Blog post by Joe Babaian
The best way to predict the future is to invent it.
– Alan Kay, Turing Award Winner
We find ourselves navigating an era of rapidly advancing new technology in healthcare. As part of the worldwide healthcare community, we wonder how we’re going to know which technology matters, which is just so much noise, and which will dramatically change the face of healthcare forever. I’m reminded of this comment by Clay Shirky in his book Cognitive Surplus:
As with previous revolutions driven by technology … what matters now is not the new capabilities we have, but how we turn those capabilities, both technical and social, into opportunities.
How indeed! In his Forbes article, Dr. Robert Pearl, CEO of The Permanente Medical Group and recent keynote speaker at @StanfordMedX. compellingly writes about the barriers to technology adoption in healthcare. Dr. Pearl describes five obstacles preventing technology adoption in healthcare:
- Many New Technologies Don’t Address The Real Problem
- No One Wants To Pay For New Technologies
- Physicians Are Reluctant to Show Patients Their Medical Information
- Technology Slows Down Many Physicians
- Many Physicians See Technology As Impersonal
Active participants in the #DigitalHealth arena will recognize and likely agree that these five key issues are slowing the adoption of effective technology. Our challenge is to find solutions that surmount these barriers.
Recently, I had the distinct privilege to ask Dr. Pearl about his five obstacles and what he sees for the future. I wondered where the best prospects lay for springing past these barriers as well the trends that might hold us back. Dr. Pearl outlined what he currently sees as the best opportunities as well as what he feels may hold us back:
The biggest opportunities will come from the Exchanges and Medicare Advantage. In the exchanges (at the silver level which is where the health care subsidies begin) it is expected that subscribers will pay on average 30% of the total health care costs. To reach 30%, the health plans include a deductible. People who have to pay first dollar out of pocket will demand alternatives to the doctor’s office visit – and technology will provide the solutions.
Medicare Advantage moves care from fee for service to prepayment and aligns incentives. Programs want to be “Five Star” and they need to provide care which is superior in quality, but also efficient and effective. Once again, technology provides powerful solutions.
The fear is that our nation won’t find a way to move to better financing approaches (prepaid or bundled) and improved delivery models (integrated and technologically enabled), in which case we will devolve into a “two tier system,” with the middle class in the lower tier and investment in new technology will dwindle.
Dr. James Legan, a Montana-based internist and fan of finding new solutions to technology barriers is an active participant in #DigitalHealth. Legan is using innovative methods to better share EHR data with his patients and foster engagement. He talks about his experiences in an interview with Healthcare Informatics:
When patients can see their own vitals over time, it is really powerful. When they can see their past medical history, it gives them a sense of power that they are a part of process. Going through and updating their family history, their allergy list, the medication reconciliation—it’s not just them looking at the data, it becomes a useful tool. I can e-Prescribe and print up a medication reconciliation form that’s accurate because the patient is right there telling me what’s accurate in real-time.
Legan took some time to talk with me about his encouraging experiences with elderly patients when it comes to sharing their EHR data with them in the treatment room:
Patients love this stuff, and I initially thought the elderly complex patient would turn off with information overload but found instead they are the ones most interested, and has worked great in this population of folks.
What can you add to the discussion and how can you help healthcare “Jump into the Future?”
Legan, M.D., James. Interview by Joseph Babaian. Personal Interview.
Pearl, M.D., Robert. “5 Things Preventing Technology Adoption In Health Care.” Forbes. September 11, 2014. Accessed March 5, 2015 http://www.forbes.com/sites/robertpearl/2014/09/11/5-things-preventing-technology-adoption-in-health-care/
Pearl, M.D., Robert. Interview by Joseph Babaian. Personal Interview. .
Perna, Gabriel. “In Montana, One Physician Brings the EHR to the “Big(ger) Screen”” In Montana, One Physician Brings the EHR to the “Big(ger) Screen” July 24, 2014. Accessed March 5, 2015. http://www.healthcare-informatics.com/article/montana-one-physician-brings-ehr-bigger-screen
Shirky, Clay. Cognitive Surplus: Creativity and Generosity in a Connected Age. New York: Penguin Press, 2010.