HIT Forums Point the Way for 2008 (Part 1 of 2)
I was fortunate enough to attend two healthcare IT conferences last week; one as a journalist (really!) and the other as an invited speaker and guest. Officially, I was gathering information at the first conference and sharing information at the second conference. Unofficially, I was flogging our products and services -- upcoming webinars on Real Time Adjudication, HIT ROI for provider organizations and the Black Swans of Healthcare IT; and our just-released 5-volume set of healthcare IT funding sources. Nobody seems to have discovered these ulterior motives so please keep my secret to yourself. Whatever you do, don't forward this email to everyone you know that might care about saving money or avoiding disaster next year!
How the Other Half of One Percent Lives
The Collaborative Communications Summit is a boutique conference for C-suiters. The concept is to put the event in a tony venue that pampers the executive appetite and bring in a raft of brilliant speakers and those who move and shake the industry. Last week’s CCS topic, “Transforming Healthcare through Health Information Technology,” was enough to pique my interest when I read about it a few months back. When the conference organizers offered us a media sponsorship that included a free press pass, we jumped on it. I was already going to be in LA to speak at the Blue Cross Blue Shield Association's Blue Health IT Symposium, so I could make the CCS event for the price of a couple nights at the hotel. How much could that be?
Historically, my conference experience has been more focused on getting in the thick of things with the doers and persuaders than rubbing elbows with the financers and deciders. I’m pretty familiar with the Metro system in DC, the shuttles at O’Hare and the rental car agencies at DFW, but finding my way to CCS’s ivy-cloaked venue, the Peninsula in Beverly Hills, was a different sort of commute. In my more skeptical moments, I fully prepared myself for one of those fly-and-bye junkets we hear about – the execs make an appearance at the keynote, then head for the golf course, spa or shopping district.
It’s good to be wrong sometimes.
The President is a Lot Smarter Than You Think!
No, not that president. I’m talking about the president of the company – maybe even your company. The CCS sessions were substantive and dealt with the underlying causes of the challenges and dysfunctions facing the healthcare industry, and the ways that healthcare IT can – and cannot – hope to address them. The event was intimate – all the sessions took place in a single conference room laid out cabaret style with round tables and a raised dais at one end.
The vendors were there, of course, but held back from the full frontal sales pitches that seems increasingly characteristic of HIT forums as the industry heats up. Instead we got case studies, policy analyses and trends. The interactive style remained consistent throughout, which lent a sense of industry gestalt to the proceedings.
Bullets over Bel Aire
Here are some of the things that seemed to emerge from the group mind.
- Consumer-directed health care is happening, and its uncertain path is strewn with dangers and littered with opportunities.
- Consumers need information to make good decisions, but when they are given the information, they refuse to change their behaviors.
- We're not giving consumers any useful information.
- Consumers aren’t showing up. They are disengaged.
- Everybody has a PHR porthole, er, portal, but nobody has a clear view of the ocean. Do you want to see the view from my portal? It's just a few flights down from the lido deck.
- In terms of interoperability, standards are key. Standards are a waste of time. Standards that exist are insufficient. We have to use the standards that exist now; we can’t afford to wait.
- All other industrialized nations deliver better healthcare at lower cost, which puts us at an economic disadvantage. The underlying cause is that Americans are fundamentally different from other earthlings; we are fat, lazy and self-destructive. They are thin, active and have better genes. The underlying cause is our dysfunctional healthcare system. The underlying cause is a lack of HIT. The underlying cause that freeloaders are sucking off the vital juices of our excellent healthcare system and leaving others to pay the bill. The underlying cause is that we don’t pay for early detection, preventive care and maintenance; instead we pay for heroic, yet fruitless, costly interventions and they die anyway. Americans are fat, lazy and self-destructive. The pastries are exquisite. I had to wait 20 minutes for that shuttle from LAX and the driver wouldn't even carry the bag to the trunk. More merlot?
- Our organization isn’t like the others. If everyone else would follow our example, then we could get a grip on costs and quality.
- No matter what we do, inertia will keep most of the industry plugging along the way it has, and costs will continue to spiral out of control while quality remains inconsistent at best.
We Have Nothing to Learn from the Canadians
Okay, geographically they're a lot like us, historically they're a lot like us, linguistically, ethnically and culturally they're a lot like us and they've fought beside us in most international conflicts, but we have to remember that when it comes to healthcare, Canadians are socialists and mouth-breathers. We may have 47 million uninsured and the worst outcomes in the industrialized world, but if you were in Canada, you'd wait sixteen years for a knee replacement and wait in a line at the ER longer than the overland road between White Horse and Moose Jaw.
In fact, if they're so smart, why did they send the guy from Canada Health Infoway to learn about our RHIO efforts? You wouldn't find any of us wandering over the 49th parallel and asking them how to run our healthcare system, would you?
That's How They Get Ya
Okay, so the guy from Infoway did have a marginally interesting story. I'll repeat what I remember him saying and leave all fact checking to the reader. Apparently the Infoway project is designed to bring interoperable health records to Canada. And it's hugely socialistic -- they're putting a few dollars per citizen into this mammoth effort, in comparison to the pennies per citizen we tally from each of our far more numerous, far more market-based federal programs. And, unlike our state Medicaid programs, where the feds set forth a few simple rules and turn over money to the states to carry them out, the Infoway program dictates, er, "goals" and suggest "best practices" and a left-leaning strategy they refer to as "voluntary standards." And they have provinces instead of states, so, you know, it's like, different.
The Man in the Plaid Flannel Suit
And instead of our market-based arrangement of turning federal dollars directly over to the state governments in exchange for promises to comply, Canada Health Infoway is a private nonprofit agency (which I'm sure is Canuck for Marxist/Leninist Conspiratorial Cadre) and it only doles out enough money to the provinces to support 15% of the investment necessary for EHR, holding back an equal amount whose disbursement is contingent on actual adoption of the technology.
Standing Up for Healthcare at Any Cost
As if we needed any further proof that this is all a vast left-wing conspiracy, my informant reported that the provinces have "somewhat enthusiastically" adopted Infoway's recommendations and are "perhaps even a bit ahead of schedule" on rolling out EHR nationwide. Enough with the wood-fired propaganda machine, my red-leafed comrade! All this American has to say is that you can have my health records when you pry the paper from my cold, dead, fingers. (Of course, you may not have to wait that long, since my US life expectancy falls 2.6 years short of your Canadian lifespan. Certainly this is not due to your francophonic pinko bilinguist health system -- I'm guessing it's more akin to why meat stays fresh longer in the freezer. I regret that I have but one life to lay down for my consumer-oriented, private enterprise healthcare!)
Sorry for the patriotic rant. Veteran's Day always brings out my inner Minuteman.
Speaking Power to Truth
As much as I enjoyed and appreciated the other presenters, the main event at CCS had to be the CEO Power Session. Three of the major provider software houses were represented, along with a guy whose business is in clinical content.
The free-wheeling session was moderated by Adam Lashinsky of Fortune Magazine. The chiefs included Allscripts President Lee Shapiro (subbing for CEO Glen Tullman), Andrew Eckert, CEO of Eclipsys, Jeff McCaulley, CEO of Wolters Kluwer Health (you all know who Wolters Kluwer is, right? It's a $4B company that's spent the last couple years trying to build brand awareness in the HIT market. Oh, yeah, that Wolters Kluwer...) and the inimitable Jonathan Bush of athenahealth.
Eckert was like the guy in high school who was both valedictorian and captain of the football team. The kind of guy who you just couldn't help liking, even as he drove off with your girlfriend in his red Camaro.
Shapiro came off as the affable geek who overcame his social aversions to take second chair on the debate team. He fell short of a four-point-oh only because he caught the flu during a particularly enthusiastic Society for Creative Anachronism weapons workshop and thus missed the first half of the Chem III final.
McCaulley was like the upper classman who was always trying to recruit members for the Key Club. Nobody knew what the Key Club was or what it did, but it was nice to get the attention of somebody who seemed to have status and wore a nicely pressed shirt.
Bush was, of course, the collector of the most Most Likely To awards. Think of Michael J. Fox's conservative teenager all grown up (about 8" taller, I'd guess), only with ADHD and a software company. He chewed up the scenery like William Shatner on steroids.
Oxymoron of the Month: Reality Television
The 90-minute session was recorded by CSS organizers. We're hoping it show up as the mid-season replacement for MTV's "America's Most Smartest Model." If we were cutting the promo, these are the scenes that we'd pull:
McCaulley: "We can deliver imbedded content -- what they want, when they want, where they want -- at the point of care."
Shapiro: [Reaction shot]
Eckert: "It didn't matter that we had the best equipment in the business. [Glares at a mustachioed guy in the audience.] When you're bidding against an international conglomerate that will give their product away for free to hospitals as long as they agree to buy enough light bulbs and batteries, no price is low enough."
Shapiro: [Reaction shot]
Bush: "I don't get all this business about standards. Standards are great, but sometimes the customers just want us to get the technology out of the way so they can do something. I mean, standards, they're so pre-internet!"
Shapiro: [Reaction shot]
Eckert: [Covers mouth, winces and/or laughs]
McCaulley: [Checks Rolex, shoots left cuff]
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