It’s no secret that the U.S. health care system is broken. It’s plagued with splintered information, wasteful duplication, and a severe lack of insight into the health of a patient, or population of patients. If you've ever sat in a hospital waiting room, clipboard in hand, filling out yet another form, you've experienced the crux of the problem: Data exchange in health care—getting providers the information they need to deliver care—is woefully behind that of virtually every other industry.
Using cloud technology to share data would make an enormous difference. It has for just about every sector of business, from retail to finance. You can, for example, download a book in moments. Transfer money between bank accounts with just a swipe and a tap. But what if you need to send CT scan images from Dallas to Detroit? You’ll likely encounter an antiquated process that requires an excessive amount of work and drives up costs. In 2014, communications advances abound, the average physician still processes more than 1,100 faxes each month.
Widespread adoption of the cloud could change all that and more. Yes, it’s perfect for storing and maintaining enormous collections of information (what many now call ‘big data’), but it is also exemplary for fast, secure, efficient data exchange—which is where physicians can truly begin caring for patients in a more meaningful way.
When doctors can access, update, and share patient information with ease, they can diagnose with greater confidence, avoid redundant tests, and improve patient safety. Your important data—medical history, current condition, insurance package details—can move right along with you, accessible by any caregiver you choose to see.
But the transmission of basic information is still a heroic task in the world of medicine, and the cost to patients is significant, both in convenience and safety. An athenahealth colleague recently shared a telling story about his father’s unexpected visit to the hospital: While making rounds, the hospitalist asked about the injury he had suffered in his bathroom at home. Wrong. The incident had occurred in the locker room at a local gym, where EMTs were called to bring him to the hospital. How had the details become so muddled on the patient record? The potential risk with mistakes like this is painfully obvious—and entirely unacceptable.
Could this situation have been remedied if the right people had been able to enter the relevant information electronically, and make it globally available to all care team members? Absolutely.
But there’s an even bigger health care picture at play here. When large volumes of medical data are securely stored and updated on the cloud, freed from closed systems, the entire industry can identify trends in population health, costs, insurance reimbursements—and use that insight to better serve both patients and providers.
On the cloud-based network at athenahealth, for example, we host more than 15 million clinical patient records for the 52,000 providers who use our nationwide network. The research team is constantly tapping into that “cloud intelligence” to monitor emerging trends that can help shape our understanding of the nation’s health. Earlier this year, for example, an analysis of available network data uncovered a rise in mental health diagnoses in children, revealing a 23% increase since 2010—and an even greater increase among kids on Medicaid and in southern states.
What can the industry do with solid proof of a far-reaching trend like this? That’s ultimately up to those involved in care (and, frankly, those that pay for their services), but the insight is there—simply because the relevant information, both clinical and financial, is in the cloud. It’s where information lives and breathes in real time, getting constantly updated (with roughly 400,000 patient visits a day, in the case of the athenahealth network), available in ways that simply don’t exist with the current tech infrastructure, which, generally, functions more as islands of information than an integrated system.
So what’s causing the glacial pace of advances in health IT?
Some of the problem is with health IT companies that stubbornly hang on to an outdated model that allows them—even encourages them—to opt for the old world of expensive software. Instead of operating from the cloud, they use a platform that prevents the free, simple flow of information to doctors outside of their own system (that can include yours and mine, by the way). And there’s absolutely no financial incentive for them to change.
These companies often charge medical practices and health systems millions of dollars in software fees just to get started. Once a purchase is made, the vendors no longer have money on the line as an impetus to continually improve their product for their clients’ success.
And they should be on the hook: Consider the state of health care when doctors can’t effectively track whether they’re meeting quality-of-care measures, or don’t get paid by insurance companies in a timely manner. If the health IT companies had “skin in the game,” they’d be more responsive to client needs. They’d run their businesses on a tech platform that’s open and flexible. But there’s zero financial incentive for them to do so, and no industry structure to change that.
If the banking industry can share data securely and with ease—and they decided long ago that would benefit all participants—then it’s time for health care IT vendors to follow suit.
Government plays a role, as well. It needs to encourage health care players to converge in the cloud, not regulate them before they even get there. Unfortunately, outdated regulations make it illegal for any health care entity to get paid for securely sending patient information where it needs to go.
Whether you’re a giant corporation or a small disruptive organization, you should have financial incentive for moving health care data efficiently. If we want more patient data on the cloud—a move that could transform American health care—the industry needs a loosening of the laws.
Even with these disheartening conditions, the cloud’s power is evident. In just the past couple years, the athenahealth team has used our cloud-based data to develop national reports on childhood obesity, the Affordable Care Act’s effect on patient visits, and potential peak points for the flu (tracked when the Centers for Disease Control and Prevention was furloughed due to the government shutdown).
Having a national backbone of real-time health care information in the cloud has compound benefits: Not only does it yield essential insight for the nation’s providers, but it makes it far easier for each provider to access the right information for every patient they care for, right when they need it. Clearly, it’s time to ditch the clipboards and set the data free.