Technology Revolutionizing Healthcare

Experts in the field of healthcare and information technology discussed the future of Health Information Exchange programs and argued for increased accessibility of patient information as a viable means to improve healthcare at the Idea Exchange for Digital Healthcare Forum on Wednesday July 10 in the Calit2 building.
The exchange served as a forum for companies and experts in the healthcare industry to discuss the future of Health Information Exchange programs and what it means for the future of healthcare. The expert panel at the exchange consisted of Sajid Ahmed, Robert Hoyt and Ashraf Shehata. Ahmed is the current Chief Information and Integration Officer at Martin Luther King Jr. Community Hospital and is a supporter of HIE programs. He worked to implement HIE programs while employed at L.A. Care and admits that the way HIE programs are currently being implemented must change if they are to be successful.
“My perspective, and my observation and opinion is that HIE, Health Information Exchange in the classical sense of how it has developed, its nomenclature, it’s structure I believe it’s on its way out,” Ahmed said.
Health Information Exchange refers to the service of exchanging a patient’s medical information between doctors, hospitals, pharmacies and insurance companies for the coordination of medical care services. According to Ahmed the program can reduce wait times in hospitals, allows for greater coordination between medical providers, insurance companies and pharmacies and allows patients to easily transfer medical information between doctors. However, despite these advantages, past attempts have repeatedly failed. These include the failure of the Santa Barbra County Care Data Exchange program in 2006 and the failure of the California Regional Health Organization in 2010.
Both programs failed due to the inability of the programs to become financially independent after the federal government withdrew grant money from the programs. For Ahmed these failures are examples of an inability to sell the idea of HIE to the healthcare industry. These past failures led him to believe that the program had to change if it was going to be implemented in the future. However, Ahmed believes that the past failures of HIE have made it harder for future HIE programs to be accepted. He pointed out that the very usage of the term HIE is seen as taboo in the healthcare industry, and that fact will restrict the growth of HIE programs until the stigma changes.
“I am proclaiming that HIE as an effort through Health Information Exchange Organizations (HIOs), unless they evolve and provide services that give value then they are on their way out; they are struggling. Health plans don’t know what to do with them, providers like hospitals are afraid in part because of the acronym,” he said.
Ahmed’s belief that HIE programs need to change is also supported by changes in the political realm. Previous HIE programs, including the Santa Barbra and Cal RHIO programs, were financed by government grant money. However future money might be harder to come by according to Ahmed.
With the recent focus on the expanding federal debt, factions in Congress are attempting to cut funding to programs like those that fund healthcare initiatives such as the expansion of HIE. Ahmed fears that this change will result in HIE programs getting cut despite their potential.
“I think the FEDs are struggling to keep the money that was apportioned to them through the High Tech Act, through the stimulus funding and I think future funding post-stimulus is a big question. I think the FEDs would very much like to keep these programs going,” Ahmed said.
However, he also feels that with the implementation of the Affordable Care Act (Obamacare) the market will have a need for HIE programs and will lead to its expansion.
“I think that the value proposition exists more now with Healthcare Reform, with the penalties for readmission, and I think those value propositions meaning the need is there now for the exchanging of data even the just for alerts of when a patient has shown up in the E.R. and the primary care,” Ahmed said.
The other panelists agreed that there was a future for HIE programs. Robert Hoyt, a Healthcare Solutions Executive for IBM, believes that HIE programs can be sustainable with a proper business model. Citing that previous HIE programs failed largely due to an inability to stay financially solvent, Hoyt pointed out that any future HIE program needed to turn a profit without government aid to be sustainable. He also believes that there is an opportunity to create a sustainable business model for HIE through marketing medical information.
“So then you start thinking well okay where do I add value, I’ve got a lot of data moving around that if I make a copy and start aggregating that and providing some analytical services, you know now I’ve got something that is worth a couple of hundred dollars per month per doc,” Hoyt said.
He also believes that there is a viable market for selling medical information to pharmacy companies. Hoyt stressed that if medical data integration programs and services were to be successful they needed to be able to function independently of government support.
Some of the audience members disagreed and felt that selling patient information to pharmacy and insurance companies was a violation of privacy and some asked who would own the data if this system were implemented.
The other panelist Ashraf Shehata, an executive at the Global Healthcare Center for Excellence at KPMG, argued that a joint ownership policy would make the patient and healthcare provider have access to patient medical records. He believes that by making the privacy issue a non-issue, it will allow HIE programs to succeed, leading to improvements in healthcare.
Shehata also believes that there is a future for HIE and other programs to make medical data easily transferable. However he believes that these programs will be implemented even if there is no major change in strategy or implementation and that technology integration will occur in the healthcare industry due to technological advances that make data integration cheaper and easier to manage.
“If we don’t try to force the issue of integration, it will happen. And what I mean by that is because of the payment models that we are starting to see emerge from providers and payers, it will happen because technology is getting ahead of the limitations we have with applications, and it’s going to happen because the data at the infrastructure level is much more open.”