Health IT still has some growing up to do


Nearly one year ago, I experienced the ultimate in joy when my son was born. I'm so excited to be a dad and even more excited--and curious--to see how he grows and changes over time. Similarly, I'm curious to see how the healthcare technology landscape will mature over time. After all, my son ultimately will be the beneficiary of all of these innovations that are currently in their infancy.

On that note, one of the most interesting conversations I had about the future of healthcare technology at the Healthcare Information and Management Systems Society's annual conference in Las Vegas last week was with Intel Chief Healthcare Strategist Eric Dishman. The central themes of the chat most certainly were in lockstep with those of the conference--primarily, technology's growing role in increasing quality and accountability in healthcare.

Dishman talked about the efforts of other nations to truly embrace technology, while at the same time scaling back on traditional brick-and-mortar, fee-for-service models. He also talked about why it's taking so long for the U.S. to do the same.

"I think that thinking is already here," Dishman said. "But I also think that it's hard for the U.S. to stop being hospital-centric until we actually reduce the amount of hospital bed space that we're trying to fill."

Denmark and several other Scandinavian nations have done just that, according to Dishman, likening their dependence on hospitals to a nation's dependence on foreign oil. They've forced themselves to get off of their reliance by closing beds and using those empty beds for other services, such as assisted living or rehab centers.

"Your dependency on hospitals will continue to scale if you keep building more and more of them," he said. "In turn, your innovation potential gets sucked into the gravity of the hospital and you can't even start to look at an alternative model."

Social networking and telehealth, among other technologies, are helping to change the hospital-centric culture, something that Dishman says we'll see in the U.S. as the movement toward accountable care begins to mature. "There's been no financial incentive to use such technology, since the only way a doctor's been able to get paid has been through face-to-face visits," he said. "Now, with the passing of health reform and the implementation of accountable care organizations [it's time to] unleash the innovation hounds. I think we'll start to see the innovation quotient go up significantly fairly quickly because now there's economic incentive that can allow that to happen."

While Dishman predicted that within 10 years, face-to-face visits will be the exception rather than the rule, getting to that point is easier said than done. How politics shape the U.S. healthcare landscape cannot be ignored--just look at the divide regarding reform and even ICD-10.

That said, I do think communication between doctors and patients will become more multi-modal over time, as both Dishman and Doug Fridsma, Director of the Office of the National Coordinator for Health IT's Office of Standards & Interoperability, said they foresee happening. In an interview at HIMSS with FierceHealthIT, Fridsma said he thinks the Direct Project and CONNECT will help to turn such ideas into reality.

"When you talk to your family, do you use email?" he asked. "Do you use the phone? Do you use Facebook? There's no set way that we communicate with our family, so why would there be just one for the way we communicate with our healthcare community?"

Dishman, meanwhile, said he envisions secure video conferencing from work and instant messaging to inform a primary care doctor that, in fact, you don't need to come in for that visit.

I hope we'll be that far along a decade from now. Ultimately, though, I think it will take a lot of baby steps. - Dan

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