By Lucienne Ide, MD, PhD
For over two decades, the U.S. healthcare system has lagged behind that of other countries, according to rankings by the Commonwealth Fund. Not only does the U.S. spend more on healthcare, we also perform lower in terms of care process, access, administration efficiency, equity and outcomes.
Considering America is home to many of the top medical institutions and physicians and has better access to cutting-edge research on new therapeutics and treatments, it’s difficult to understand why our healthcare system is underperforming, doctors are burning out and patients are dealing with multiple chronic conditions.
To address the problems impacting our system, providers and patients alike, we must come together as an industry to solve some of healthcare’s biggest challenges:
#1 Misalignment of Incentives
The U.S. is currently transitioning from a fee-for-service model to one that puts greater emphasis on patient outcomes. This evolution is difficult to manage since it significantly alters the ways in which health systems and individual physicians are paid and requires new incentives to achieve value-based care goals.
Generally, only about 5% of physician pay is tied to performance. This is not significant enough to drive behavior change or incentivize new practice models. At least 25% of individual physician compensation must be tied to outcomes to drive real change in care delivery and foster an effective transition to value-based care.
#2 Data Silos Prevent Interoperability
One of the biggest operational burdens for healthcare organizations is interoperability, according to the Health IT Industry Outlook Survey. Healthcare providers should be able to access all patient data, no matter where the data was generated or what systems were used to create it. However, incompatibility between vendor solutions has created silos that make doing so virtually impossible.
Moves are underway to knock down these silos, including the release of Fast Healthcare Interoperability Resources (FHIR), a standard describing data formats and elements and an application programming interface for exchanging discreet health data elements. Essentially, FHIR created a shared language for health IT systems that all EHR vendors and health apps could use to exchange, interpret and process data in a standardized way.
The Centers for Medicare and Medicaid Services (CMS) also recently renamed its Meaningful Use program to “Promoting Interoperability” to underscore its focus on advancing data sharing in healthcare. While FHIR has made interoperability possible from a technical standpoint, a lot of friction remains in the business models supporting data exchange with the major EHR vendors, which must be resolved to see interoperability take hold at scale.
#3 Slow Adoption of New, Effective Therapeutics
Seventeen years. That’s the average time it takes for evidence-based findings to reach clinical practice, according to the Institute for Healthcare Improvement. Given the speed of innovation in other sectors, this is unacceptable and prevents patients from getting timely, quality care.
We must drive evidence directly to the point of care. Creating a more efficient information infrastructure to connect the most recent outcomes and guidelines during point-of-care decision making is an important first step. One way the health IT community is tackling this issue is with CDS Hooks, a technical specification that enables health IT apps to present patient-specific clinical decision support within the existing clinical workflow – right when clinicians need it.
#4 Disconnected data means discontinuous care
Patients use a variety of devices and apps to track everything from heart rate and nutrition to blood sugar and blood pressure. But if these devices are not connected with their EHRs and embedded in the clinical workflow, physicians will not have a full picture of all personal health data.
Integrating these innovative connected devices into the existing physician-patient relationship can deliver important insights into patient health and behavior, and support decision making that will result in better patient outcomes.
#5 Increased Physician Burnout
Busier practices due to revenue pressures and increased documentation requirements result in physicians suffering from burnout at almost twice the rate of other workers, costing the U.S. $4.6 billion annually. Considering studies have shown burned-out physicians tend to make more medical errors, patients can be at risk, all the while less satisfied with their health outcomes. As the sector puts more responsibility on primary care physicians in the value-based care era, they need technology that allows them to get back to the practice of medicine and the human connection with their patients. Let the technology deliver quantitative support and the physicians deliver the qualitative care.
As a starting point, we must begin to address these five challenges. As leaders in healthcare, it’s our jobs to work together to provide today’s physicians with the tools and technologies they need to deliver efficient and impactful care to patients.
About the Author
Lucienne Marie Ide, M.D., PH.D., is the founder and chair of Rimidi, a cloud-based software platform that enables personalized management of chronic cardiometabolic conditions across populations. She brings her diverse experiences in medicine, science, venture capital and technology to bear in leading Rimidi’s strategy and vision. Motivated by the belief that we can do so much better as individuals, an industry and society, Lucie left clinical medicine to join the ranks of healthcare entrepreneurs who are trying to revolutionize an industry.