Curbside Consult with Dr. Jayne 2/11/13

Dear Dr. Jayne,

I’ve spent most of my career in EHR development. Although HITECH has been a boon for vendors and system sales, it’s been a major stress on development teams. I’m starting to feel like I should think about doing something else, maybe more outside the box. I’m looking for someone who has vision in the Accountable Care Organization space, or even someone who is thinking beyond that at an even bigger picture. It seems to me that the next big wave of health IT will come from outside the traditional vendor space.

Big Data and analytics seem like overused buzzwords, but there is a tremendous need for true clinical decision support and analysis that goes out across hundreds of sources and maximizes not only care but reimbursement across patient populations including multiple unaffiliated physicians who may not be part of a true ACO infrastructure.

I don’t want to wind up at just another vendor that starts with a vision but ultimately ends up fighting over the scraps left by Epic and Cerner. If you were in my shoes (which I assure you are very fashionable), how would I begin looking at this?

Always your gracious reader and devoted fan,
Herve Villechaize

My Dearest Tattoo,

I think that some of the biggest differences in how companies will be able to approach the challenges of the future (both those that are known and those that have yet to reveal themselves) will be defined by a variety of things.

One factor is whether they are publicly traded or privately held. It’s certainly easier to execute a vision when you have leadership that both runs the show and controls the checkbook. We’ve all seen companies sacrifice themselves on the altar of shareholder profits and those behaviors certainly raise red flags. On the other hand, there is a certain amount of protection in being a publicly traded company as there is a higher requirement for transparency.

I’m always intrigued by the development shops that are part of a hospital or health system. I like the aspect of their having to eat their own dog food. Their close proximity to the end users doesn’t give much room to hide behind sloppy code or badly-executed ideas. I would enjoy seeing the major vendors set up model clinics that truly field test their products rather than relying on their customers to perform the final round of QA and usability testing.

Although it’s not specifically in the areas you mentioned, I think there is tremendous opportunity in the market spaces that Dr. Travis and Lt. Dan cover on HIStalk Connect. Patient outreach and engagement are going to be major parts of any Accountable Care strategy. Companies that address virtual visits or link different types of providers across the care continuum – from prenatal education to ambulatory to acute care to home health to hospice –will be well positioned. We need to start coordinating care from cradle to grave if we’re going to be successful at providing higher quality coordinated care as well as controlling costs.

Sincerely,
Dr. Jayne

As vendors combine and products are sunset, I’m sure these questions are on many people’s minds. I’d like to ask our readers what they think. What do you think is the next “big thing” in healthcare IT? If you could work in any healthcare space, what would it be and why? What companies do you think will be around in ten years and who will be leading the pack? E-mail me.

E-mail Dr. Jayne.