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The Challenge for Vendors in Healthcare IT

By Gary Bryant

My wife was kind enough to schedule an appointment for me with a new doctor. I went to the doctor's website, captured the address, googled a map and followed the precise directions right to the front door within a minute of my appointment. Instead of being greeted by a cheerful receptionist, I instead was confronted with a small terse sign that read "Dr. Blah-Blah's office has moved to …"

When I finally arrived at the doctor's office 20 minutes late, I informed the office manager that I had gotten the address from their web site. "What web site?" She responded. Having worked there for over six months (the office moved more than a year ago), no one ever told her about the doctor's website. We can only imagine if the doctor knew he had a website.

Speak to any doctor or nurse, and it's clear that the patient's care is utmost in their mind. Clinical intentions are noble, but doctors and support staff fails to connect the dots when confronted with health IT implementation and its subsequent benefits (or consequences). Healthcare culture, office politics and personal resistance when draped around an ill-prepared IT initiative can lead to poor customer service, inefficiency, low morale, medical errors, and more expensive treatment scenarios. All of which contributes to the growing lack of confidence in health care system overall.

Doctors often take the wrap for the slow adoption of IT. They're busy, they're often seen as aloof, unreachable and uninterested in the business of running 'the business'. While that may be true in some cases, the problem may really lie in the business structure of the community's doctor's offices, rather than the culture. While traditionally esteemed and respected in the societal hierarchy, advances in other sciences gives the impression that doctors are simply well educated and highly compensated technicians, much the webmasters of the 1990s. How many company boards would let their webmaster call the shots today?

Still, we have ten-year-old children using sophisticated text messaging capabilities on personal cell phones. We have doctors directly connecting nerves to prosthetic devices that put the 6-million dollar man to shame, we have store front owners and even politicians growing adept at blogging, internet commerce and web-conferencing. Yet the public perception, supported by ours and other studies suggest that many doctors and much of their clinical support staff, have never sent a patient email, have not spent ten minutes looking at their own clinic's web page or spent time watching an online training video. When one considers the benefits of technology integration, particularly in light of the fact that the rest of society has embraced en mass, it's very puzzling as to why a medical practice would not find the time or where-withal to adopt even a minimal understanding of a technology that could improve their business position, increase their bottom line, offer better customer service, improve patient care and possibly save patient lives.

The Reality for IT vendors
Consumers and health IT vendors have something in common; they're both frustrated with phycisian foot-dragging when it comes to upgrading technology adoption. Maybe vendors should take a page from pharmaceutical firms; market benefits directly to consumers and let them educate their own doctors - after all, they already have appointments and the doctors are in effect, being paid to listen.

There are of course, plenty of IT problems to be solved in healthcare, from patient safety to EMR standards (electronic medical records) to privacy, and EPS systems (electronic prescribing systems) - it's just that nobody wants to pay for it. As long as the public leaves providers and lawmakers under the impression they receive reasonable services, nothing is going to change anytime soon, regardless of the reality, (See the Rand study: The First National Report Card on Quality of Health Care in America)

The Bright Side
Both Massachusetts and Vermont are introducing new ways to tackle healthcare coverage, moving away from the traditional job/insurance model to a person/insurance model. If successful, these new alliances with medical payers/insurers will create a new paradigm for the insurance industry that will provide new opportunities for health IT vendors.

Future IT
Looking over the last 10 years of HIPAA compliance (or lack there of) the future for a national healthcare network seems a bit bleak. The technical issues aside, the business and political complexities are frankly, overwhelming. A top down, mandatory approach to standards compliance may not work. There are way too many conflicting interests and proprietary issues to be sorted out that most providers will not be willing to disclose or collaborate on.

One solution might be more akin to the way both television and certain Internet services developed their own respective standards. While we squirm at the thought of a national healthcare system, we may end up with one just the same, the only unexpected difference being that it may be in private hands.

The Doctor Monster
Healthcare needs a young Boeing, a new Google, a fledgling Microsoft, a doctor monster. It is quite possible that the leaner technology driven providers, clinics and hospitals that are cost effective, consumer oriented, and willing to embrace both the short and long term benefit of customer satisfaction, will shakeout to forge only one or two major franchisable players. One scenario may include the evolution of a private/public RHIO partnership. This evolutionary model, will bring health IT standards to the industry from within, without the competitive wrangling and may in fact address consumer demands more effectively.

Does the Consumer Have a Say?
In the study and subsequent report
Communications Issues in the Healthcare Industry 2006-2009, when patients were asked whether or not their doctor had a web site, 39.1% said they did, 35.1% said he didn't and 25.8% didn't know. The bottom line is that almost 75% of patients were informed and interested enough to want access via a website and nearly half of those were being denied.

More than 73% of patients didn't have access to their physician's email address.

While nearly 72% of patients preferred an online billing system, less than 14% actually had that option.

Again, when asked how patients wanted to fill their prescriptions, nearly 70% wanted to use an online system, less than 30% had that option.

The Outlook for Vendors
If you're a CEO that sees your customers' problems as your opportunities, then opportunities abound. Your challenge is that your customers see your solution as the real problem. It's a vision thing, or lack there of.

Gary P. Bryant wass the founder and executive producer of Wisdomatics. As editor-in-chief of Health Industry News, and Breakthrough Digest, Mr. Bryant offers unique analysis of healthcare trends and industry events. A member of the New York Academy of Science, and the author of 'Searching the Web for Health - A Reliable Guide to Medical Information on the Internet (ISBN 0-595-30343-9).




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