Can software solve our healthcare crisis?

Can software solve our healthcare crisis?

Summary: HC1 CEO Brad Bostic says Healthcare Relationship Management can eliminate the communication and information management disconnects between healthcare organizations.

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In line with my recent thinking about the importance of the health services market and the obvious criticality of a good health services system, here is some interesting thinking on the subject from Brad Bostic, CEO of HC1, an up-and-coming company in the health services industry.

They are proponents of HRM — Healthcare Relationship Management — and, while I can't say I've done enough homework to know that they are right, I think they might be onto something really interesting and valuable here. I know this: Brad is a smart, smart dude whose head is screwed on straight and HC1 is a company to watch in this industry. So take heed.

Take it away Brad...

There is no issue more front and center in today’s news than the U.S. healthcare system. The consequences of this crisis hit home on a personal level, whether it be unnecessary or repeat testing when we visit the doctor’s office, a prolonged waiting period to receive results, or expensive healthcare bills that require a special decoder in order to comprehend.

Diagnostic healthcare entities require more than what is offered by traditional CRM.

The system is broken and has been for quite some time. Legislation won’t fix it. CRM can’t even fix it, but Healthcare Relationship Management (HRM) can…

Let me explain:

Solving our current healthcare crisis requires something that other industries have done successfully for decades: efficiently managing complex relationships. But diagnostic healthcare entities require more than what is offered by traditional CRM.

The easiest way to illustrate this point is by thinking of your own experiences in a healthcare setting. What is the first thing your primary care physician typically does when you pay them a visit?  They almost always take a blood draw. This draw initiates the process of laboratory testing, which often occurs within a lab business that is external to your physician's office. Based on the results of that blood draw, additional tests may need to be ordered by a specialist, such as a cardiologist, endocrinologist, etc.

This simple example demonstrates the fact that healthcare is composed of many entities and individuals conducting various clinical diagnostic activities. Patients are treated across the continuum of care with little interaction among their primary physician, pathologist, radiologist, or pharmacist.

The problem with traditional CRM

In order for healthcare to take a giant leap forward, these entities and individuals must become coordinated in their approach to providing high quality care, in a timely manner, and at a reasonable cost. Ultimately, the focus should be on making the patient experience amazing, not just tolerable.

The problem with using traditional CRM to tackle these challenges lies within the diagnostic activities. Unlike other industries, where generic CRMs track standard business activities such as phone calls, emails, and meetings with clients, healthcare relationships across the continuum of care are more complex. Remember that initial blood test ordered by your primary care physician? Which then turned into five more tests ordered by a specialist…?

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Over multiple entities, providers and patients, those tests translate into massive quantities of diagnostic activities (lab tests, radiology studies, etc.). This complexity necessitates a more sophisticated underlying data model than what is offered by generic CRMs. The answer is Healthcare Relationship Management, or HRM.

HRM holds the ability to ingest and automatically convert these clinical diagnostic activities into rich, intelligent profiles for all providers and patients across the continuum of care.  Armed with this 360-degree view of all clinical and business activities, the professionals who run the various entities (e.g. lab, doctor's office, radiology group, institutional pharmacy, health system) are able to work together in delivering the best patient experience possible.

The bottom line is that there is nothing more important than healthcare to the future success of our nation. 

By transforming an abundance of raw healthcare data spread across silos into real-time client intelligence, HRM eliminates the communication and information management disconnects between healthcare organizations. All healthcare professionals and executives are informed of the critical information they need in real-time and on a personalized level, resulting in something that we can all benefit from: a higher quality of care at a reduced cost.

With HRM, healthcare entities can deliver an amazing experience to all patients and the providers who serve them.

Topics: Enterprise Software, Emerging Tech, Health

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20 comments
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  • Software won't fix anything.

    The problem is the legal system and insurance system that the medical profession has to work in.
    jessepollard
    • Agree and disagree

      I agree SW will not fix much, but I mostly disagree on where the problems lie. There may be issues with both the legal system and the insurance system, but the biggest problem is the terrible health of the average user of the system. When you eat mostly "garbage", do not get much exercise, the medical profession just prescribes more medication, no wonder you need a lot of on-going health services.

      The millions and millions with chronic conditions may one day bankrupt the nation. And the health care system has no incentive to help you get healthy. There is no money to be made from healthy people.
      Economister
  • I agree

    And the insurance and legal morass has limited the ability of software systems to share data. From a legal perspective, patient data is both protected and highly regulated. From an insurance perspective, patient data=customer data and it is not in their financial interest to share customer data. Unlike a traditional market, health care costs are deliberately obscured by hospitals and insurance companies, with the patient having little or no control over the level of service, the costs incurred, and no ability to shop around based on price.
    krossbow
    • Krossbow makes a very good point

      Legislation requires hospitals say in NY to publicly post their rates and prices.

      http://www.huffingtonpost.com/2013/05/08/hospital-prices-cost-differences_n_3232678.html

      Take the MRI unit at a hospital, the private practice down the street has a better price, surprised don't be. I attended a Craneware user group in NYC this year and though MD has it rates set by the state: NY and NJ were having to balance the institution operating costs against it's offerings. Additionally there is patient confidentiality, does the MRI technician need to know that the patient has Hep-C?

      While in theory I agree with the concept that this information shared would reduce costs I believe that the existing system is best illustrated with anonymous data in systems similar to HAI (health acquired infection) tracking systems. The real dirty secret is that this is probably the most actionable reducer of health costs.

      I cannot speak specifically for my wife's employer but to state that the emphasis on watching and managing costs within existing legislation and emphasizing again and again to wash hands and follow sterilization offers today best hope in reducing hospital stays.

      To what extent post-analysis can provide metrics for improved diagnostics and procedures from big data will be determined in how well the industry can say: trust us we are interested in the big picture and hard facts and not tracking your lifestyle clicks across the internet.

      I agree the utopia solution would help, but we still have a real journey in actionable big data not performed
      cdaringer@...
      • Publicly posting prices

        It could help, but I note that nearly every state requires hotel owners to do the same thing (rates are posted in the rooms). Nevertheless the posted rates are almost useless as consumer guides as they are almost always wildly inflated maximum prices rather than what is typically charged in practice.

        So the rules would need to be carefully drawn, and it may be more trouble than it's worth.
        John L. Ries
        • Anything is better than a decade ago...

          A friend of mine without health insurance asked me to help them figure out where they'd pay the least for a simple x-ray. I called two local hospitals and four local clinics. Not a single one would give me a quoted price. I got everything from "We're not authorized to give that information" to "How should I know" to "Why are you asking how much it costs? Just bring her in and get an x-ray and stop wasting my time."
          jasonp@...
  • One example

    http://translate.google.com/translate?sl=auto&tl=en&u=http%3A%2F%2Fwww.svt.se%2Fagenda%2Flakarna-later-som-foretagsledare

    From the IT practice that computers can solve everything, by consumption domesticated Swedes.
    X15meshman
  • And where are the security controls?

    I'm not talking about the NSA. I'm talking about UPMC losing patient data. Patient data on a laptop at the Univ. of Mississippi Medical Center being lost. What about yesterday's report of the loss of patient data at Rady Children's Hospital in San Deigo? The problem is that not only are the systems too open but the security training by these medical providers is either lacking or non-existent.

    Sure, having medical data could be beneficial to the patient and potentially reduce the costs of medical care. But if you are not going to create, implement, and preach security, then not only will you continue to feel the pressure against computerizing medical records, but the regulations will erode the savings. So far, the medical informatics industry has done a poor job of dealing with security without regulation. Maybe the industry should get their heads out of their collective behinds and start there before someone gets the idea to make violating HIPAA a punitive action!
    sbarman
  • No, but exercise an diet would go along way to helping things.

    People have to take an active role in promoting better health first. Otherwise, it is just good money after bad.
    Bruizer
  • It can help...

    ...but the core of the problem is a non-competitive system that is so expensive that insurance is almost mandatory even for routine care.

    And frankly, there isn't much the feds can or should do about it (it's really the job of the states), except be a repository of good ideas (federalizing insurance regs is a bad idea). But one thing the feds could do to help would be to extend the employer-provided insurance tax credit to both individual insurance and individual out-of-pocket expenses (either that or abolish it outright). The idea here is to make it easier for individuals to take charge of their own health care instead of having to rely on their employers and to encourage patients to shop around. And providers who provide low cost services to the indigent should probably get a substantial tax break. Congress could also abolish patents on chemical compounds and life forms, specifically prohibit patents on minor modifications of previously patented inventions, and significantly tighten patent requirements generally (again, if it is commonplace to accidentally infringe on a patent, chances are that the patent never should have been granted in the first place)

    What the states could do is to reform licensing requirements so that the emphasis is on demonstrating that the applicant has the necessary knowledge and skills, and can be trusted to employ them in an ethical manner; rather than on how he got them. It may also make sense to adjust the "guild lines" (perhaps one only needs a nurse-practitioner to conduct a medical exam, rather than an MD or a PA). And if it can be made cheaper to get the training, we're not saddling new practitioners with huge debt burdens, so they won't need to make quite so much money right away.

    There's a lot that can be done, but the emphasis has to be on reducing the need for health insurance, rather than to make sure everybody has it.
    John L. Ries
    • I couldn't disagree more...

      ...about federalizing insurance regs being a bad idea. Leaving insurance regulations up to the states is what gave us nearly every single problem we have with out of control healthcare costs and extremely limited competition in the marketplace. There's no reason why there should be different rules from one state to the next when it comes to health insurance. It's not like medical procedures work differently in New York versus Texas.
      jasonp@...
  • Major Problem

    The 800 pound gorilla is security. Medical information is some of the most sensitive information about anyone available. Any data management system must address that first.

    One must assume the average person working with this proposed system has very limited computer knowledge and even worse security knowledge. This one must assume a PICNIC incident is only a mouse click away.

    Also, this presumes some data centralization which always make hackers slobber at the mouth. Lots of information that must be accessed by many different people 24/7.
    Linux_Lurker
  • Lead a horse to water...

    Dumbing it down enough for even the lowliest underpaid, questionably qualified, sincerely unmotivated worker to be unable to find an excuse for failing to accomplish their job is simply another race to the bottom. Though there are unquestionably smart people, they have no choice but to do stupid things. Highly educated, trained and qualified personnel are obliged to work with anyone that can pass a drug screen, even when they display an inability to operate so much as a fax machine. But what can you attract, when offering a wage for the position that most dishwashers would resent? "Management" from down south sends highly paid people up from Texas to finally train doctors and staff on a system being discontinued at the end of the month. They are trying to build accountability into the system, but are simply adding to the onerous and inapplicable. They might know what was going on, if they had bothered to set foot in the building since last year. But even local administrators have failed to do that. Until top to bottom participation, communication and accountability is enforced, any physical or virtual tool provided can be most likened to giving a monkey a typewriter.
    cafetomo
  • In a perfect world an imaginary solution can be perfect.

    Other than a three letter acronym which is also shared by a much more popularly used business obfuscation (see: Human Resource Management), where does the system you envisage exist? Of course if pooled patient data were organized and optimally presented, there would be less waste and potentially more safety in the system. And of course there is no reason to believe that what currently passes for CRM would do much for it. But to think that either would "save" the system is marketing hype of a high order.

    While others have commented that legal and privacy concerns are the major impediments to realization of the limited but real benefits you envisage, the root cause of the problem is that there is no system to be fixed. The health care delivery system is a morass of competitive entities using proprietary data formats, and sweetheart deals to insulate themselves from competition, in a market in which the ultimate beneficiary is unable to judge quality and largely prevented from judging cost.

    I have worked as a physician in a large HMO where such systems as you envisage are commonplace and effective. Hundreds of health workers can be presented with data on hundreds of thousands of patients within the boundaries of any system that will clearly benefit from that sharing. But once the data reaches the boundary of that system it runs into the complexity of dealing with dozens of proprietary data formats whose differences have more to do with keeping the users locked in to a particular provider than improving care, thousands of institutions that have similar motivations, and tens of thousands of suppliers of goods and services that also benefit from the balkanization of patient health data and payment sources. The problem is exacerbated by the annual shuffle of patients between providers and insurers as individuals and employers seek the latest lowest bid for premiums, crossing borders which their data in many cases cannot do as easily.

    The obvious solution to this particular problem, and many others related to the cost and safety of health care, would be to truly create a system in which a single payer has only the incentive to provide good care at a reasonable price, without trying to gouge a profit from the competition, and ultimately from the patient.
    geonque
    • I would that it were competitive...

      ...but the fact that nearly everyone is paying via insurance they don't pay for directly (except for a modest copay), together with the tendency of insurance companies to try to tell providers how to do their jobs greatly reduces the competitiveness of the system.
      John L. Ries
    • If there is competition...

      ...it doesn't appear to be the kind that actually benefits patients.
      John L. Ries
    • Single payer

      I know that there are a lot of people all over the world that are happy with their single payer systems and that may be the direction we have to go, but at least my own experiences and understanding of history suggest that monopolies are inherently inefficient, are to be avoided if it is feasible to do so; and in a less than democratic system (and even democracies are susceptible to bossism), it can be one more tool for rewarding one's friends and punishing one's enemies (that said, I prefer publicly owned monopolies to privately owned ones, all things being equal).

      My preference is for a competitive system that works well for patients and providers alike with minimal need for middlemen, and with only such governmental intervention as seems necessary to insure the public health, to protect patients from quackery, and to insure that nobody goes without necessary treatment (narrowly construed) because he can't afford it (but all should pay for what they get to the extent they can be reasonably expected to). We Americans might have to settle for single payer in the end, but I hope for better.
      John L. Ries
  • The American Way

    If you ain't rich, you die painfully and sooner that necessary. Software can't fix that mentality!
    dhamilt01@...
    • That's only true...

      ...to the extent that people regard their fellows as abstractions. When actually confronted with suffering by real live human beings, we tend to be at least as compassionate as anyone else.
      John L. Ries
  • Competition and choice

    Are two necessary things to keep costs down and not the government mandating what we should carry in our policies. The government built a insecure morass of a web site for $1 billion and took three years to do it. this is what we need to avoid. Some states built their own sites for some $300 million and then had to scuttle them because they were completely inoperable. The government can make some rules but let us in the private sector do what we do best.

    Obamacare is a complete failure and no software will fix it. It needs to be over-hauled. We don't need a 30,000 page law....keep it simple !
    pizzaman7