor
Posted by: Gary Claytor | June 25, 2009 01:33 PM
Thank you for the varied opinions on this subject. It is clearly a hot topic in healthcare globally.
Let's keep the conversation going.
Gary
Posted by: Gary Claytor | June 25, 2009 01:35 PM