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April 06, 2016 01:00 AM

Commentary: Cut the strings on software

Jonathan Bush
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    Bush

    The electronic health record, healthcare's golden ticket to better patient care and increased efficiency, is officially middle-aged. The amount of good intentions and effort that has gone toward creating the EHR is staggering. It was meant to be the “Great IT Hope”—a national patient record system to digitize, standardize and connect healthcare. Yet decades later healthcare languishes in a disconnected state, technologically operating as it did when Wilson Phillips topped the music charts. Doctors and nurses still contend with imperfect technology that hijacks their time, taking them away from patients.

    Beyond the quagmires of moving too slowly and being overregulated, healthcare has a major problem called software. Remember it? Software isn't obsolete, but it's like oxygen—incredibly necessary to live, but alone not sufficient to guarantee growth or survival. Other industries have moved beyond and innovated atop software to create networks, ushering in the era of “the network effect.” Consider Uber, LinkedIn or Facebook—all were made popular and powerful by mass use of their networks.

    Healthcare can no longer sit complacently on the sidelines and watch other industries move ahead. That's why I wager the “network,” specifically one driven by intelligence with the ability to learn from its own data, will be powering the next acceleration in the delivery of care.

    Greater intelligence=better healthcare

    Everyone talks about big data. But if you can't crunch data at scale and extract actionable information, what's the use? Matt Turck of FirstMark Capital talks about “network effects” and “data network effects” on LinkedIn. The former can be demonstrated with the Uber model. The network gets stronger as more drivers and passengers join. The latter refers to network smarts—the more people on the network, the more information the network consumes, and the smarter the network becomes.

    Imagine what the “data network effect” could look like for healthcare: A doctor is notified that a patient is at risk for a certain serious disease because the network detected a similar patient across the country with the same symptoms. The potential is astounding—and increases exponentially as the network expands. According to Turck, with a network, learning can happen at scale, “which can mean anything from core performance improvements to predictions, recommendations, personalization, etc.”

    My mission is to harness the combined intelligence of doctors, nurses, patients, hospitals, laboratories, insurers and everyone else who touches the care continuum. Just as Amazon can tell you when you need a new pair of running shoes, my team—through our network—is working to drive connectedness and introduce “bright-spotting” across healthcare. A recent example is our efforts to improve patient engagement and portal adoption, an important strategy as providers take on financial responsibility for the health outcomes of their patients. By analyzing millions of portal visits from more than 2,000 clients, we identified the “bright spots” on the network and used insights from their successes to make portals more user-friendly and help other providers replicate best practices.

    We already track “healthcare in the wild,” such as diagnosis patterns for ADHD, health trends related to childhood obesity, and the effects of industry-specific regulation, and we can also inject knowledge at scale. For instance, shortly after it was available, every doctor on our network had access to the guidelines from the CDC and American College of Gynecology related to the Zika virus. No new software was purchased or installed. Everyone gets smarter through such rapid information sharing.

    My prescription for better care delivery at lower cost is simple: Cut the strings from software and follow the proven “network” model of success. Healthcare needs all the brain trust and connectedness it can muster to let doctors be doctors. With new innovations built for distribution across networks and powered by the knowledge from networks we can give providers back precious time to better care for patients.

    Jonathan Bush is CEO and co-founder of Athenahealth and the author of “Where Does it Hurt?: An Entrepreneur's Guide to Fixing Health Care.”

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