UCSF’s Robert Wachter says health IT still hasn’t realized its full potential, but promise is there

LAS VEGAS—Robert Wachter, M.D., a healthcare leader who has been critical of health IT's shortcomings, believes the industry is still behind when it comes to effectively implementing new tools. But he’s also seeing some bright spots that leave him optimistic about the future.

During a keynote speech at the College of Health Information Management Executives (CHIME) CIO Forum at HIMSS18 in Las Vegas, the chair of the University of California, San Francisco (UCSF) Department of Medicine struck a sometimes optimistic tone, highlighting instances at UCSF where data analytics has helped clinicians identify the origins of a deadly infection and allowed a specialist to review glucose data for every patient at the hospital in the time it typically took to do a single consult.

In most industries, widespread digitization takes 10 to 15 years, Wachter said. The complexity of healthcare will lengthen that time frame, but he appeared hopeful that the process is underway.

“Healthcare is harder; it will take longer, but I think this is beginning to happen,” he said, noting that Google shut down its early attempt to create a medical record because it was simply too difficult.

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Watcher also defended Meaningful Use and the government’s EHR incentive program, which laid a foundation for healthcare to begin using data more effectively. He called the backlash against the program “a little bit of revisionist history,” noting that 9 out of 10 hospitals have EHRs because of those incentives.

But his qualms with implementation have ebbed only slightly. He cited numerous instances in which technology was still failing clinicians. Along the spectrum of four health IT stages—digitized records, connecting various systems, gleaning meaningful insights and creating actions that improve value—Wachter says the industry has only completed the first stage.

But he also envisioned an EHR of the future that includes elements of a Facebook or Twitter feed for patients to easily digest information, built-in artificial intelligence for medical chart and literature reviews and “if there’s a God, we’ll ditch E&M coding.”

Finally, Wachter had high hopes for the Amazon, JPMorgan and Berkshire Hathaway venture which has the resources to push the industry forward. But he cautioned that healthcare isn't the book industry and didn’t think the partnership would eliminate the major EHR companies because of the money that hospitals have already spent to implement those systems. In the future, he believes EHRs will be just a kernel of the entire data system.

“Every big IT company is getting into healthcare, and I think they are going to stay,” he said.