For many of the years that I have been involved in Healthcare IT I have had the good fortune of working for EHR software vendor organizations. It was very exciting to develop bleeding edge technology supporting interoperability standards, and see the benefits realized in real-world use. We broke through many barriers in the healthcare field, although we certainly did not reach the ceiling. However, as in many market sectors, times change and with such change innovation and new ideas take a front row to what has become solid and stable. EHR solutions are mostly now considered to be the foundation for the industry, providing a solid framework upon which more complete solutions are being delivered in interest of bettering patient health outcomes.
In the past few years so many niche applications have arisen to address very specific problem areas. This is in part due to a natural industry shift requiring fresh perspectives on older problems. This is in other part (in the US) due to government incentive programs driving forward a need to improve patient health outcomes such as ACO, PCMH, and MACRA (QPP).
As technology solutions mature, they naturally become more difficult to adapt to changing conditions. The more components a solution has the more effort it requires to update those components while retaining backwards compatibility and the harder it is to craft deployment packages that do not interrupt existing live productions in significant negative ways. Managing a technology solution over the long term definitely comes with its challenges as well as its benefits. New comers into the market are able to quickly adapt to changing requirements that exist, freely building innovative and creative solutions that are not so dependent on existing components and choices made earlier in development by the more established solutions. These newer solutions are able to be plugged into the older solutions to address gaps in functionality that might not otherwise be addressed. This is the nature of software engineering and development as it has progressed since its inception in the middle of the last century.
The other driver of new technology solutions in healthcare is that of federal incentive programs that are placing a strong emphasis on improving patient health outcomes. Research is beginning to show that improving health outcomes for patients across a population is more than just using a certified EHR system or following the medical practice guidelines from the appropriate medical college. Rather, it involves a much more complete and holistic approach of medical practice that looks not only at the clinical facts of a patient, but engages the patient in a relational aspect, understanding the impact that social determinants have on that particular patient. Understanding the mental health of the patient is also quite important, often times being very difficult to properly diagnose and treat for a number of good reasons. To address these sorts of issues doctors must find ways to meet patients where they are today, using tools and approaches that are natural to patients. This means making use of apps developed against popular platforms that interact with social media, are intuitive to use, integrate with existing systems of all kinds to provide seamless access and management of the patients health data and care from both the provider and patient perspectives.
This IS the new face of healthcare, this combination of the foundational EHR vendors’ existing solutions, in conjunction with newer solutions that focus in on very specific problems that need solving. And really, this is not much different than how technology has always been managed. As solutions age, various components of those solutions are wrapped with interfaces that abstract them away, providing a way for the newer, more efficient, and many times more socially accepted solutions to interact with the older technologies. In the same thought, wisdom is valued more than mere intelligence or trend. That wisdom is grounded in the foundational participants in healthcare IT that continue to drive forward standards-based development efforts, focusing on the shared goal between patients, providers, and payers of improved patient health outcomes for all.