Some of the leading lights of healthcare IT gathered for a Monday afternoon symposium titled "Healthcare In Transition: How Information Technology is Remaking Medicine."
Sponsored by Xconomy, the forum, held at the MIT Media Lab in Cambridge, Mass., explored the challenges and opportunities ahead. Special attention was paid to explaining healthcare's relative slowness, compared to other industries, in embracing the transformative potential of information technology.
Another recurring theme was the power of IT to change the relationship between doctor and patient.
Media Lab Director Frank Moss said attendees would help "carry the revolution forward," pointing out that while nearly every other industry has been transformed by IT, "sooner or later, this must happen with health." Even with recent health reform, he said, we are "headed still for disaster."
The cost curve must be bent, he said, by using technology to transform – not just reform – medicine and "empower ordinary people to take control of their health."
John Moore, MD, a research assistant in New Media Medicine at MIT, said this must be done by "engaging the patient with technology" – using IT to show diagnoses and allowing them to carry clinical knowledge out of the exam room and into the real world, using social support to empower the care of their own health.
Mike Gillam, director of the Microsoft Healthcare Innovation Lab, said he sees a healthcare "singularity" in the coming decades, where diagnostic innovations are all but instantaneous as a "Copernican shift" in healthcare puts patients and their PHRs at the center of care where the hospital once was. There "could hardly be a more exciting time," he said.
The centerpiece of the afternoon was a panel discussion, moderated by Wired executive editor Thomas Goetz. Comprised of Paul Bleicher, chief medical officer of Humedica and founder of Phase Forward; Daniel Palestrant, founder and CEO of Sermo; Roy Schoenberg, president and CEO of American Well; Joe Kvedar, founder and director of the Center for Connected Health; and Ed Park, chief technology officer at athenahealth; first tackled the question so many have asked: "Why has it taken so long?"
Information technology "has changed pretty much everything … except healthcare," said Goetz.
The reasons for this, the panel agreed, have little to do with any impotence on the part of technology itself. Instead, Goetz said, the lag has to do with a healthcare system "locked in regulatory amber" where "well-meaning innovation runs up against wall of regulation and institutional recalcitrance."
Another reason has to do with incentives, said Schoenberg, whose company enables online, real-time specialist consultations. "One of the key drivers for getting physicians to change" is their ability to "make a decent living," he said. The key is to tie technology adoption into direct remunerations, he said.
When doctors "get paid for every 10 minutes with a patient, they will take the time to learn how that Web cam works," he added.
Park agreed that it's "not a technology problem."
"The problem is the microeconomics of a doctor's office," he said. It's imperative to "align economic incentives with ones that are good for the patient's care."
With healtcare expenditures accounting for 18 percent of the Gross Domestic Product and counting, there are "many parties that are doing very well with maintaining the status quo," Palestrant said. In healthcare, he said, "a dollar saved is a dollar of someone's income lost."
Moreover, said Bleicher, the "foisting of uncomfortable and cumbersome technologies on physicians has caused a lot of hesitance along the way."
Goetz suggested that the current model is simply "too physician-centric," which "limits the power of technology." To truly allow IT to be transformative, he said, the patient should be using it just as much as – if not more than – the provider.
Indeed, said Park, the "paternalistic view of the doctor" is losing currency.
Kvedar said technology is giving people the "tools to be their own provider whenever possible … (drawing) patients into their care."
In the coming years, added Palestrant, "the empowered consumer is going to be biggest impact on the healthcare system."
