Healthcare technology is improving, but not as fast as it should be.
That’s the message behind the leaders who spoke at HealthIMPACT, a new conference on enterprise healthcare technology.
At this year’s HealthIMPACT, approximately 30 nursing leaders, physician executives, business advisors, and hospital administrators convened in San Francisco. The conference was headlined by Shahid Shah (@ShahidNShah), a highly-published technologist and executive communicator, angel investor, computer scientist, and entrepreneur.
How can we get patients involved with technology?
One of the biggest issues—and trends—in healthcare is the push to get patients more invested in their healthcare. However, habits are often ingrained.
“There’s a cultural factor,” Neal Ganguly (@CIOCHIME), Vice President and CIO of JFK Health, said. Patients often say, “I don’t want to have to deal with my kids’ vaccinations. My doctor manages that. I don’t care.”
Even with the deluge of data behind a patient’s health, Ganguly says that it’s not enough because the data is often not transferable between large hospital systems. Complicating that is the mandate for patients to use web portals—websites that allow them to look up their healthcare information.
“We struggle to create a solid picture of the patient. Even with all the data out there, we can’t bring it together effectively. We have to figure out which patients are going to be the ones who will engage with the records.”
Howard Landa, MD (@CMIO_Landa), concurred.
“We see patients who are very involved, but then some have families who are very involved, but then some who don’t really want to know.”
Landa, who oversees at least six different electronic medical record systems as Associate CMIO of Alameda Health System, says that socioeconomic factors drive how engaged patients can be.
“There are language barriers, health literacy, intellectual, cultural literacy—complicating what you can talk about and what you can’t—and there are so many things you can’t manage in a single physician face-to-face visit. But that can’t be the main way we interact with patients if we want to improve patients’ health.”
Mohan Nair, Senior Vice President and Chief Innovation Officer of Cambia Health Solutions (@Cambia), said that his company uses peer support and caregiver support to spur patient engagement to help veterans lose weight. Nair said,
“The strongest social network is not millennials—it’s the military. If their battle buddy says something? They do it.”
Their peer support system helped spur changes not just by encouraging the patient to exercise with Fitbits, but also providing them to veterans’ spouses. And, they stimulated patients to adopt very “minor” habits, such as sleeping one more hour.
“You’re not using the medical system. You’re using the human system. For every person who lost 30 pounds, their spouse also lost 25 pounds.”
What’s holding the technology back?
Technology holds enormous promise for improving healthcare. Ben Rooks, Founder and Principal at ST Advisors, cited Steve Case’s quote,
“‘What healthcare really needs is more technology for its own sake. I’ll take my knowledge of technology to fix healthcare.”
But advanced technology has been around for decades. Telemedicine and telehealth— which primarily refers to video-based healthcare provider visits and remote monitoring technologies—has been researched for at least half a century. The Internet has been present for decades. These technologies can help with boosting patient access to healthcare systems, but such technologies are still not mainstream.
“Telehealth, the capabilities are there, but in reality, it’s not there,” Ganguly explains. He points to the two major electronic medical record systems within the United States, as one huge impeding factor: “The big guys—Epic, Cernercare are far away from that stuff. As customers, we’re not seeing it from them. And that’s a problem. You get locked in [to their ecosystem].”
“I think the answer is to come up with ways for marginal improvements. There is the ‘big bang idea’—to disrupt it all using Uber. But the healthcare system doesn’t work that way.”
For instance, interoperability—where data is shared between computer systems—is still not fully available in healthcare. Imagine taking smartphone photographs and not being able to share the photographs with a friend. Or, not being able to transfer them to another computer.
Shah noted that physicians now have 100% e-prescribing so that prescriptions can be submitted without having one particular system. “But, what about physician order entry? Or information governance?” He stated that a barrier may be that health systems—hospitals, clinics, and other health services—“take the easy way out” by buying whatever systems are available.
“We are willing to pay for systems that will prevent us from doing things we want to do! That’s a fundamental flaw in our purchasing as our group. Strong CIO’s can move their vendors in a direction they need to go.”
And why are there so many hospital and healthcare data hacks?
One of the biggest fears in healthcare technology is the risk of hack attempts. But, according to Malcolm Palmore, Assistant Special Agent in Charge of the San Francisco FBI Cyber Branch (@MKPalmoreFBISanFrancisco), these hack attempts are often due to employees being manipulated and duped into revealing their passwords.
Palmore said, of the types of hack attempts performed,
“Social engineering and spear phishing is still #1. It’s the path of least resistance.”
Criminals often find a way to get into healthcare systems by pretending to be a helpful or an official company that needs a password. They “send 1,000 e-mails to your workforce and ensure someone clicks on an e-mail to get them access to your environment.”
Shah added, “Cybersecurity is a yin and yang between convenience and safety & security.” Shah recommends measures that make it difficult for users to easily jeopardize security. “In our environments, every e-mail that gets in, the links are removed. You have to copy and paste it into the URL, then hit the button.”
Many of the attacks originate overseas, but it’s becoming more difficult to determine the origins of such attacks.
“There was a time you may be able to determine whether an e-mail was coming overseas. Easy grammatical mistakes. Or, cut-and-paste jobs from a banner with spelling mistakes.”
Now, attackers are becoming more sophisticated:
“They’re getting better. They are sharing information with one another. If there is a campaign that’s executed, and the campaign happens to have been very successful, believe me, that criminal shares with others, and they take the good, make it even better, and shoot it out to a different target. It’s becoming more difficult to determine whether the threat is from within the States or abroad.”
Why it’s still important to advance healthcare technology
Despite all these factors, fear, and failures prevalent in the industry, it’s still important for Americans to continue advancing and researching these healthcare technologies.
“You’re seeing concierge practices [taking these up, plus] international companies legally or illegally coming in,” said Mark Blatt, MD MBA, Worldwide Medical Director of Enterprise Solution Sales at Intel.
The tipping point, Blatt said, is “once healthcare here becomes unaffordable, and you can’t afford it, and you hear a neighbor doing a visit to American Well,” citing a telemedicine company offering video visits with doctors and clinicians, “It might take a generation to flip [to favor healthcare technology versus traditional face-to-face care], but it’s going to flip. It’s going to be consumer-driven.”
An interesting trend, Blatt said, is where doctors overseas will provide the healthcare. The trend of medical tourism underscores this, in which Americans travel overseas to get medical procedures at a fraction of the cost within the United States.
“You’re going to find a lot of brilliant doctors who want to deliver great care at an affordable price. They might not be even U.S. based, but get U.S. licenses! [We need to] figure this out as a country. The good thing is that the rest of the world thinks America healthcare is the best.”
Blatt recommended that the United States look into “exporting” healthcare to other countries.
“If we don’t do this, we’ll see the opposite happen. We’ll see other doctors accepting lower fees.”