There is no disputing that the Covid-19 pandemic has been the spark that ignited the revolution, which will change traditional pathways of care in this country. There are many pain points and inefficiencies that must be addressed. Chief medical officers (CMO) and chief information officers (CIO) believe that the medical industry in on the cusp of transformative change and this partnership will be a key driver of innovation. This collaboration will usher in an era of technological advances in healthcare, which we refer to as Future Care.
Challenges to overcome
Today, many caregivers are trapped in poor environments that inhibit the ability to effectively serve patients. Providers need a high patient flow to remain financially viable, which has limited time spent with each patient. Inefficient technology such as legacy electronic health records (EHRs) require too much time spent interacting with the EHR rather than with the patient. This leads to a great deal of patient and provider dissatisfaction, decreased efficiency and increased stress, for both providers and patients.
Despite these inefficiencies, prior to the pandemic there were established pathways for care delivery. For hospitals, that pathway was in-person delivered within its four walls. The pandemic disrupted that model, first by filling facilities and preventing elective procedures and then by forcing a move towards remote care. The Covid shock to the medical system has also proven that data must be analyzed and used much more efficiently to create new pathways for care.
Technology – Current problem, future solution
EHRs have evolved from their initial use as data repositories and documentation systems that capture data in support the health systems billing activities. Today these systems help to facilitate the care delivery process and optimization of clinical workflows. However, like all technologies, EHRs as we know them have reached the end of their lifecycle.
According to a recent Gartner report the EHR (also known as generation 3 EHRs) alone are no longer sufficient to meet the demands of mass digitization and personalization of care. Instead, the EHR is a foundational capability that must connect to a richer ecosystem of modern digital health applications, systems, services and devices necessary to deliver high-quality, affordable and patient-centric care. The next generation EHR must evolve into a clinical data platform capable of supporting the use of evidence-based medicine at the point of care.
Unlike earlier monolithic IT approaches, this new platform is digital and modular, and much more adaptable to business change. To keep pace with changing business, clinical and consumer expectations, healthcare provider CIOs are shifting from monolithic IT (i.e. legacy EHRs,) to a digital health platform (DHP) architecture. EHRs must now evolve into a platform that support a DHP model.
Many of these new EHRs have been designed with open architectures, as part of the move away from all-inclusive and inflexible systems. Most current EHRs are not designed as native open architecture platforms. Some emerging EHRs are native Fast Healthcare Interoperability Resources (FHIR) at the core. EHRs that are FHIR-based can integrate into best-of breed-systems that enable advanced analytics, virtual care, improved patient engagement and population health management. These are critical steps toward customized care and a health model that emphasizes pay for value rather than fee-for-service.
Part of this major shift is a change in how IT itself is viewed in medicine. Over the past few decades, there has been a revolution in computing and communications. IT is the new utility, as necessary as things like clean water and electricity. Much like utilities, in today’s data-driven environment information systems (i.e., servers, networks, mobile devices, tablets, etc.) and the applications that support the business ecosystem have become a vital part of how care systems deliver their products and services.
It’s taken a bit longer in medicine for this view to take hold. But today’s care organizations must accept the reality that their IT infrastructure (the new utility) is critical for the dissemination of business intelligence (or informational currency) and is essential to remaining competitive. Every business and clinical decision today has an IT component attached to it.
The new applications fueled by patient data are coming soon and are truly amazing. Remote patient monitoring (RPM) will be the standard rather than the exotic. Customer applications that are simple to use but yield a wide range of physiological data powered by Photoplethysmography technology and connected to the clinical data platform, hint at the possibilities. These wearable devices will revolutionize chronic care management, as well as in-patient monitoring. Virtual reality platforms, combined with 5G throughput, will eventually have patients interacting with an avatar of their physician making the virtual visit more realistic.
The addition of haptic technology will enable the performance of remote physical exams. Artificial Intelligence (AI) will improve the accuracy of clinical decision making and improve the recognition of population health data which will drive down costs. If this seems like science fiction, think of the concept of a self-parking or a self-driving car 30 years ago that are today’s reality. This powerful constellation of emerging IT and devices will allow increased access to Health Care for patients and dramatically improve health equity.
CMO and CIO collaboration
The line between caregivers and IT in medicine used to be stark. In fact, the cliché arose that most doctors were hopeless with IT. That has changed dramatically, and the lines are blurred today. Doctors have been forced to learn about IT to do their jobs, and facilities are pushing back against the assumption that medical workflows need to adapt to technology. It should be the other way around – HIT needs to incorporate medical processes.
The role of the medical CIO has also changed. The need to update delivery pathways, accommodate remote work and better analyze data has made CIOs more collaborative. Inputs for decisions are coming from outside the CIO office, from more savvy practitioners and other stakeholders. With technology evolving so quickly, the bar has been raised for understanding on both sides.
This collaboration bodes well for making the right IT decisions and not being distracted by the latest “bells and whistles.” Facilities need to move beyond Generation 3 EHRs and surround themselves with technology that extends their capabilities beyond the traditional use of these systems. Everyone involved with the strategic delivery of care deserves to be at the table, and hopefully this editorial is a small example.
The nostalgic memory of the trusted doctor by your bedside with a small black satchel is gone forever. The medical industry is catching up with other industries in the analysis and activation of patient data for greater efficiency and enhancing clinical care. This is the path forward by which quality healthcare can be personalized at scale for a rapidly aging population.
“Future Care” is here to stay! The growing application of technology in healthcare and its possibilities for enabling the disruptive change in our industry is exciting!
Photo: Feodora Chiosea, Getty Images