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Op-Ed: Breaking Through Healthcare’s Aversion to Change

Change is inevitable, even in healthcare. It should be embraced, encouraged, and fostered, for without it we risk untold costs measured in lives and dollars

Tomas Gregorio
Tomas Gregorio

No single industry has been more resistant to change than healthcare. Despite repeated attempts by major global corporations to implement new technologies that improve care and the consumer experience, the industry has remained stubbornly behind the times either unwilling or, more concerning, unable to adopt needed reforms. Many would argue that healthcare’s resistance to change is a natural byproduct of work that revolves around intensely personal issues that need to be protected and secured, often at the expense of the latest gadget, app, or device that promises the world but whose use is impractical.

Over the past decade, many highly promoted products were brought to market only to be quietly shelved several years later. Perhaps the most famous example was the launch of Google Health in 2008, a free personal-health record service that enabled people to manually input their health information into a private and secure centralized repository to keep a consistent and accurate medical history. The product failed to catch on and three years later was discontinued. Microsoft launched its personal health records product HealthVault in 2007, and in 2011 abandoned its plans to make a profit with it in the United States. In 2012, U.S. health-insurer giant Aetna launched Carepass, a cloud-based system used to store health information, but in 2014 the program was discontinued.

More recently, Apple, Samsung, Fitbit, and other high-tech companies debuted smart watches that monitor heartrates, count calories, track sleep patterns, and review hundreds of other data points in an effort to keep consumers healthy. The newest versions of these devices even allow people to download an app in which a physician can, in real time, track vital signs and direct a proper course of care.

Unfortunately, results of all of these efforts are inconclusive, and one recent study by the American Medical Association shows that young adults who are overweight or obese and added wearable activity sensors actually lost fewer pounds after two years when compared with similar-sized people who stuck to traditional weight-loss tactics.

Even technology that has been adopted, such as electronic health records (EHRs), contribute to a fragmented healthcare system that makes sharing information cumbersome and inefficient.

Take for example the wildly successful EPIC EHR. Currently, 190 million patients have an electronic record in EPIC. However, the system is proprietary and despite the fact that 90 percent of the market is dominated by relatively few companies, the competing systems are designed on different platforms making interoperability, or the sharing of information between systems, virtually impossible. This lack of cohesion makes the goal of a large-scale health information network that links providers, hospitals, and payers together within states and nationally an elusive proposition despite billions of dollars invested from both the private and the public sectors.

This problem is not a secret, and public and private entities are working around the clock to find ways to link healthcare stakeholders together. For example, the State of New Jersey is partnering with the New Jersey Innovation Institute (NJII) to help advance health information technology through the New Jersey health information network. NJHIN is being funded and built to connect health-information exchange organizations, healthcare systems, and providers together in a legal and technical network-of-networks framework.

Virtually every state in the nation is making similar attempts, and with good reason, as estimated savings due to full interoperability in the United States range from $30 billion to $78 billion, according to the West Health Institute, the Journal of Health Affairs, and other research organizations. While promising, the rate of adoption and use of health information networks varies greatly from state-to-state and the predicted benefits have not, as of yet, been realized.

So where is change in healthcare coming from?

One area of growth resides in helping entrepreneurs bring new products to market by creating incubators to spur development. In Newark, on the NJIT campus, NJII and Hackensack Meridian Health are launching a healthcare ideation center that will serve as a living lab to fuel the launch of new products into the market. The center will drive the process that takes a good idea and turns it into a great product.

Federal and state governments are pinning their hopes on voluntary programs and legislation that requires a shift from fee-for service to value-based care. Hospitals use aggregated health data to comply with programs such as the Delivery System Reform Incentive Payment Program (DSRIP), a Medicaid-based program that pays hospitals on healthcare outcomes, not on the number of tests prescribed. Providers are facing a similar paradigm shift as the Centers for Medicare and Medicaid Services is now tying Medicare payments and penalties to quality outcomes for patients with chronic illnesses such as diabetes and heart disease.

The increased use of artificial intelligence and analytical-software technologies is also on the verge of transforming healthcare as we know it. Take, for example, the remarkable IBM Watson that stores over 200 million pages of information and is bringing the promise of precision medicine to cancer patients.

Change is inevitable, even in healthcare. It should be embraced, encouraged, and fostered, for without it we risk an untold number of lives and billions of dollars in unnecessary costs.

Tomas Gregorio is senior executive director of Health Delivery Systems iLab of the New Jersey Innovation Institute.

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