Guest commentary: Moving healthcare into a new state of openness

The future of healthcare belongs to social, mobile, analytics and the cloud. Although most industries have embraced these technologies, the healthcare IT industry has been slow to adopt them.

The country has taken good first steps to digitize the paper-based medical industry, but now it is time to build on what we've done, enhancing usability, better engaging patients/families, and preparing for the future of reimbursement, which is based on value, not more healthcare.

“Meaningful use” has been a foundational catalyst to accelerate IT adoption. However, it has come with a price. As new regulations mandated new functionality in a compressed timeframe, features were “glued” onto existing platforms, often creating awkward user interfaces and hindering clinicians. We need an agile approach that can rapidly absorb lessons learned and refine the software for all users. Cloud-hosted software, which brings the same version of the same functionality to all users in an instant, can do that.

The idea of embracing the Internet in 2015 should sound appealing. In the past, hospitals and professionals were motivated to keep data silos. In a fee-for-service world, incentives are aligned to do more and document more. In an accountable care world, incentives are aligned to deliver the right care at the right time and share data openly. Hospitals have failed to embrace an open model for information management and sharing. In many ways, this is because there has never been an Internet-based option to do so. The industry standard has been to build and deploy information systems that serve only the organizations that sign the software purchase agreement. We still live in a disconnected-care ecosystem where manila folders and fax machines still exist, missing an opportunity we can't afford to miss: to connect care across the continuum.

Beth Israel Deaconess Medical Center, which has built its core inpatient and outpatient Web-based systems, wants to share its experiences with the world and leverage the scale of a cloud-hosted vendor to reach payers, providers and patients throughout the country, so it sold its self developed systems to athenahealth.

The coming of the healthcare Internet brings a wealth of opportunity and advantages, most of which will come from lowering the barriers to information flow in and out of otherwise unaffiliated organizations, and through a significant cost decrease for hospitals to manage information. Hospitals and professionals should leverage the Internet in these ways, as well as to engage patients better and to better compete on the quality of their services. All stakeholders—physicians, hospitals, patients, payers, actually everyone—can benefit from more connected healthcare.

We have miles to go before anyone should relax into the idea that healthcare will become more open, but today, we have made a start.

Getting to a national state of openness will require more than just a philosophical shift. Doctors will need to understand how to leverage the Internet as part of their care processes. Healthcare institutions will be forced to seek a new basis of differentiation; they'll need to be as easy to do business with as a restaurant on OpenTable. It will be a tough challenge, but the potential payoff will be significant. There will be fewer expensive data centers for hospitals to manage, enabling the staff to focus on innovation.

A more connected healthcare system won't happen overnight, but it will happen. Economic incentives are finally aligning to favor agile IT, connecting all team members, and embracing the same technologies that have disrupted other industries.

Dr. John Halamka is chief information officer at Beth Israel Deaconess Medical Center in Boston. Jonathan Bush is co-founder, president and CEO of cloud-based IT provider athenahealth.