May 26, 2015

IT-centric notes on the future of health care

It’s difficult to project the rate of IT change in health care, because:

Timing aside, it is clear that health care change will be drastic. The IT part of that starts with vastly comprehensive electronic health records, which will be accessible (in part or whole as the case may be) by patients, care givers, care payers and researchers alike. I expect elements of such records to include:

These vastly greater amounts of data cited above will allow for greatly changed analytics.

And so I believe that health care itself will be revolutionized.

I believe that this will all happen because I believe that it will make health care vastly more successful. And if I’m right about that, no obstacles will be able to prevent it from coming into play — not cost (which will keep going down in a quasi-Moore’s-Law way), not bureaucratic inertia (although that will continue to slow things greatly), and not privacy fears (despite the challenges cited below).

So what are the IT implications of all this?

As for data management — well, almost everything discussed in this blog could come into play.

Finally, let me say:

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6 Responses to “IT-centric notes on the future of health care”

  1. sreeni on May 27th, 2015 11:38 am

    In the next 100 yrs, I believe collecting data for welfare of human beings will not have that much traction as collecting data about plants / animals / enviroment

    That’s where big data should find its trumpcard

  2. Neil Raden on May 27th, 2015 5:04 pm


    Can’t argue with any of it, but I’d temper it with a few things:

    1. If you think the whole medical/hospital/pharma nexus will give up their $3 trillion good thing without a vicious fight and immense obfuscation you are wrong
    2. There are as many doctors who finished at the bottom half of their class as the top. As clinicians, they are stubborn, narrow and defensive because they don’t know anything and they have to pretend they do
    3. EHR is still a mess, mostly useful for generating invoices but not records. Patients hate doctors tapping away instead of making eye contact. More is needed here
    4. Most journal articles are reversed in the first 5 years, but the downstream effect of the mistakes can last much longer

    The whole system is a big cesspool and technology can only address part of it

  3. Chris Selland on May 28th, 2015 7:29 am

    Curt – I share your optimism. Here’s a great proof point that I’m well acquainted with;) –

    The biggest hurdle right now is the way EMRs are being used and perceived. Doctors need to see data-driven medicine as something that helps them (rather than a tool Big Brother is using to look over their shoulder – which is more typical these days). There’s been so much focus on cost control and it needs to shift to ‘better care’ – we’re getting there but it’s still going to take time.

  4. Curt Monash on May 29th, 2015 10:31 am

    Neil, Chris,

    By no means do I want to minimize the difficulties.

    But I’d also note that not ALL technology needs to be adopted US-first. Perhaps certain healthcare IT will wind up being adopted first in countries with comprehensive national health services.

  5. dhenry on June 10th, 2015 2:22 pm

    As usual, you bring up many good insights. A few observations from the perspective of a BI Analyst at a physician practice group:

    – Diagnosis is ‘typically’ not where the difficulty lies, it’s in managing the treatment.
    – Today’s EHR’s are pretty much revenue/compliance oriented, not care oriented.
    – EHR technology will be used in a meaningful way when it has more to offer beyond just ticking off the right checkboxes on a patient screen in order to get your bonus or avoid penalty.
    – there is little room for innovation in today’s healthcare environment. The risk:reward ratio is skewed in favor of status quo. Innovation is largely going to have to come from the top-down because the current structure does not allow much deviation. Bureaucracies ‘can’ innovate, but it’s not usually their hallmark. That being said, there’s an enormous amount of low-hanging fruit to be picked.
    – a lot of budgets took a huge hit in recent years to ‘go electronic’; it will be a while before many of them can start tech shopping to fill the large gaps that came with their shiny new EHR. IT costs are in many cases the straw that’s breaking the smaller providers’ backs. Leaving the larger, less responsive organizations to figure out how to leverage IT. An unfortunate twist.

  6. clive boulton on August 10th, 2015 4:44 am

    Just how open is EPIC?

    “EHR vendors do not have a business case for seamless, affordable interoperability across vendor platforms.”

    Word on the street one EPIC EHR interface ends up costing about $75,000 – $50,000 coding + $25,000 in other fees.

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