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n the United States we have access to unparalleled medical innovations. Laser eye surgery restores 20/20 vision. Infertile couples have means to become biological parents. Robotics enable a doctor in California to perform surgery on a patient in Florida. We may even be close to the day when a patient’s gene code will predictably inform an individualized treatment plan. Unfortunately, even with all of these advancements, studies show that our avoidable death rate is still around 100,000 patients per year. This same study shows that we are not improving significantly in that the rate of avoidable deaths has dropped only slightly (4.4 percent) in the 5 years between 1997 and 1998 & 2002 and 2003. On the financial front, hospital CEOs are struggling to keep their organizations prosperous and physicians (many worried about making ends meet) are scrambling to align with these larger health systems so that they have a safe haven. Medical advancements touch many lives directly and indirectly, yet basic problems, such as the inability to provide affordable health care to all, frustrate consumers as costs continue to rise and more uncertainty surrounds the future of health care. Clearly, as many have pointed out, the business of medicine needs to change but where do we start? And why the seeming innovation paradox with health care being so advanced medically yet so lacking in other areas?
Outpaced by technology Scientists and medical professionals have extensive knowledge of the human body and medical technology has been developed to repair complex issues, so the lack of medical technology is not the problem. Could it be that the lack of non-medical technology, which enables the ‘business’ side of medicine 46 | JUNE 2012
(medical processes and information management) is the cause? If we look at these medical processes and information management as it applies to health care, it all boils down to common generic processes that exist in other industries, such as: • Collecting usable data at the point of care • Ordering things and making sure the order is filled • Measuring operations and taking action if results are out of line • Securely passing information between business partners • Coordinating delivery of services between partners • Combining and analyzing data to look for efficiencies and opportunities Health care is uniquely complex in that it deals with caring for the human condition on all levels and it requires, on a regular basis, delivery of services to individuals with no ability to pay. Notwithstanding, other industries have found ways to innovate the above processes and leverage that innovation toward customer satisfaction and high profitability. Regardless of the complexities, the fact of the matter is that health care is not effectively leveraging these nonmedical technologies and this creates the innovation paradox. Statistics show that of the approximately 500,000 Eligible Professional (EP) physicians, only 31,000 or 6 percent have attested and received payment for Meaningful Use of an electronic health record (EHR) system. Meaningful Use measures include the percentage of physicians who use an EHR system to: • warn them if a patient is allergic to a medication. • keep track of patients medications and problems. • enter orders electronically (Note: receipt of order does not need to be
tracked). • electronically communicate with other physicians and patients. • give their patients educational material related to their condition and a summary of their visit. • generate a list of patients with a certain condition such as diabetes or obesity. Like most industries, health care couldn’t survive without the technology-enabled systems that perform their day-to-day operations. The technology is available but lack of adoption (and market driven improvement) of these technologies is a big part of the reason the U.S. health care system is struggling. The bottom line is that the innovators (you and I), not the technology, have become the limiting factor.
Behavior drives markets A recent Wall Street Journal article titled “The Wireless Revolution Hits Medicine” points out that “…while medicine is one of the globe’s premier drivers of innovation, it is also a conservative culture that now finds itself buffeted by transformational change.” As health care professionals we find ourselves in the throws of transformation and it is our reaction to this transformational wave that will define the new horizons of health care. How we behave when our comfort zone is challenged or “buffeted” will determine how and where innovation happens. We have the power to drive or squelch innovation and we have displayed this power time and time again. Our willingness to adopt innovations has driven technologies such as the personal video recorder, fax machine, personal computer, flat screen TV and cell phones from the point of unaffordability to ultimate ubiquity. Likewise, we need to adopt innovations that will drive affordable health care to the point of ubiquity. What would it take for this kind of