We have all heard this from exasperated colleagues, innovators, venture capitalists, politicians, regulators and most importantly patients. The healthcare delivery system has been overwhelmed with so many regulatory and reimbursement changes that there seems little interest in taking on yet another tech solution. Despite the policy changes being for the benefit of the patient, even the most elegant of systems creates significant and exhausting process change that it almost works to the detriment of care delivery. I also continue to be surprised by the complete lack of transferability of skills with the new IT infrastructures across care networks and that our workflow hierarchy lacks any malleability to adapt outside of an EHR construct.
The incredible inertia created by a faulty tech backbone has anchored healthcare innovation and the paradigm shift is kept at bay by regulatory cattle fences. Telehealth and mobile care delivery solutions are making a solid run for the flag here but meeting with incredible regulatory resistance, most of which is nonsensical and the antithesis of optimizing convenient care delivery. So why be bullish on healthcare innovation.
As an entrepreneur and physician I still earnestly believe that the promised land exists. It may be my rose colored glasses but I see the new generation of technology making fundamental shifts possible. We could not iterate on the EHR and make it more adaptive and interoperability is a regulators dangling virtual carrot. So as entrepreneurs we fundamentally decided to design systems that would make the EHR obsolete.
Obsolescence requires a stake at the heart of the function that the system that it was built on. With reimbursement changing to accountability we have the opportunity to transform and simplify the payment for services and transform the documentation back to the original clinical note. Building solutions that weave the data from the normal course of care interactions across multiple communication and engagement channels to one record that have the underlying ability to parse that data to hone in on what’s vital at a given point of time, will create an intelligent and living graph of the individual. This is the premise of any interactive tech solution of today, across industries. Additionally, bots that can create simpler more timely care navigation alerts to the patient based on this data will create a drop-down free interface for the care record and protocol driven care management.
EHRs are no longer considered comprehensive when it comes to clinical information about the patient and population. The EHR today is viewed as very narrow in focus and providers, population health managers and clinical trial specialists are increasingly incorporating insights from the periphery to create an augmented and dynamic clinical record of the individual as well as the population they serve. This data is close to impossible to extract from the EHR in any sort of longitudinal fashion. This new data has another nuance, it is collected, synthesized, and distributed in real-time, thus enabling more timely and effective intervention. We are on the cusp of systems that can be made to actually improve outcomes.
Clear networked communications, structured data bots and engaged patient triage alerts at point of care are all becoming this augmented care reality. We are also exploring new realms of monitoring beyond the simple biometrics of heart rate and steps taken that will allow us to query the health status of a patient throughout their day and bring compliance of care issues into focus.
New health-tech companies are building non-regulated care management paradigms that improve compliance, improve intervention time, provide consumer like interactions that optimize for behavioral care insights and personalized care modifications. We are dealing with a complex human customer and there is clear momentum that we are moving away from structured billings and documentation engines to more care oriented insights and interventions. A new era of care delivery and engagement will be realized by the confluence of data management, behavior modification and precision care paradigm alerts in an augmented care reality.