High Stakes

Innovation: Boon or Bust?

Seeing The Down (and Up) Sides of Healthcare Tech

Chicago has long been an important hub for healthcare, especially in the thought leadership realm. The metro area is home to a wide array of healthcare trade and professional associations with familiar abbreviations (ACHE, AHA, AMA, HFMA, HIMSS … I could go on). And an outsized share of national healthcare trade media outlets are clustered in the Loop (the location of the Jarrard Chicago office is no accident).

Two events, held within 13 hours of each other last week, neatly illustrated Chicago’s status as the epicenter of thought leadership in healthcare, as well as its more recent efforts to cement its position as a healthcare innovation center.

During an evening program at the nascent Health Care Council of Chicago (HC3), Dr. Ezekiel Emanuel – former Obama healthcare advisor and Affordable Care Act architect – gave a talk about his research into the key principles and practices that can transform healthcare.

Emanuel does not see health IT as a driver of transformation. “If you are trying to ‘disintermediate’ the doctor-patient relationship,” he said in a room loaded with health IT disruptors down the hall from Chicago’s white-hot tech incubator, 1871, “you are going to fail.” Health IT products and solutions that enhance what physicians do can play a role in changing healthcare, Emanuel allowed.

The next morning, Crain’s Chicago Business hosted its inaugural Who’s Who in Healthcare breakfast panel with leaders of the American Medical Association and IBM Watson Healthcare, a data scientist, and a serial health IT entrepreneur, moderated by a managing director from one of the city’s many healthcare-focused private equity firms.

Emanuel spoke about the practices that enable healthcare provider organizations to transform healthcare for their patients. In a nutshell, his position is that it is not flashy, novel or complicated ideas that will change healthcare. It is the straightforward solutions on care coordination and changing incentives, focusing on high-touch care and “warm handoffs,” i.e., clinician to clinician, that will do it.

Emanuel fully acknowledged these changes require a lot of hard work and time. It takes five to 10 years to change culture and common practices and to phase in new contracts with the right incentives, he said.

This skepticism was contrasted by the optimism the next morning.

Robert Grossman, director of the Center for Data Intensive Science at the University of Chicago, said the only thing holding back the promise of big data in healthcare is that data are highly siloed, stuck inside proprietary EHR systems that are better at archiving data than making them safe and secure for authorized exchanges.

In five years, Grossman predicted, healthcare data will be “in a good place” to give physicians real, actionable information to guide diagnosis and treatment decisions thanks to the secure exchange that blockchain technologies will allow. And Chicago, he added, with its history of institutional leadership in healthcare, newer efforts like MATTER Chicago and 1871, and the general growth of the city as a tech hub, is poised to be the leader in healthcare data science.

Glen Tullman, the founder of EHR company Allscripts and now the CEO of Livongo, a consumer digital health company, pointed to computerized physician order entry for prescriptions as a clear case of technology solving a problem in healthcare.

Anne LeGrand, vice president of imaging for the artificial intelligence giant IBM Watson Health, echoed Emanuel’s comments in calling Watson Health a powerful “cognitive assistant” in the hands of a skilled operator – physicians.

It wasn’t all pie in the sky. Tullman acknowledged that health systems have not focused enough on the physician user experience when picking EHRs, and that has hampered their development from data repositories into true data systems. Tullman believes the healthcare industry is focused on transformation and innovation like never before – because private and public payors alike are out of money.

Having worked in healthcare for more than 16 years, I have the sense technology is always on the verge of revolutionizing healthcare. I am reminded of bearish analysts during a long stock market boom. At some point, the stock market pessimists are right. Let’s hope the tech optimists are right sooner rather than later.


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