Pardon the disruption


I've just returned from the sixth annual Healthcare Unbound in Seattle, where I sat in on two days of presentations and workshops about  transforming healthcare with technology. There were some cool, new gadgets, such as a wearable monitor for seniors that detects falls, which I reported on in FierceMobileHealthcare on Tuesday. However, there was plenty that I heard that was not all that new: empower patients, encourage preventive care, make IT more intuitive. What made this trip worthwhile was that people actually had real ideas for getting to those oft-repeated goals.

As I also discussed in FierceMobileHealthcare, Dr. David Kibbe, senior advisor to the American Academy of Family Physicians' Center for Health IT, offered some clarity, presenting a list of five "disruptive innovations" that are transforming care:

  • Tools to close the "collaboration gap" between providers and patients
  • Telemedicine and telehealth technologies
  • Clinical groupware
  • Data liquidity
  • Point-of-care decision support

I touched on the first two on that list in my earlier column. For the purpose of EMRs, the final three are more relevant.

We all know that clinical decision support helps put real muscle behind EMRs. The problem is, it takes a year or more of good EMR data to make CDS really work at the personal level, putting healthcare in kind of a chicken-and-egg conundrum. Data liquidity also is a huge challenge, seeing that so many EMRs store information in proprietary formats. Kibbe long has championed the Continuity of Care Record standard to facilitate movement of individual patient records. As we report today, national health IT coordinator Dr. David Blumenthal says that healthcare organizations probably will have to figure out interoperability if they want some of the stimulus money for EMRs.

And then there's this notion of clinical groupware. Microsoft healthcare honcho Dr. Bill Crounse, another Healthcare Unbound presenter, describes it on his blog as "a set of practice management, electronic medical record, decision support, prescription writing and other solutions that could be delivered to clinical practices as services over the Internet." Think software-as-a-service, a growing alternative to expensive, license-based EMR systems that so many doctors have been avoiding.

"I'm going to suggest that clinical groupware is a disruptive innovation," Kibbe said. Still to be determined, though, is how clinical groupware can help extract data from EMRs for the purposes of interoperability and outcomes reporting--the same problems people face with traditional setups.

Hey, nobody ever said this stuff was going to be easy. That's why it's disruptive. - Neil

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