My older son was driving me through the hill country of central Texas when we came upon the gate of a ranch. Over the gate was a huge archway with the name - Circle W, Lazy Z, Flying Q Ranch. "A long name," I observed, "but where are the cattle?" My son replied, "They didn't survive the branding."
I see a similar challenge for the healthcare CIO surviving the long list of technology demands, like implementing an Accountable Care Organization (ACO), while complying with regulatory demands like ICD-10 and meeting a long backlog of organizational demands. Let's look at the ACO challenges first, and then address what an already-overloaded CIO can do about meeting the demand. I see three critical technology components/challenges of an ACO:
An ACO calls for the sharing of health-related information between providers. As a patient visits a specialist, it becomes critical for the primary care information to be shared with that specialist. As a hospital discharges a patient, it becomes critical for the primary care provider to be aware and supportive of the discharge instructions and meds. And if you were checking into the Emergency Room, wouldn't you want the ER provider to know your medical history, meds, and allergies? The providers in these various settings must work together and share information, in the spirit of collaboration, to bring down costs and improve healthcare quality.
This technology element, involving the patient in the care process, can take many forms. A do-it-yourself portal might include scheduling appointments, viewing lab results, ordering prescription refills, securely emailing your provider, or researching medical conditions. A mobile app might record blood pressure, weight, or compliance with prescribed meds, and then alert the provider of significant deviations. Or an app might offer encouragement, advice, and social connections to others with a similar condition. These portals or apps can take place on the web or a mobile device, and can involve social media. This element is an opportunity for innovation. How can we leverage technology to involve the patient and to motivate behavior?
As I've seen in my healthcare IT career, care management is a huge opportunity. Both quality and costs can be improved via monitoring handoffs between primary care and specialists, hospitals to primary care, and in general between ACO provider participants. Care management's monitoring avoids the potential for a dropped baton in communication. With chronic disease, care management can help avoid ER visits by monitor compliance with provider visits, tests, and meds. Like with the rise of the financial advisor, a person to help guide your 401K or other investments, I see the rise of the health coach. Healthcare is too complex, medically and financially, for the DIY approach exclusively.
With ACO demands, plus ICD-10 and a long list of backlogged IT projects, the CIO's workload challenge is intense. What is a CIO to do to meet these organizational and regulatory demands? Work harder? Ronald Reagan once said, "It's true hard work never killed anybody, but I figure, why take the chance?" I don't think working harder is the answer. Lots to do, a skill set challenge, and the need for innovation - from my vantage point as a former healthcare CIO, I would suggest :
In this dynamic time in healthcare, with a long list of project to-do's, The Garage can help get things done and make these ideas, like ACO, a reality.