We have the huge honor to serve on the board of a college foundation, and in that role, we have oversight to the investments and the investment advisors, in this case it was Bank of America. In our meeting this week, our lead advisor said to me, “Noel, the report from the investment committee is all about you.” I asked what that could possibly mean; and they referenced the report released on March 24, 2016, titled “Healthcare | Automatic for the people; the intersection of tech and healthcare.” Imagine my smile when I heard this statement and the subject matter. I will try to refer to that report in the next two blogs and share their view with my editorial. If anyone actually reads these, they will know my near obsession with that intersection – not for a few years, not since HITECH Act was passed in 2009, not just for a decade, but really since the first day I stumbled into healthcare, and before we filed our first patent application. Since I was not an actual caregiver, I felt it my calling to help move information faster from doctor-to-doctor, patient-to-doctors, and eventually, from payers and employers to the entire ecosystem.
As the report notes, healthcare and technology are at the opposite ends of the innovation spectrum as it comes time to change. In the last 25 years in healthcare, I have seen the glacial pace whereas technology companies change literally overnight; if not extremely slow than exceptionally fast. Recently there has been talk on Wall Street if Apple, Inc., the most valuable company in the world today, has lost its edge. However, as we have noted in these blogs, the time is here; change is coming to healthcare because of the convergence of the baby boomer and millennial generations. We have noted that baby boomers have grown up with technology, and I for one, built my first Heathkit® H8 computer while I was in high school around 1977; this actually required soldering. On the opposite side, millennials have only known advanced technology and have grown up with the digital world. They have never seen a bank without an ATM, and a passbook savings account is a term they don’t even know. They did not see the emergence of black and white television migrating to color; they grew up with flat screen digital TV with the internet and on-demand television. Those two generations are forcing the healthcare industry to change.
The benefit from ability to organize and analyze healthcare data is obvious; however, the issue today is still in the electronic medical records, all the data is in silos. The real transformation of healthcare is when information flows. In fact, this was the idea that inspired what is PWeR® today. We asked, “How do we enable the providers, empower the patients, and improve the science™?” I believe that the industry must find a way to make those bridges connect. Those troves of large data will allow us to see correlations, trends, and diseases across the entire patient record, and then link to behavior, lifestyle, and even environmental issues.
Though we have been critical in the past with the shortcomings of the HITECH Act of 2009, and certainly of the Affordable Care Act of 2010, it is impossible for us now to recognize that they served as a catalyst, maybe at the right time and place. We have been working on our EHR project for a decade, but those two Acts changed the trajectory, and proved to be an inflection point. The next Act we see ahead will be the Medicare Access and CHIP Reauthorization Act (more on this in a few weeks). Through the cost of healthcare, the number one goal of both the HITECH and ACA has not been achieved; they are very important for the future of healthcare. The key was the incentives of over $30 billion (USD) to adopt EHR, as well as the penalties that will increase to 5% in just two years. The next goal must be to make EHR universal, interoperable, and transparent (Basic 3). So, we are in the second inning of a nine-inning game, maybe like when I was building the H8 many years ago versus the iPhone 6S of today. Or perhaps, the latest Dell Laptop that I use with solid-state drives, and the difference in paying per minute access to get to Compuserve® over copper phone lines at 300 baud modem (does anyone remember the sound of the computer handshake anymore?) versus the practically unlimited speed and access on fiber optic.
Besides the Basic 3 above, we now need to connect with devices and sensors the rest of our lives – our cars are more connected to technology than our health and wellness records. That actually brings up one key word wellness; when we embarked on this path to build a new type of EHR, we hated the entire acronym for EHR, yes we still use it however, we settled for a more important word, wellness, and that is how the “Personal Wellness electronic Record®” was born. More on the Bank of America report next time.
-Noel J. Guillama, President