By Aaron Drunsic, managing director of healthcare IT strategy, Accenture, and
Craig Miller, principal director of IT strategy, Accenture
Change in health care is happening more rapidly today than at any time in the past. Today, the majority of physicians are hospital employees rather than owners of clinics. Hospital chains are consolidating to gain bargaining power, economies of scale and virtual oligopolies in many markets. Accenture estimates that U.S. health systems set year-to-date record in acquisition volume of $241 billion last May. Most significantly, with the goal of 50 percent of care being delivered under value-based payment models in two years, it has the potential to flip the traditional economic incentives of care delivery on their head.
Health system CIOs need to take action now if they hope to succeed in 2020. Focus on the “second curve” changes that are coming. Some challenges will pose existential threats to existing enterprises using traditional operating models, but also opportunities that provide an opportunity to differentiate and ensure that CIOs have a seat at the enterprise strategy table.
From CIO to Chief Data Integration Officer
More sources of meaningful health information are becoming available than ever before and this will only increase through 2020. Electronic health record data, such as diagnostics and clinical encounter summaries, are increasingly being augmented with various sources. This combined with data from claims, quality measurement, population health and genomic data from precision medicine. Wearables, personalized health data storage (which may be a card, not a portal) and smart phones will generate vast amounts of biometric data. What’s more, much of the information won’t come from neatly coded claims or HL7 summaries, but from clinical notes, virtual health video interaction and other sources.
The bad news is that it will be a tsunami of data, and virtually none of it will be integrated, which is where you come in. According to one study, 30 percent of all electronic data storage in the world is health care data, and it is expected to grow by a factor of at least 20 by the end of the decade. You will be responsible for data fusion – synthesizing all of this information together.
As Chief Data Integration Officer, it won’t be enough to focus on data your own organization generates – much of it will come from other providers through health information exchange as open platforms finally emerge to compete with massively expensive and proprietary EHRs, industry data from CMS and other sources, even social media. Patients and providers will expect data to follow them across all care settings – including home – interoperably and securely.
What’s the payoff? Your role will be critical to improving the quality and profitability of care. You’re the only one with the data needed to drive analytics that reduce hospital readmissions and proactively manage the 5 percent of your patient population who equal 50 percent of your costs. You’ll creating a virtuous data circle for the enterprise. Care data drives analytics which drives evidence-based pathways of care that lowers the gap between your best and worst performing clinicians. Analytics moves from a predictive to a prescriptive role.
That’s getting kind of personal
As the cost of complete human genome sequencing has finally fallen below $1000, invest in pilot genomic (and eventually proteomic) initiatives focused on identifying markers for chronic disease, cancers and other high-priority conditions in order to create market differentiators. Assume your enterprise will start processing and storing genomic data within the next five years. Invest in massively scalable big data solutions in the cloud, as the data sets will be far too large to manage through traditional technologies.
You’ll see this disruption play out in other ways too. Expensive lab referrals will become inexpensive chips with microfluidics in the exam room. Maker anatomics means you’ll be able to fabricate unique prostheses in-house using 3D printing. Nanotechnology – first for diagnostics, and then therapy – will certainly be here within ten years at most.
Plan for partnerships. Clinical organizations today lack the specific expertise to collect, process and analyze life sciences data. Build partnerships with specialty science labs, recruit the emerging talent in this space straight from college, and team with disease-specific non-profits who are already investing in genomic analytics.
The same thing, over and over
As health care pivots away from fee for service, the best opportunity to increase margin will be technology services that reduce the incidence of chronic disease and then reduce the cost of managing it. This should serve to drive numerous technology initiatives, including population health analytics, remote patient monitoring and care services, coordination of care and more.
Assume that more and more clinical care will shift to wellness counseling and home-based care. Give or lend wearables and internet-enabled monitors to patients – the cost savings in disease management will more than justify it. Use Big Data stacks to manage the high velocity data streams and emerging Internet of Things standards to coordinate sensors.
Chronic disease will increasingly use remote technologies to effectively manage the cost and quality of care. Robots will be routinely used (as iPads on top of Segways, for example) to provide hospital room remote consults, especially for neurology. Robotic surgery techniques are already in place for limited procedures. In five years expect robots starting to come into the home at least in limited ways, such as dispensing medications and collecting biometrics. In ten years they’ll be companions.
As a CIO you’ll have to keep a lot more balls in the air. Do it right, and you won’t just be implementing strategy. You’ll be an important voice in driving it.