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Tag: Emmi Solutions

The Non-Physician’s Guide to Hacking the Healthcare System

Screen Shot 2014-07-30 at 8.23.49 PMWe 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.

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Providers Are Held Accountable. Why Aren’t Technology Vendors?

As healthcare shifts from fee-for-service to fee-for-value, hospitals and physicians are increasingly being held accountable for outcomes by the government, payers and patients. Historically, provider organizations only had to meet performance criteria to earn a pay-for-performance bonuses or hospital certification, but with the arrival of Accountable Care Organizations (ACO), Meaningful Use and other programs, payment is now based on to quality of care rather than quantity of services.

Health information technology (HIT) systems are able to track physician actions and measure outcomes down to the individual patient level and allow organizations to closely monitor the quality levels of a given physician. These same tools should be able to monitor the performance of the vendors who are there to support these clinicians. With patient engagement solutions, for example, vendors claim they can help improve HCAHPS scores, treatment adherence, patient outcomes, and reduce costs, but have no evidence to back it up.

Vendors should be willing to commit to their patient engagement promises, present proof showing improved outcomes and face some financial risk for failing to deliver.

Global accountability

Since patient engagement was included in the Centers for Medicare and Medicaid Solutions’ Meaningful Use of Electronic Health Records program, it has become a popular buzzword. Every HIT vendor claims to offer tools to assist providers with this important clinical quality issue, but no one is holding anyone accountable.

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