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Time for Truth-Telling at the CIO Forum

February 20, 2011
by Mark Hagland
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It was refreshing this morning to listen to Nate Kaufman’s presentation at the CHIME CIO Forum. Put very simply, he told it like it is. So often in healthcare, people—including the senior executives and leaders who should know better—prefer to lull themselves to sleep in terms of denying what’s going on before their very eyes in the healthcare industry and in U.S. society at large.

The reality, as Kaufman hammered home, is that the old healthcare is going away, and faster than many think. The era of unaccountable, inefficient, undocumented-quality care is rapidly coming to a close, he noted, and in addition, regardless of whatever might happen in the U.S. Supreme Court regarding federal healthcare reform, the reality is that the cost-increase path of the Medicare and Medicaid programs is deeply unsustainable over time, and healthcare financing and delivery are going to be forced to change dramatically. Indeed, virtually every advanced, industrialized society in North America, Europe, East Asia, and Australia is facing a demographic and socio-medical tsunami, with the aging of populations, and an explosion in obesity-fueled chronic illnesses, among other challenges, putting intensifying pressure on all healthcare delivery and financing systems in those countries (and just wait until all those Asian smokers start spiking the cancer curve on that continent).

As Kaufman so cleverly put it, until recently, to “get into the game” of being a healthcare provider, “all you had to do was show up in a uniform.” What’s emerging, though, in the new era of ACOs and bundled payments, is that “you’ll need to show up with a team” of people in uniforms—uncoordinated, unmanaged, fee-for-service medicine is soon coming to an end.

The “good” news in all this, as Kaufman pointed out, is that CIOs and other healthcare IT executives and leaders, are now in a position of real influence, as they are increasingly being called on to leverage information technology to facilitate real change. That’s the bad news, too, of course, because in this new world, IT will become a make-or-break facilitator for coordinated, accountable, efficient, high-quality care. And it will be metrics-driven, measurement-driven care. And CIOs will have to be a part of the team that tells individual physicians that the old way of delivering care will no longer work or be acceptable.

I heard lots of good buzz from the CIOs attending the CIO Forum following Kaufman’s presentation. Moral of this story: CIOs are big boys and big girls. They can handle the truth. And the time is over when change-deniers can keep denying the fundamental changes that are taking place and forcing delivery and financing change in healthcare. In other words, if anyone in the room is still thinking that the handwriting isn’t on the wall in terms of forcing providers to restructure and transform care, it’s time for them to retire or move rapidly into the background and let their organizations’ leaders move forward as needed to create the future that’s on our doorstop now.