We are residents and a software developers. Before starting residency, we spent time as software developers in the startup community. We were witness to tremendous enthusiasm directed at solving problems and engaging people in their health. The number of startups trying to disrupt healthcare using data and technology has grown dramatically and every day established healthcare companies appear eager to feed this frenzy through App and Design Competitions.
When we started residency, the restrictiveness of data and reliance on decades-old technology was grossly apparent. Culturally, hospitals are an environment of budgets and deadlines that are better suited towards maintaining the status quo than promoting the creative process. Hospital IT departments harbor a deep cover-your-rear-end mentality and are incentivized for two things: first, keep systems running, and second, prevent security breaches. Perhaps rightly so–privacy and security need to be prioritized–but this environment has delayed them from facing the inevitable challenges of effectively using their own data and investing in new tools, including ones that could improve the triple aim of greater quality care with greater patient satisfaction and lower cost.
In the future, as hospitals and health systems become more accountable for the long term outcome of patients, we are optimistic that they will innovate as much out of cost-cutting necessity as for providing a better product to patients. We have little evidence that established players can power innovation solely on their own engines and expect many of the solutions will come from problem-solvers outside medicine. Doctors and patients will choose from an arsenal of apps to interact with the health information in EMRs. These healthcare apps come in three major categories: education, workflow, and decision support.