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Innovation in Health IT
Last week we had an interesting discussion on innovation in Health IT. Based upon the EHR-S Functional Model we produced a reference model for EHR Systems in the Behavioral Health sector in The Netherlands. The discussion focussed on the degree of innovation incorporated in the reference model. Some participants commented that the reference model lacked true innovation, whereas others insisted that the model already incorporated quite a lot of functions that are not present in any EHR System in Behavioral Health today.
This discussion reminded me of a meeting between healthcare management and computer science researchers some years ago. The researchers were looking for "true" innovations, whereas the managers were much more looking for methods to succesfully introduce and incorporate existing technology in their healthcare organization. Given the fact that the outcomes were to be presented to the Dutch Science Foundation as part of the computer science research program, you can imagine which perspective received most attention.
Meanwhile, subsidized programs from both the Ministry of Health and the Ministry of Economic Affairs in The Netherlands focus on the adoption of proven pilot innovations, rather than on projects developing the next innovation in the application of Health IT. For instance, a program supporting the adoption of videoconferencing as part of multidisciplinary oncological meetings, in which an outside consultant participates from a distance, has been carried out succesfully over the last few years. This can hardly be called a break-through technological innovation, but it does illustrate the dilemma that healthcare organizations face. Is technological innovation getting in the way of large-scale adoption? Are we investing lots of money in yesterday's technology?
Posted by Robert Stegwee on October 6, 2008 | 
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Comments
# on October 15, 2008 11:03 AM, Anthony Reardon said:
Some healthcare operations that consider themselves already optimized paperless businesses are confronting a barrier to much needed EMR enhancements. Notable efficiency improvements can be made with technology that exists.
However, if you consider this as a baseline, then you still need solutions to address declining margins. EMR providers remain fixated on the market margins to be found in migrating from traditional charts. It is big business. As a consequence, you can suggest all the potential hot apps an EMR provider can incorporate only to meet deaf ears.
Operations benefitting from conventional technologies are ahead of their time. In some cases, the vested interests they have in proprietary contracting with EMR vendors prohibits them from moving forward to keep up with next generation technology. In a competitive environment, far more innovation is needed in patient relationship modules.
More thought and money should be going into development in support of healthcare innovation for optimizing practices. In the U.S., the market is taking care of large-scale adoption. Neither healthcare IT nor medical providers seem to be looking at this from the perspective of the real "end-user" customer yet.
# on October 19, 2008 10:26 PM, Robert Stegwee said:
Thanks Anthony for your comment. Indeed there are multiple hurdles confronting healthcare providers these days. One solution to the declining margins is to concentrate buyer's power and working actively to minimize the fragmentation of the market, without creating a virtual monopoly. The baseline is not something that needs fierce competition among a large number of players.
With respect to the more innovative applications, once an open, standards-based platform is in place, multiple companies can take up the challenge to develop hot apps to accompany the baseline EHR product. These would definitely include the patient relationship modules, including internet therapy modules such as www.interapy.com (in Dutch).
The push from the "end-user" community, i.e. the patients in the healthcare system, has been identified as a major contributor in the recent HIMSS publication on EHRs from a global perspective. Capgemini contributed to this publication.