Key for Health IT Entrepreneurs: Don’t Disrupt the Wrong Thing

millenson-headshotAmong the 200 demos, 60 exhibitors and more than 100 speakers at the annual Health 2.0 conference on digital health, a critical insight for succeeding in this burgeoning market might have gotten lost in the noise.

The crucial advice came on separate days from two of the savviest digerati doctors in Silicon Valley. Not coincidentally, both Dr. Robert Wachter and Dr. Michael Blumpractice at the University of California, San Francisco (UCSF) Medical Center.

Wachter, an internist, was an early and eloquent advocate of the potential of electronic health records (EHRs) to improve the safety and quality of care. Actual EHR implementation, however, brought not nirvana, but a jarring number of “side effects.” Not least was the way the technology often distracts, confuses and complicates the lives of clinicians, endangering patients in the process.

The centerpiece of Wachter’s latest book is the story of a vulnerable 16-year-old boy who goes to UCSF for a colonoscopy and is supposed to get one antibiotic pill. Instead, for a variety of reasons linked to computerized drug ordering, robots and human dependence upon both, the patient ends up with 38-1/2 pills and suffers life-threatening seizures. Wachter’s book is entitled, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age.

“We’re on the cusp of a revolution” that is much more than a technological change, Wachter pointed out. He added, “We will get it right if we figure out not only the technology, but the adaptive change” needed for doctors and nurses on the front lines of care.

That same blunt message of “don’t hype, don’t harm” was reinforced the next day by Blum in regard to digital health apps. Blum, also an internist, is Director of the Center for Digital Health Innovation at UCSF. Like Wachter, he’s a health IT leader, not a Luddite.

Blum’s innovation title (he’s also associate vice chancellor for informatics) makes him for a magnet for entrepreneurs wanting UCSF to help them demonstrate the digital health fix for health care.

Too many entrepreneurs, said Blum, come to him with “a fairy tale. There’s a new sensor, Bluetooth-enabled, and it zips right to your doctor, who’s waiting for this.”

Added Blum, “Someone’s delusional…. You can’t just dump data in the medical record. It needs to be in the care process.”

What Wachter and Blum were both warning about, albeit from different perspectives, is the danger of disruptive technology that disrupts the wrong things: upsets checks and balances that keep patients safe, makes working conditions more stressful and simply doesn’t play well with others.

“Technologies don’t fix things,” noted Blum, standing in front of a slide showing a frustrated user tearing out his hair. “At best, they’re an enabler.”

A promise of some objective assessment of those enabling capabilities came from two exhibitors, the Care Innovations Validation Institute, a joint IntelGE company, and Social Wellth. The Validation Institute bestows a “certificate of validation,” along with a money-back guarantee, on vendor offerings in population health whose claims are found to be credible. Social Wellth, meanwhile, describes itself as a curation expert, providing verification that individual mobile apps are safe, credible, functional and effective.

So far in 2015, $3.4 billion in venture funding has been poured into digital health companies, according to Health 2.0 co-chairs Matthew Holt and Indu Subaiya. That doesn’t count the millions being invested internally by corporations like IBM IBM +0.25%, which has made the health care marketplace a centerpiece of its Watson artificial intelligence platform.

As I noted in a joint keynote with Matthew, being a doctor without Health 2.0 tools will soon be like being a doctor without a telephone: Information Age medicine is medicine.

The key to business success, however, will be to disrupt medicine without disrupting the lives of those who practice it.

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2 replies »

  1. In my work with thousands of burned out physicians we will often survey the docs asking them to identify their top three work stressors. When you look at a weighed average in any group of physicians … IT in some form occupies three of the top five spots every time.
    In most cases it is a combination of the EMR and other digital means being used to blow holes in the doctors ability to invest quality time face to face with the patient.

    The docs are certainly NOT waiting around for another piece of data to stream in from another app. Feels to me like a pendulum is swinging back into balance with this article. I hope we can stop the mindless “Creative destruction of medicine” mantra that thinks digital can “fix” doctors. We aren’t broken and digital is a tool best used for a specific job … not a panacea.

    My two cents,

    Dike Drummond MD

  2. Nice post, Michael.

    Too bad it took this long for this advice to get out.

    Too many entrepreneurs are operating under the assumption that docs and nurses need to be disrupted. Disrupting a dysfunctional healthcare system and disrupting docs + nurses are different things.