Over the past decade we have moved from a world where more than half of healthcare processes were paper-based to one that is mostly electronic. We also saw the rise of patient portals, a movement towards value-based care, the implementation of a new billing code system and an explosion of health data.
It’s hard to pick just one development from the past decade of Health IT as THE ONE that stands out the most, but that’s exactly what John Lynn and I tried to do on a recent episode of the Healthcare IT Today Podcast. My pick was government regulations. Nothing else had a bigger impact on healthcare in my opinion.
Things got started with the Health Information Technology for Economic and Clinical Health (HITECH) Act which begat the Meaningful Use program. That program eventually poured $28 Billion in federal stimulus money into EHRs (and Health IT in general) starting in 2011.
Later, we had the Patient Protection and Affordable Care Act (commonly referred to as Obamacare) which led to the creation of the federal health exchange – HealthCare.gov. This exchange landed with a thud. The story of HealthCare.gov became both a case study on how NOT to launch national government IT initiative and how to FIX one.
After recording our podcast, I thought it would be interesting to ask a few healthcare leaders what stood out to them over the past decade in health IT. Here is what they said.
Rasu Shrestha – Chief Strategy Office and Executive Vice President at Atrium Health
Yes, we had tremendous adoption of electronic health records in the last decade, but perhaps what’s equally as monumental is the rise of the consumer movement! Healthcare went from patients going to their doctors when they need care, to consumers being engaged in their health and wellbeing: curious, online, connected and motivated financially and beyond to play a more active role in decisions around the health and wellbeing for them and their loved ones. Now that’s one powerful dynamic waiting to be fully tapped into!
Luke Bonney – Co-founder and CEO at Redox
Meaningful Use propelled the electronic exchange of clinical information and incentivized the adoption of electronic health records. It brings the data to providers to more effectively treat patients and reduce medical errors. Although it was painful in the early stages, incentivizing the adoption of EHRs was a huge step forward for the industry to modernize the data infrastructure and begin a more purposeful patient-provider engagement
But equally important development was the acceptance of the cloud by healthcare. A critical event happened in 2017 when Cerner and AWS (Amazon Web Services) announced a collaboration. This was a single data point, that was part of a larger trend showing that the incumbents in healthcare realized that being on-prem was the way of the past, and cloud was the necessary way of the future. Healthcare began to view itself more as a business that needed to evolve its technology practices and buy in to the fact that cloud is where innovation happens. Healthcare knew it needed to take advantage of the cloud evolution or it would not survive as a business.
Shereese Maynard – Managing Director at Envision Care
When I look back at the last decade of health IT what stands out is our struggle with security and transparency. The U.S. has struggled with carrying out the intent of HIPPA, our nation’s regulatory answer to the portability of protected healthcare data, almost since its inception in 1996. The HITECH act of 2009 anticipated innovation and the sharing of data through EHR adoption and implementation, but we still have yet to secure the data of vulnerable patients. In 2019, HHS announced it was changing the penalties under HIPPA, moving to a tier system and lowering fines on three of the four tiers. This is counterintuitive to the breach activities we’re seeing, in my opinion.
Transparency has also been elusive. Over the past decade, regulation has sought to make the transparency of patient data related to the cost of care more readily available. Most recently enhancements to the Public Health Service Act were adopted to ensure price transparency but to date, patients are reporting the data to be confusing and true transparency denied.
Stacy Lindau, MD, MAPP – Founder and Chief Innovation Officer at NowPow
A decade ago, the health IT advancement of the year would have been drug e-prescribing. Digital drug prescribing was championed by the medical profession as a movement toward safety and error reduction. Drug e-prescribing was further championed by the pharma and retail pharmacy sectors for the benefits to sales, adherence, and business intelligence to be realized from prescribing data.
Just like drug prescribing systems work for all prescription medications, IT solutions that enable referrals to community-based supports must address whole-person needs. In addition to basic resources, impactful technologies will enable referrals for people to the full range of community resources needed to manage with chronic illness and care for others. People are not diseases – people have a range of needs and conditions that change over time.
Bill Kotraba – Vice President, Healthcare Solutions and Strategy at Information Builders
I look at the last decade as putting the first foundations in transforming how healthcare will be delivered. Two major pieces of that foundation were the move to put in large integrated EHR systems and the move to value based care in various forms. The tying of payment to quality and efficiency is a longer game that will be built around data and is just starting.
Chris Gervais – CTO and CSO at Kyruus
Through the introduction of important legislation and funding, we saw a massive effort to digitize healthcare. That set the stage for new workflows and standards for how people interact with their healthcare. Of course, it came at a price, both in terms of the organizational effort required for EHR rollouts and the toll it took on providers, in terms of time and attention using systems. EHRs were not designed initially for user friendliness and productivity. Thankfully we learned important lessons during that time – that leveraging best-in-breed solutions is viable and that we need to improve the user experience by involving both providers and patients.
BJ Boyle – Vice President and General Manager of Post-Acute Insights at PointClickCare
In the early part of the decade, electronic health records were used to bring paper-based processes to the electronic age and automate as much as possible within an organization. As the decade winds down, the move toward leveraging data to drive action, outcomes, and results is inspiring. Data being collected shouldn’t just tell us where we are at in a particular moment in time. It should tell us where we are going by helping us predict potential issues before they happen. We are recognizing that the end goal isn’t in how we collect data, but the meaningful insights and results we can get from it, and the tools that we can leverage to get to that end state.
When you look back at the past decade in healthcare and Health IT what stands out for you? Share your thoughts in the comments section or on Twitter using the #HITsm hashtag.