Health IT and the Provider: Are Requirements Misplaced?

In the midst of all of the enormous energy dedicated to Health IT innovation, regulation, and implementation, an unfortunate consequence too frequently occurs: patients and providers are lost in the shuffle of user complexity and confusion that often outweighs touted benefits.

Health IT is an exciting and frustrating world. Anyone with an awareness of today’s healthcare landscape knows that technology is here to stay, offers great potential, and presents complex challenges for effective implementation that are often overwhelming. In the midst of all of the enormous energy dedicated to innovation, regulation, and implementation, an unfortunate consequence too frequently occurs: patients and providers are lost in the shuffle of user complexity and confusion that often outweighs touted benefits.

A Complex Landscape

Certainly, reimbursement issues and insurance have impacted this landscape in a huge way, but with the advent of digital health, this environment has become complicated by too many factors to count.

Providers are now swamped with new regulations and technology tasks that have caused many to leave healthcare altogether—which requires a look at whether the requirements of digital health are often misplaced.

Though there are exceptions in larger settings equipped with adequate resources, the burden for Health IT expertise and implementation can be too much for individual and small group providers. These physicians have much to offer in terms of the clinical expertise they provide, but the ongoing demand to meet endless and changing technology requirements drain limited resources and distract them from the care of their patients. 

Competition vs Need

Why is this? Why does the promise of digital health fall short of meeting the identified needs?

Unfortunately, what we often see is that innovation in healthcare technology is increasingly driven by competition rather than need, as Jeff Rowe recently pointed out in an article for HIMSS Future Care. In reference to the health-related competition that’s heating up between Apple and Google, Rowe notes,

“While the competition between Apple and Google may indeed be interesting…what’s perhaps more interesting from a purely healthcare perspective is how market competition, and not necessarily a specific need articulated by healthcare stakeholders, is giving rise to a new line of products.”

In a recent post for nuviun, Maneesh Juneja expressed similar concerns:

“Many Digital Health entrepreneurs are eager to come up with ideas for products and services that could change the world. But before they leap into the next big thing, I have just one question for them: What does the world really need from Digital Health?”

As a clinician for many years, and one who has been involved not only in the implementation, but development of EMR systems, I believe that we need to see more clinicians seated at the development table.

The disconnect between need and competition could easily be bridged if vendors could fully understand that the shiny objects of success lie not in product comparisons with competitors, but in the satisfaction which leads to provider acceptance and engagement—and that listening to the clinician’s voice will be the key to getting them there.

Sluggish Trends

A recent RAND report supports such concerns,

“In our view, the disappointing performance of health IT systems to date can be largely attributed to several factors: sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care provider and institutions to reengineer care processes to reap the full benefits of health IT. We believe that the original promise of health IT can be met if the systems are redesigned to address these flaws by creating more standardized systems that are easier to use, are truly interoperable, and afford patients more access to and control over their health data. Providers must do their part by reengineering care processes to take full advantage of efficiencies offered by health IT, in the context of redesigned payment models that favor value over volume.”

Though this report emphasizes certain responsibilities on the part of providers, which I agree are necessary, it also highlights the fact that the health IT systems available need to be easier to use and truly operational—something that was highlighted in the recent vendor failures to meet MU2 criteria, which left many hand-wringing providers stranded in systems that couldn’t do the job.

Hope on the Horizon

If health IT vendors offered truly effective products, more providers would certainly be open to using them. That’s why the solutions I recently highlighted, such as the Open API movement, vendor-neutral hubs, portal technologies, and collaborative initiatives are so exciting. In fact, any or all of these efforts may completely change the picture, even creating scenarios in which the needs of patients and providers can return to center stage—forging the path for technology to serve medicine, instead of the other way around.

Though effective and lasting solutions remain elusive, something must certainly change on the Health IT landscape, and we need to examine the amount of responsibility that is currently being placed on providers to make that happen.

A hybrid breed of clinicians-who-are-technology-experts do exist, but they are few and far between. We are, however, fortunate to have them in our midst—as their visions, passions, and abilities to combine both clinical and technology expertise may be healthcare’s only hope for sound and logical interoperability solutions.

Certainly, as the younger generation of healthcare professionals—who will emerge from the womb with iPhones in hand—continue to enter this environment, the seeming rigors of technology will be second-nature. But we’re not there yet, and the excellent providers who know medicine should be rewarded for this clinical expertise, not punished for the inability to get a software program to operate according to meaningful use criteria.

The current plethora of health IT software and medical device vendors continues to grow, and that doesn’t begin to include all of the activity on the consumer side—with the explosion of other sectors such as mHealth, wearables, and associated applications.

In the current environment, we’re faced with a vortex of proprietary interests and government regulations that stall progress—continually forcing a return to nearly starting from scratch. This creates continued frustration among providers who endlessly seek the best solutions for patient care and the bottom line of business—and leaves patients in the dust of disillusionment, wondering why the promises of technology have failed them.

The good news is that real collaboration appears to finally be taking place among the right players and within the right environments. Here, perhaps the leapfrogging development and implementation of effective solutions within global collaborative networks can be the answer. If so, we may see some significant progress in interoperability which leads to patient empowerment and the unleashing of healthcare providers from the burdens of health IT—helping both to heave a collective sigh of relief as they begin to experience actual benefits from all that digital health has to offer.