Two digital health pioneers opened the HIMSS18 conference in Las Vegas discussing the future of healthcare and how disruption and innovation will transform the industry.
Opening the CHIME (the College of Healthcare Information Management Executives)-HIMSS (the Healthcare Information and Management Systems Society) CIO Forum in Las Vegas was Nicholas Webb, CEO of Lassen Scientific Inc. a management consulting firm that provides innovation management consulting services, and who is the inventor of one of the first wearable technologies and one of the world’s smallest medical implants. Following him was Robert Wachter, M.D., chair of the department of medicine, University of California, San Francisco; and author, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age.
In his keynote, Webb first noted the importance of taking disparate data sets in healthcare and turning them into actionable insights that can be used to improve patient care or the patient experience. Webb, who also is the author of The Innovation Playbook, The Digital Innovation Playbook and the best-seller What Customers Crave, contended that there are four pillars of disruption in healthcare: consumerization; disruptive innovation; connection architecture; and economic models. “These pillars will impact everything about your business in the next six years. We used to believe that change was a linear curve, and we are [misled] in believing that change is linear. But it’s not; change is explosive,” said Webb, adding that the depth and speed of change could “sink” some healthcare organizations.
To this end, Webb said that his firm recently interviewed some 130 healthcare executives, asking them on a scale of 1 to 10, how important disruption is to their organization. Amazingly, Webb reported, every single person who was interviewed responded that disruption ranked a “10 out of 10” in importance.
But perhaps just as noteworthy, the executives were then asked to explain what disruption meant—and not a single person was able to do so clearly, Webb said. “Disruption is like a unicorn in [the sense] that nothing too weird has happened yet,” he said. Explaining further, Webb attested that breakthrough innovations are certainly occurring right now in healthcare, but he feels that isn’t the same as disruption. “Disruption means destruction. We are destroying clinical models and patient relationships and replacing it with betterness ran by three things: connection architecture, consumerization and disruption,” he said.
Webb went on to call the session’s attendees “chief technology executives who will be impactful in [being] inventors and disruptors.” He noted that for healthcare technology professionals, “Saying ‘Hi, I am an inventor’ is like saying ‘Hi, I am a breather.’”
Webb said he believes that hospitals and clinics are “technology organizations that happen to deliver patient care.” He noted that while this sounds disrespectful “to the genius of physicians,” if “we want to understand disease processes and better engage patients, it will be driven by the technology executives. Ten years ago, the technology executives were relegated to the basement. Now their role is to be innovators,” he said.
Indeed, U.S. healthcare will be undergoing a massive shift from diagnosis and treatment to anticipation and prevention, said Webb. “People believe that this will happen [all] through genomics and pharmacogenomics, but I don’t think so.” When people become sick, he explained, most commonly it’s through disease processes, and while some of those disease processes are non-variable and genomics will help in their ability to understand what to do before disease gets too far down the line, Webb said that’s not of the highest interest to him.
What Webb said he finds more interesting is wearable technology, in which “we’re looking at hundreds of data sets that then go to a learning cognitive machine to understand the meaning of the signals [that were derived from the wearables]. If we can leverage a learning machine to understand the meaning of a signal, we will take healthcare to a new level,” he said, adding that the paradigm needs to change so that folks don’t wait until they are sick to get healthcare, because at that point, options are limited and expensive. “We need to change the dialogue from intervention because we can’t afford it and it’s not sustainable. We need to leverage genomics and anticipatory care to get there,” he said.
Webb was asked during the Q&A part of the session about how to convince physicians that disruption is necessary, to which he responded by saying, “Put together the evidence by articulating the threat. Too many people in healthcare play the game ‘not to lose’ rather than playing to win. Don’t persuade [physicians and hospitals] that disruption is needed; talk to them about the bad things that will happen if they don’t [embrace] it.”
Meanwhile, speaking on the industry’s digital health transformation, Dr. Wachter noted how in the last decade, the most information-intensive industry known to man—healthcare—has evolved from the information backbone being paper records and fax machines to one where it’s EHRs (electronic health records). Wachter said, “People criticize HITECH saying that the government should have pushed interoperability more at the time, but for $30 billion [in federal funding to incentivize healthcare digitization], the government succeeded in digitizing a [$3 trillion] industry. So even though I think meaningful use went too far, I am a fan of what they did and I think the criticism is revisionist history.”
Wachter opined that the most important key for unlocking the “productivity paradox” in health IT is to reimagine the work itself and not do things a certain way just because that’s how it’s been done in the past. He brought up how companies such as Google and GE have failed in healthcare since the industry is so complicated and these firms didn’t know enough about the healthcare business. Wachter said he sees healthcare-specific companies building IT systems as a “win” in the EHR derby.
Wachter added that there are four core stages in the transformation from paper to digital health: digitize the record; 2) connect the parts—inclusive of third-party apps to enterprise systems, and patient-facing systems to enterprise systems, and to one another, rather than just Epic-to-Epic, for instance; 3) gleaning meaningful insights from the data; and 4) converting those insights into action.
Where is healthcare on this path? Wachter said stage one is done; the second stage has been started but not finished; and stages three and four have barely began. “When we do get to stage four, it will be magical,” he said.