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Why healthcare in the U.S. needs Amazon (or anyone) to shake things up

Brian Eastwood | April 29, 2014
As healthcare in the United States embarks on what PwC describes as its most radical shift in 80 years, most health IT incumbents just aren't cutting it.

The accountable care organization, it's worth pointing out, is espoused by the Affordable Care Act as the care model that will give patients better, more efficient, more coordinated and more proactive care. Oh, and if it succeeds, it will kick to the curb the fee-for-service model that got the U.S. into its healthcare mess in the first place. Vendors that ignore it do so at their own peril.

Healthcare IT Must Adopt Social Media Principles
Last week, Dr. John Halamka, CIO of Boston's Beth Israel Deaconess Medical Center, spoke at MIT's Information and Communication Technologies Conference. Halamka gave the audience, which included the leaders of close to 20 startups, a veritable laundry list of the technology that healthcare needs.

  • For ICD-10 coding, Halakma says, "We are desperate for [natural language processing] solutions to take unstructured data that doctors capture in the course of their work. It needs to be turned into structured, analyzable data."
  • Cloud-based analytics platforms that gather data from all facilities a patient visits, as well as from any medical devices a patient may use, and present that data in "innovative interfaces."
  • Biometric login solutions for electronic prescriptions of controlled substances, since federal law deems username and password insufficient.
  • Better security, especially for mobile devices. "We need tools and technologies that give us control over devices we don't own," Halamka says.
  • Improvements to the electronic medication administration record (eMAR) that "close the loop" from the time a drug is ordered to the time a patient takes it, ensuring that it's the right patient, the right drug and the right dose. Medication reconciliation that pulls data from a patient's pharmacy will help, too.
  • An ecosystem of applications that actually lets patients view, download and transmit their electronic personal health information. Meaningful use requires healthcare organizations to make ePHI available to patients, but there's no place to put it.
  • Cloud-based secure information sharing across institutions, especially in states where health information exchange hasn't quite caught on.
  • Cloud-hosted stores of anonymized data that patients volunteer for research purposes.
  • A nationally curated registry of best practices, drawing on decades of research from all leading institutions, which any physician or hospital could query at any time.

If there's a takeaway from this list, it's that "healthcare could use a lot of Facebook- and Amazon-like apps," as Halamka puts it - applications that use social media principles to make it easy to gather, analyze and share patient information. EHR systems written in Visual Basic 5 (nee 1997) aren't going to cut it, Halamka suggests.

If Amazon Can Make Recommendations, Why Can't Hospitals?
Blogger Paul Roemer asks, What if Amazon ran population health management? Amazon collects lots of data on shoppers' purchasing behavior and makes recommendations for future purchases. Healthcare organizations collect lots of data on patients' (un)healthy behaviors - but they sit on it.


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