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Charting a New Course in Healthcare

May 16, 2013
by John DeGaspari
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Russ Branzell speaks of a healthcare revolution
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In the opening plenary presentation of the HCI Executive Summit, Russ Branzell, CEO and president of CHIME said we have come along way in healthcare IT, illustrating his point with a mix of vintage and modern photographs. But we have a really, really long way to go, he said.

He said it can be a bumpy road—we are in the midst of a perfect storm. That’s how he characterizes healthcare in 2013.

The nation is are spending way too much on healthcare, calling it Defcon 1—17.6 percent of GDP in 2010. “We will blow past 20 percent soon.

It is time to change healthcare, and health information technology is the answer, he said

Of the top issues confronting hospitals in 2012, HIT was low on the list of issues that provider organization CEOs worry about; but more and more, IT has become a survival strategy, he said.

Most healthcare IT issues is techy stuff, he said. What CIOs used to bring to the table is plumbing, data centers, etc., but most CEOs are interested in broader issues such as financial challenges, patient safety, and ACOs. “We have to make the connection,” he said.

CIOs are dealing with issues such as security, cost pressure, lack of agility, enable new products and services. But IT leaders have evolved into the role of drivers of change in healthcare," he said. “We need people who are defining a vision and driving changing. We need hardcore change,” he said.

Evolution is gradual development, which is the kind of change that has happened so far. We need fundamental change in a way of thinking about or visualizing something. CIOs are revolutionary leaders, or should be. He named three process trends to make change: integration, value (cost and quality) and transparency. But it can’t be baby steps, he said.

Managed care, quality care, value care, are all steps to achieving wellness care, he said. CIOs’ job is to make sense of all of this change. Alll stakeholders are under pressure: CIOs, physicians, vendors, etc. People are doing more and more with less and less. CIOs job is to make sense of all of this.

Building blocks of HIT 2.0 are HIEs, certified EHRs, patient portals, data warehouse, BI, data analytics, world class IT team, unified communications, ACO system, population health system, document management. “I am not sure we can check off any of these” today, he said.

For example, a nationwide health information network must be: private, flexible, secure, seamless, flexible, responsible, affordable, simple, scalable, reliable, according to its original vision. But Branzell says there are hundreds of HIE types. All use different standards; every health system in the country has a HIE strategy, connect with local, regional, and national HIEs, and there are no standards.

Regarding EHRs, we haven’t given enough recognition to the work that needs to be done. EHRs need interoperability, patient matching, clear standards, vendor readiness, and hospital/provider readiness. Washington doesn’t understand how complex healthcare is. We as revolutionary leaders we have to take responsibility to teach the country how complex healthcare is, he said.

He cited a plea from CIO in Washington: some vendors are not ready for Stage 2. Their customers will be forced to rush implementation. This CIO asked to delay Stage 2 or make reasonable accommodations when hospital or providers request hardship exception.
We know something is broken in the move to healthcare reform. There are ways we can do it differently, and we must find ways to create some revolutionary change, he said.

Don’t accept status quo, Branzell urged: Always be flexible. Plagerism is a skill, not a adopt successful practices. There is no need to constantly reinvent best practices for diabetes, or create standardized order sets. Don’t evolve—revolve, he said.

Survival is for the ones that can change the quickest, he said.