The Good, The Bad, and The Ugly

By Charlie Miraglia

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Now that we’re halfway through the second decade of the 21st century, it seems like a good time to examine where we are with respect to advancements in healthcare, with special emphasis on technology and availability of data. For the sake of simplicity, I’ll put current opportunities and challenges into one of three buckets – the good, the bad, and the ugly. While perhaps not as dramatic as the 1966 spaghetti western, I’ll try to make these big picture – no pun intended – observations as interesting as possible.

Before getting into which bucket certain topics fit best into, I’ll set the stage to hopefully clear up how and why I came to the conclusions discussed below. First of all, we have entered an era when we as consumers have certain expectations from any industry with which we interact, and healthcare is not immune. It follows that we expect healthcare to be as responsive to our wants and needs as is Amazon or any other retailer. Providers need to deliver better outcomes at lower costs, while focusing on patient engagement and the consumer’s overall experience to keep them coming back.

We often hear terms like disruption and innovation these days in discussions about the transformation of healthcare. Hospitals and health systems are investing significantly in electronic health records (EHRs), big data analytics, and at-risk population health management. They are using new technologies to help trim costs and improve efficiencies, adopt best practices, and learn from other industries like manufacturing and retail. In other words, they are acting more like “businesses” than ever before.

The Good

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The most forward thinking providers in healthcare are developing digital strategies to improve the quality of care delivered, expanding access for patients, and creating comprehensive patient profiles that lead to a more personalized approach to treatment. In addition, they are beginning to invest in mobile apps, wearable devices, virtual care, and remote monitoring of patients for more comprehensive care delivery. These initiatives will lead to the increased demand for data analytics capacity to support the at-risk population.

As we continue to shift to value-based models in healthcare, there will be much more attention given to preventive care, wellness, and tracking of chronic conditions to keep people’s illnesses from progressing. Focusing on these activities will have a significant impact and be of great benefit to communities. Add to this the patient-centered approach and personalization of processes and healthcare begins to look like other successful retailers.

The Bad

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While this all sounds like motherhood and apple pie, there are certainly a number of down sides to consider. First, significant investments will be necessary to adopt these strategies and many organizations historically invest in solutions that have not resulted in better health outcomes. Second, there are regulatory demands that also require considerable resources – like conversion to ICD 10, Meaningful Use 2 (the sequel), and interoperability – to name just a few. And last, but certainly not least, we have to keep in mind that many health systems have recently grown by merger and acquisition, essentially creating collections of facilities with varying cultures, strategies, technologies, etc. It may be some time before they are aligned and capable of leveraging each hospital’s distinct capabilities.

The Ugly

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A discussion of technology advancement would be incomplete without referencing cybersecurity concerns, especially given the major hacks that seem to be occurring more frequently these days. Obviously, healthcare providers are concerned with protecting patient information while making it available to those who need it to care for patients. However, with the growth of mobile technology, EHRs, and huge databases both in and out of the cloud, keeping patient information safe has never been more complicated – or more important.

Finally, the closure of many hospitals may be unavoidable in this new reality of healthcare, not unlike the closure of local hardware stores when Walmart comes to town. Sadly, the hospitals most likely to close are the ones that are often most needed – the so-called “safety net” hospitals – that serve an extremely vulnerable part of the community.

To end on a positive note, patients are finally becoming more empowered to take control of their treatment plans, their data, and even what they pay for healthcare. The new transparency we’re seeing in pricing will lead consumers to shop around for their medications and everything else they need for themselves and their families, from office visits to surgical procedures. We still have a long way to go, but we’re off to a pretty good start!

Dr. Charlie Miraglia is hc1’s Chief Medical Officer, and Chief Movie Buff. You can reach him on Twitter @ccmiraglia.

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