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Healthcare Cost

The Wall Street Journal reported this week major tech companies have signed a commitment to, “share the common quest to unlock the potential in health care data, to deliver better outcomes at lower costs.” The companies, convened at a Trump administration event focused on healthcare technology, included Amazon, Google, IBM, Microsoft, Oracle, and Salesforce. Apparently, Apple was not at the meeting, but is quite active in healthcare, much of it centered around its cardiac monitoring program with the Apple Watch.  

The promise the   companies made should help accelerate the emergence of a data-driven revolution in healthcare. Patients, providers, payers, and researchers all need easier and more compatible access to health records in order to enhance patient safety and lower the cost of healthcare. Unfortunately, healthcare data today is stored in silos at providers and payers. 

In theory, patients have access to their health data since the Obama administration distributed $30+ billion in incentives for the creation of patient portals and electronic health records (EHRs). The reality is quite different. Most people over 65 have multiple providers. Consolidation has occurred and many hospital networks have a range of services. However, some of the sub-specialty providers, such as urology and dermatology, remain outside of the networks. In addition, standalone practices in orthopedics and radiology have their own EHRs and portals. Another factor adding to the complexity is many people choose to get a second opinion or comparison shop on services such as radiology. The result of all this fragmentation is patients don’t have one patient portal, they have multiple. I have 13. None of the healthcare records are compatible. Even worse, you can look at test results at one provider, but you can’t download or email it to another provider. You also can not sort or search your health data. The bottom line is EHRs have become a train wreck. It is a tie between patients and providers as to who dislikes EHRs the most. EHRs are a failed promise. We can’t live without them, we can’t live with them.

G. W. Bush hired a Chief Information Officer to fix this problem ten years ago. The CIO knew how to fix the problem but could not pierce the armor of special interest groups who wanted government to stay away from the issue. The CIO resigned in frustration. Bottom line is government has been completely ineffective in solving the healthcare data problem. Now lets see what the tech giants can do.

I am optimistic the promise made by the companies mentioned above will be successful. There are two reasons for my optimism. First is healthcare cost has risen out of control to the point where it is nearly 20% of the economy. The tech companies are not startups. They have hundreds of billions in revenue and millions of employees which cost the companies billions of dollars for healthcare. They are motivated to solve the healthcare problem. The second reason for my optimism is technology. Cloud computing has risen like a rocket ship. It can bridge the silos and make data access easier for all. Security technology has evolved to provide anonymity and protection of the data. Equifax and others have shown their incompetence in this regard, but the tech giants know how to do it. Lastly, mobile technology has advanced rapidly. With finger prints and face prints, they offer strong authentication. Mobile apps are easier to use. Banks, travel companies, food services, and many other segments have developed mobile apps which are easy to use and way better than their websites, except in healthcare. I expect Atul Gawande, CEO of the new Amazon/JP Morgan/Berkshire Hathaway healthcare company, to become a shining light to help rally all the tech companies to work together. They are fierce competitors, but their motivation to solve the problems is huge. 

The Wall Street Journal said, “The Trump administration sees better use of health-care data as a key to unlocking savings and holding down costs while improving outcomes.” Seema Verma, Administrator of the Centers for Medicare and Medicaid Services, said .“We want to lean into technology and use it as a potent force to create more efficiencies in our system.” The tech giants will help make this happen.

To read more about EHRs, take a look at Health Attitude: Unraveling and Solving the Complexities of Healthcare.