Standard hospital hardware and software solutions, especially electronic health records, can cost billions of dollars and place incredible demands on data centers and the people who oversee them. Despite the fact that the purpose of these systems is to advance information flow across health care, they too often are “closed,” a situation that few people appreciate. Meaning, data cannot be accessed and used by hospitals, providers, or patients as they see fit.
While other industries are flourishing as a result of advances in data access and information flow, and consumer and social technology, health care lags. While other industries use IT as a tool for revenue growth to attract and retain new and existing customers, health care IT can inhibit or prevent efforts to connect with customers in ways that create loyalty. Why? Because the market leaders in health-care technology are not delivering massive advancements to the systems they sell. In part, this is because tough regulations make it difficult for new entrants to come into the market with alternatives. Also, many hospitals are locked into contracts with closed, antiquated software vendors that fail to keep up, let alone set pace with industry quality and technology initiatives. And finally, it’s because hospitals in the market for a new IT system often follow suit of their peers; instead of exploring new technology models that are already proven standards in other industries.
I’ve seen firsthand that the majority of hospital EHR installations to date do nothing to help hospitals improve their operating margin, collaborate with others, leverage technology advances, or rapidly adapt to change. None are cloud-based, open, social, or capable of becoming such; at best, there are some very limited mobile capabilities found within a couple of them. All require significant capital investment, and therefore create a sunk-cost relationship that intimidates hospitals away from exiting. None are offered as a service, but rather are sold on a “book and ship” model, meaning they recognize revenue right away, and it does not matter if a hospital ever gets value from the product. In short, these vendors have no incentive to make hospitals successful.
Even with all this, the most egregious issue is that hospitals are directed to pursue a strategy that encourages consolidation onto a single vendor technology platform instead of interoperating with heterogeneous EHR systems–something anyone who accesses and exchanges information from PCs, to an Android phone, to a Mac can realize is not a difficult feat. Even when hospital CIOs or CEOs request to interoperate with another system, it’s not done without vendor-led transactional fees tied to data access and flow. And, because these systems are traditional server-based software platforms, such information channels can’t be created at scale; they need to be built again and again – a slow, cumbersome, and ineffective process when the end goal is patient information being available ubiquitously.
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It does not have to be this way. Hospitals can reject technology partners who lack accountability for advancing clinical, technological, and operational outcomes, and play an undesirable role in terms of balance sheet trauma. Successful hospital management teams will be the ones who focus capital and expertise around new quality initiatives, population health, and care expansion instead of funding and running 1980s-era data centers. Fortunately, more flexible technology platforms are dancing around the corridors of hospitals; operating in some cases as a bridge to affiliated physicians. This tech transition from client server to web, from desktops to mobile, and from locally-hosted to cloud has happened at an astounding clip everywhere but health care, but make no mistake the opportunity to be smarter and balance costs, agility, and functionality in the form of a Web-based network has arrived.
Date: August 12, 2014