Sunday, December 27, 2009

Seven things to watch in 2010

Since we're at the end of the year, I thought I'd give you seven things to think about in 2010. These are trends I see happening in healthcare IT, especially with the Meaningful Use criteria upon us. Remember, my list is free, and you get what you pay for. :)

1. Embedded Informaticist - If you don't know what this is today, you will soon. These are the key, crucial people you will need to make your EMR and CPOE efforts work. Without them, your C-suite will eventually confront : Do we rewire our hospital's departments, policy mechanism, and educational/training mechanism, or do we unplug our EMR? Having a good CMIO will help you organize them. Look for a labor shortage in Clinical Informatics as soon as the ink dries on Meaningful Use. Look to the AMIA 10x10 class to help you grow your own embedded informaticists. If you don't have them early in your EMR/CPOE/clinical documentation implementations, you will eventually throw your money away.

2. "CMIO" versus "Physician Champion" - Many places confuse the two. Confuse them at your own peril. In 2010 a lot of places will be learning about the difference between the two.

3. Flower - This project is noble and has teeth. I'm one of the early architects, so how can I not tout it? If you're not sure what Flower is, it's basically a way of cutting through chaos and competition, and developing a clear national healthcare IT standard so that patients medical information is more portable and accessible. We're developing the technical details and marketing. The point? It's going to be a patient-led effort to organize healthcare. Remember : The patient is the boss. Ignore them at your own peril.

4. Confusion - Meaningful Use should be ready soon, and the political landscape is shifting RAPIDLY. The Beacon Communities funding opportunities will be forging new healthcare landscapes and political alliances that nobody ever thought possible. While all of this is promising, how it will actually pan out, and who will not be able to keep up, is harder to predict. Should be an interesting year.

5. Transparency - I see healthcare as needing to become more transparent - The patients are demanding it. Prepare to open balance sheets, have frank conversations that you never thought reasonable, maybe even (gasp!) doctor/administrator/patient partnerships to help build a better community. With healthcare reform in the air, partnerships will be crucial. If your organization isn't politically nimble enough, or your C-suite doesn't get energized on this, the next few years will get more difficult.

6. Healthcare shortages - While most of the healthcare reform seems to be focused on proving more access, little else other than HITECH has any muscle to improving efficiency or costs. As the baby boomers age, we don't have enough resources to provide the care they grew up with. The current healthcare bills don't address tort reform, and in my opinion both the House and Senate bills lack the muscle to turn around our current system. In my head, the bills are like a tiny parachute trying to stop a car from hitting a brick wall. The problem : Some people will point to the bills (tiny parachute) as the "reason the car hit the brick wall". A bigger parachute would help, but in our current system we don't have the political support for that. I expect the "give more access and don't fix the efficiency" approach will be a problem. Be ready for a lot of people to point to the tiny parachute as the reason the car hit the wall.

7. Patient-led reform - As I described in #3 above, the patients are our bosses - Ignore them at your own peril. I'm very impressed with the ePatient initiatives - The patients are figuring out why healthcare isn't meeting their needs - We're all too busy competing! (It's important that they know - They're the boss!) I anticipate the ePatient movement will continue to grow as social media allows them to organize and discuss their beef with modern healthcare. Look for the strong leaders in this movement to accomplish what government and insurance companies and healthcare can't. ePatient leaders also help educate the many, many people who have strong opinions about healthcare reform who actually have little actual experience with healthcare. If there is one place healthcare reform can happen, it's in the ePatient political arena. If I had to fix the nation's healthcare, I would look to some of these people to help lead the political movement, and partnerships between them and front-line clinical staff will be crucial. They have political clout nobody else has.

That's it for now - Hope everyone had a good 2009, and let's all work together to make our good healthcare system even better in 2010!


The EHR Guy said...
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The EHR Guy said...

Excellent insight!

Many providers neglect the value of the CMIO and this forces vendors to foster and promote a champion within the physician population.

This creates an ad-hoc CMIO without the necessary planning and strategic organizing.


Dirk Stanley, MD, MPH said...

Yeah, this is a common mistake - In a small place, the CMIO can be your physician champion, but in a big place, you really need both. And confusing the two can just set up a physician champion for failure, if they don't have the administrative support they need to succeed.
Thanks for the compliment!