How Much Should My Hospital Invest in EMRs Today?

Posted on | April 6, 2009 | Comments Off on How Much Should My Hospital Invest in EMRs Today?

"How much do you think my hospital should invest in electronic medical records over the next few years?” This was the question asked of me last week by a CEO of a large Health Care System, who was a member of the American Hospital Association’s Long Range Policy Committee, after I had just shared with them a message that might be summarized in five words: “Big Changes Ahead: Get Ready!”

More specifically, I was predicting that health care in the United States would soon move from being hospital-centered to being home-centered. Health would become a customized strategic planning exercise with a 100-year-forward horizon. I was also predicting that new technology would focus on engineering the home for health in the same vein as GE’s ‘Carousel of Progress’ catalogued GE’s success in engineering the kitchen to “improve the quality of our lives.” A vision of health care where killer applications were on the way that would suck up varied health data, organize and customize it, and assist an individual in his or her future decision making. A prediction where this transforming killer application would flip the entire health care system toward active prevention versus passive data aggregation. Finally, that this organizing online scaffold, which I call the ‘Lifespan Planning Record,’ would be free, online, ubiquitous on all computers within 5 years, and (most importantly) come from the consumer rather than the provider side.¹

For any of you who have followed me over the years, there is nothing new in the messages above. On June 27, 2005, I delivered the same opinion to Louis Burns, then Vice President of Intel Corporation and now General Manager of Digital Health, in my conference room in New York. Some months later I shared the same concerns in the same location with David Brailer, who was charged with building out a virtual Medical Highway for President Bush. I have also talked about my predictions by conference phone with the leaders of Dossia, a large employer consortium interested in health platforming.²

Face to face, over the next three years, this same vision was shared with varying degrees of penetrance with health information pioneers like Don Detmer and Paul Tang, consumer association giants like Bill Novelli of the AARP, John Sefrins of the American Cancer Society and the American Heart Association; medical association leaders like Mike Maves of the AMA, John Russell of the American College of Surgeons, and Doug Henley of the American Academy of Family Physicians; and a range of top leaders from politics, nursing, long-term care, integrative holistic care, and the consumer-health and prevention industries.^2,3,4

And yet, it’s taken this long – 4 years – to hear the right question (written above) asked. What this hospital CEO was asking, as he clarified it in person last week, was “If ultimately, health care is to be centered in the homes of the hundreds of thousands of families we serve; and if we are providing a portion of the data to them, so that together we might plan for the future; how much should I be paying today for a proprietary system, not designed to integrate with these new consumer platforms that will shortly arrive?”

It is a complicated question. The short answer: “You must invest enough.” Enough for what? Enough to properly organize hospital data to maximize quality and safety as you address the combined chronic burden of disease of your patient population. But-and here’s the tricky part-enough also to prepare yourself to link easily to the coming open source consumer health platforms and ensure 2-way, 24/7 communications with your patients and forward planning activities.

As I flew back from Chicago last week, I wondered, as I have so many times before, whether my message and it’s purpose – to encourage health leaders to embrace technology and use it to reinforce relationship-based care has made any difference. Who knows? But one thing is certain, time marches on. I awoke the next day to headlines: “GE and Intel Working on …Home Health Care”, and to Intel’s Louis Burns’ words, “Today’s systems just won’t scale. Health care has to go efficiently into the home…”⁵

That’s GE, with 17 billion dollars a year in everything from medical imaging to standard electronic medical records, and Intel, with a virtual personal health record application, called ‘Health Guide,’ with two way video capability that links the people to the people caring the people.⁶

Look for GE to take the lead, because they have an excellent presence in hospitals and homes and are well positioned to bridge the two. And they are excited. In short: it is the ‘Carousel of Progress’ all over again.

Says Jeff Immelt, head of GE, "Improving healthcare accessibility and reducing costs are essential to economic recovery and growth. We think this partnership offers the potential to lower costs by keeping people out of hospitals while giving health professionals the data they need to deliver the best possible care. Intel and GE share a vision to use technology to bring effective healthcare into millions of homes …Together we can deliver innovative products to serve this rapidly growing market."⁶

Back in 2005 I said, “The train will soon leave the station, and you don’t want to try to catch it once it’s gained a full head of steam.” Well, it has left the station now. Best strategy for hospital CEOs today? Buy a ticket and climb aboard.

For Health Commentary, I’m Mike Magee.

References:

1. Magee M. Home-Centered Health Care. 2007. Spencer Books, NY, NY.

2. Magee M. Personal Communications.

3. Expert Panel. “Personal Health Records and Electronic Medical Records: Navigating The Intersection”. Bethesda, MD. 28-29 Sept. 2006.

4.Future of Family Medicine. Expert Panels. Leewood, Kansas. 2006.

5. GE and Intel to Form Alliance.

6. Lohr S. GE and Intel Working on Remote Monitors to Provide Home Health Care. NYT. B3. 3 April 2009.