Information technology in the healthcare industry has the capacity to improve the experience of consumers, but it if not handled properly those efforts could backfire. For every wearable device and mobile app, there’s a potential security breach lurking in the shadows. With the ability to crunch Big Data comes the responsibility to present that data in a clear and meaningful way to patients.
Expensive healthcare IT systems can make patients safer, but only if you use them properly: fragmented IT systems can add complexity to an already complex industry, making things more confusing for the consumer. On the other hand, implementing an effective IT system can make things easier for doctors and patients, thus improving health outcomes.
We spoke to a handful of experts in the field about some of the promises and pitfalls of healthcare IT. They brought up five important issues related to IT and the consumer experience.
1) Patient Safety
One of the most important areas where healthcare IT is intended to help is with patient safety.
“If you walk into an American hospital today, your chances of being injured – during a typical four to five day hospital stay – is between 10 and 20 percent,” said Ashish Jha, K.T. Li Professor of International Health at Harvard T.H. Chan School of Public Health. “There is nothing [else] we do in our lives that puts us at that kind of risk.”
The risk would be about the same in Canadian, English, and German hospitals, he said. In other words, it’s not unique to the United States.
“It’s not because the doctors and the nurses are uncaring or don’t want to do it right,” he said, “it’s just that these are very complex places that have not invested in the kinds of systems you need, like information technology systems, that really help [doctors and nurses] think.”
Tejal Gandhi, CEO of the National Patient Safety Foundation, pointed to the improved communication, data collection, and documentation that stem from electronic health records. It’s much better than the paper charts of years gone by.
But, “There’s still a lot of work to do to make all that data really usable to the frontline providers,” she said.
It’s important not to disrupt the workflow of frontline providers with clunky, cumbersome computer systems. Pointing to things like pesky pop-up windows on computer screens – a few are helpful; too many are counterproductive – Gandhi said, “We’re trying to figure out the right balance between getting safety benefits versus so interrupting the workflow that people can’t get their work done.” She added, “It’s a challenging thing, but most studies have shown that if you do it reasonably well you really do get good safety benefits.”
2) Tech Innovations Aimed at Consumers
“If I could take my crystal ball out,” said Marjorie Bessel, vice president for clinical integration at Banner Health, “I think what the next ten years will look like for the industry will be lots of electronic tools, apps, portals … that help us engage with the patient and [help] the patient engage more in their own health, their own health outcomes, and how they decide to get there.”
The effect of all this will be to put patients and consumers “much more in the driver’s seat,” she said.
Mary Finlay, from Simmons School of Management, pointed to telehealth as an area of growth, referring to the ability of patients to communicate with their physicians remotely. “I think it’s just really at the beginning of taking off, so I think we’ll see a lot more e-visits and e-communication with our physicians,” she said.
“In a number of organizations they’re looking at what kind of appointments could be replaced by doing it electronically versus having to physically come to the hospital,” she added. She pointed to dermatology and wound monitoring as two areas where patients could send photos instead of coming into the doctor’s office – at least in some cases.
Finlay also pointed to “a lot more integrations of wearable devices.”
As for wearable devices, John Glaser, CEO of Siemens Health Services, which is now part of Cerner, agreed they would become more and more important. Referring to the Internet of Things, with microprocessors attached to your car, wrist, home heating system, and other objects, he said, “I think we’ll see innovations in just the sheer proliferation of microprocessors being connected to things, and some will be to measure your health.”
3) Protecting Patients’ Electronic Health Records
“A medical record is more valuable on the black market than a financial record,” said Glaser. “A pediatric medical record is the most valuable of all.” That’s because an identity thief can steal a child’s social security number, use it to open credit cards and wrack up lots of expenses, and the child won’t know about it for about two decades. “When you turn 21 and go to get a credit card, they won’t touch you with a ten foot pole,” he said.
If you walk into an American hospital today, your chances of being injured is between 10-20%.
It’s why there’s increasing anxiety about security, he said. The problem is no longer lone hackers, but “advanced persistent threats,” or APT: efforts that are tenacious and that relentlessly seek to break into healthcare computer systems over “long periods of time in very sophisticated ways.”
“People, consumers, and patients have very specific and strong feelings about privacy and security of health data,” said Jha. “Not that anybody wants to see their credit card get hacked, but then if your credit card gets hacked, okay, you’ll just get it replaced and the credit card company will deal with it. If your health information gets hacked, boy that’s hard to replace. It’s your life story.”
4) Help Consumers Understand Their Data
As noted above, the proliferation of mobile technology, tele-health, wearable devices, and patient portals will lead to greater openness and transparency for consumers (patients) and better consumer experiences.
“Everything’s going to be electronic, and patients are going to have full access to their medical records,” said Gandhi.
“We’re moving to a world where everything will be very electronic and openly transparent between physicians and patients, and there probably will be all kinds of new cool tools and apps to help people have better ways to interact so you don’t need to come into the office necessarily to get done what needs to get done,” she said.
A key to doing that successfully is making sure medical information is presented in a digestible manner, said Bessel, who helps oversee the Banner Health patient portal, MyBanner. “The more we’re able to integrate that [data] for the consumer in a way that is then presented back to them in a patient-friendly view, the better they’re able to connect with us, to engage in their own healthcare and become a more savvy consumer,” she said.
5) Practitioners Are Consumers, Too
It costs tens of millions of dollars, at least, to install a functioning, modern IT system and train people to use it. In addition to the money, it takes time.
For Bessel, who has overseen this process at her organization, the best way to do this is through what she called “Big Bang” implementation.
There’s still a lot of work to do to make all that data really usable to the frontline providers.
She explained: “We prefer to sort of charge ahead and do it as quickly and as fast as we can, and just try to get on the other side of the implementation rather than do kind of incremental and stretched-out implementations.”
“We just think it gets us to the other side in a much less disruptive way, to kind of take our disruption in one big lump, rather than spreading it out over a prolonged period of time,” she said.
Banner Health has close to 30 hospitals, she said, and with the rapid pace of technological change, if you stretched out the organization-wide implementation over, say, two years, by the time last facilities receive their new tech, the first facilities already need upgrades. “It just puts you in a perpetual state of people being at different levels,” she said. That, in turn, defeats the purpose of having one uniform platform that works across the organization and population it serves.
Different organizations, of course, would have different needs and strategies.
Drs. Bessel, Gandhi, Glaser, and Jha, and Ms. Finlay teach in Leadership Strategies for Information Technology in Health Care at Harvard T.H. Chan School of Public Health. To learn more about this opportunity, click here.