America’s Health Insurance Plans (AHIP) hosted its annual Institute in Salt Lake City last week. Perhaps it’s being shut in a hotel meeting room when SLC’s natural beauties and mountain air beckon, but even FierceHealthIT’s dispassionate reportage could not conceal the crankiness evident among the panel participants. If we are at the “intersection of science, technology and delivery system transformation,” it’s one with traffic jams, slammed brakes and detours. Louis Burns of Intel-GE Care Innovations maintains that the technology is there, but then qualifies that the data doesn’t connect with doctors who need it at the right time, and it may not be end user-friendly. (Perhaps he read this Soapbox?) Robert Margolis, MD of management services company HealthCare Partners, concurred that ‘giving someone technology is not the solution’. Burns again on why it’s taking so long to use effectively: standards are not established (wasn’t that resolved with Continua?) and HIT is siloed. But the real kickers are near the end. The Janssen panelist, Diego Miralles, MD, admitted that the ‘healthcare industry’ doesn’t want to take risks (sectors unnamed to protect the guilty). Burns, apparently with some frustration, lambasted ‘pilot-itis’ and ‘screwing around’ with little pilots. Whoa! The subhead to the article ‘…IT can fuel improvement, innovation–if only healthcare would get out of its own way’ cleverly picks around the potholes here. We have the technology to save healthcare. Now what?
Dr George Margelis
Actually, whilst it is true that IT can fuel improvement and innovation, I think we may have the sequence wrong. Healthcare and those who provide it need to be the instigators of the innovation, not be beholden to the limitations of the available hardware and its current usage models. They need to have the flexibility to experiment with the technology to discover what usage model provides the right outcomes in a clinically safe way, and evaluate the data properly.
Whilst I agree that we have too many small scale irrelevant pilots, we do need to make sure we have a properly evaluated trial to provide the relevant evidence of effectiveness and efficacy.
What we need is a way of coordinating the various pilots and trials around the world to enable sharing of the information so that we are not all forced to make the same mistakes, and can leverage the successes faster. Ironically it is IT that will enable to do this much faster than what it did in the old days of clinical trials.