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Live from the iHT2 San Diego Health IT Summit: Hurtling Towards 2020 in Healthcare

January 21, 2014
by Mark Hagland
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Healthcare IT leaders discuss the broad range of opportunities and challenges facing the industry in the next several years

During the first day of the Health IT Summit in San Diego, being held Jan. 21-22 at the Manchester Grand Hyatt Hotel in San Diego, the opening panel discussion, titled “Healthcare 2020: The Hurdles and Opportunities Ahead,” healthcare IT leaders discussed a broad range of urgent issues facing healthcare in the next several years. The event is sponsored by the Institute for Health Technology Transformation, which since December has been a partner with Healthcare Informatics and its parent company, Vendome Group LLC.

Among the many issues covered during the session: the panelists’ perceptions of the biggest opportunities and challenges facing them in the next half-decade; payer-provider collaboration and new payment models; mobile health and virtual care management; and new relationships between patients and providers.

The session was initially introduced by Jay Srini, one of the Summit’s three co-chairs. Srini is chief strategist at the Sherman Oaks, Calif.-based SCS Ventures and an adjunct faculty assistant professor at the University of Pittsburgh. Following her introduction, as well as introductory remarks by Raymond Lowe, senior director, information technology, at the San Francisco-based Dignity Health, Daniel Ruppar, the moderator of the session, and the San Antonio-based global research director, connected health, in the Healthcare & Life Sciences division of Frost & Sullivan, initiated the discussion.

panel members (l. to r.): Ruppar, Kenagy, Anderson,
Ingari, Slepin

The panelists were Robert Slepin, vice president and CIO at the Phoenix-based Scottsdale Lincoln Health Network; John Jay Kenagy, Ph.D., senior vice president, CIO, and chief information security officer, at the Portland-based Legacy Health System; Frank Ingari, president and CEO at the Boston-based NaviNet, Inc.; and Hans Anderson, healthcare practice director at the Sunrise-, Fla.-based IT service provider Synechron. Below are a small number of excerpts from the discussion.

Daniel Ruppar: What is something you are excited about, and what is something you are afraid of, in terms of changes in the system, in the next several years?

John Jay Kenagy, Ph.D.: My answer to both would be the same; it’s the shift from payment for volume to payment for value. I think that is exciting, the opportunity to really incentivize the healthcare system to work towards value and the Triple Aim.

Crossing the Quality Chasm was published over 14 years ago, and we’re still talking about changes that need to be made. At the same time, the payment system is such a blunt instrument. I have concerns about the ability to create that change; this is a big system to change. But at Legacy, there is an excitement, an exuberance around size, and growth. We’re a $1.5 billion organization; some are saying you need to be a $10 billion to really create change. The thing is that healthcare is local; and I worry some about this excitement around growth and acquisition; one, from an IT organization, this will be difficult to accomplish.

Hans Anderson: My biggest excitement is integration to promote the continuum of care, care. The flip side is identification of patients for care management and health information exchange. There’s a lot of work that still needs to be done to normalize data and normalize the identification of the actual patient.

Frank Ingari: I’m most excited about the millennials, the fact that they’re used to using technology. It’s shocking the extent to which we do not coordinate and collaborate across healthcare; and this new generation takes for granted that we’ll use technology. The thing I’m most concerned about is the failure of the Affordable care Act, to date, to attract the “invincibles”—the healthy young millennials—to purchase health insurance [through the state health insurance exchanges]. This relates to the fear that the ACA will simply move the uninsured into exchanges.

Robert Slepin: I share the same excitements and fears. I’m excited to see our incentives across stakeholders in the system be aligned in a way that’s rational for the first time in the system—not just hospitals and doctors, but also the payers and consumers. That’s a rate-limiting factor in terms of our ability to transform healthcare, to make sure that incentives are aligned. Another excitement for me is the convergence of various trends—connectedness, social, mobile, genomics, big data, interoperability; and we’re not there yet, but there’s great potential.

Another concern for me is, I agree that healthcare is local. We can talk about population health, but at the end of the day, it’s behavioral change among patients that will change things. And if patients don’t trust the system because of fear of big-government control or because of NSA surveillance or whatever, we’ll have problems. So data privacy and security are very important.

Healthcare needs to operate like any other industry that provides value. There’s a trend now of healthcare organizations adopting Lean, because they’re recognizing that they need to get waste out and produce real value for the consumer, who will increasingly be the purchaser.