Collaboration-enabled healthcare enterprises – Part 1

The new value currency of healthcare in a post-EHR world: Conversation

Nearly every health system is now in an all-out sprint to retool its organization to operate in the new consumer-centric, outcome economy where outcomes are fast becoming incomes.

But amid all the commotion about industry disruption, what nobody seems to have noticed is that this shift to an outcome economy has also triggered two other shifts that could disrupt the health information technology (HIT) industry:

• The first is a disruptive shift in the product of the practice of medicine.
• The second is a disruptive shift in the value currency of health and care.

Under fee for service, the product of medical practice was provider-centric piecework—think encounters, tests, and procedures that providers were paid to deliver à la carte. But in the new outcome economy the product is now interdisciplinary, patient-centered teamwork. Highly mobile teams of prescribers, nurses, pharmacists, and care coordinators now work together to complete a series of high-stakes processes to improve the health, outcomes, and experience of care for more people at the lowest cost and in the shortest time possible. The ability of these teams to work as a unit can make the difference between a rapid recovery and a costly readmission or life-threatening complication.

This silent shift from piecework to teamwork has, in turn, forced a disruptive shift in the value currency of health and care. Under fee for service, the value currency was information. Autonomous providers were the prevailing decision makers and what they needed most from technology was information at the point of care to help them diagnose, prescribe, and delegate tasks (i.e., write orders) to other health professionals. But the new value currency isn’t information as much as it is the ongoing conversations between team members, consumers, software agents, and other caregivers that enable them, together, to remove inefficiencies and create the best, most cost-efficient outcomes. And many of these conversations need to proactively involve and engage the consumer, because the consumer is the new center of the team.

So why are these shifts threatening to disrupt the current HIT industry? These shifts radically change the purpose of technology from delivering information to autonomous providers at the point of care to empowering mobile, interdisciplinary teams to work together both virtually and physically as one team. The current generation of HIT solutions—EHRs, PHRs, and HIEs-—were never designed to support teams on the move. That’s because they were built on database platforms best suited to capture, organize, move, and present information to experts at the point of care to speed the delivery of piecework and to document what was done.

To truly empower virtual teams to work together across organizational boundaries and engage patients in their care, health, and management of their risks and conditions, technology has to do much more than connect these teams to just information. Technology now must also connect every team member to people, teams, insights, things, and complex processes both within and beyond their four walls—and automate as many portions of those processes as possible. It also must help coordinate those processes in a way that improves the outcomes and experience of care at a lower cost. Of course, information is still important. But the leveraged power of technology now lies at the intersection of people and team processes rather than people and information. Information has been relegated to a feed into those team processes.

Workflows that involve health professionals who are mobile require advanced, cloud-based, communication and collaboration platforms that can extend and work alongside the current generation of database-driven EHRs, PHRs, and HIEs. With the current database-driven HIT solutions, it’s cumbersome and takes too much time for geographically dispersed care team members, consumers, and family and friend caregivers to find each other, converse, share insights and documents, and coordinate processes quickly.

This upcoming blog series is dedicated to industry thought leaders that have recognized these disruptive shifts and are decisively extending their EHRs. They are taking advantage of next-generation, cloud-based platforms to reduce conversational friction and latency for care teams, transform their culture, and raise team performance and the experience of care to new heights.

What your thoughts on these three shifts?? Let us know via email, Facebook, or Twitter.

Dr. Dennis Schmuland

Chief Health Strategy Officer | US Health & Life Sciences

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