Healthcare + Technology:
Perfect Storm or
Flood of Opportunity?
Presented by the Sudler & Hennessey eHealth Group
1
H
ealthcare communications has been the foundation of the
work
work Sudler & Hennessey (S&H) has excelled at for decades. Whether getting the right drug onto
the prescribing pads of physicians or educating consumers about various diseases and treatment
options, S&H has been at the global forefront of strategic healthcare marketing communications and
education. S&H knows how to speak to physicians and engage them through clinically validated,
evidence-based conversations.
The healthcare industry has, for several years, been on a steady and, now, accelerated, path of change.
Skyrocketing costs, a challenged pharmaceutical pipeline, personalized medicine, unprecedented
access to information and globalization of care, have all significantly influenced how healthcare is
practiced and received. This new world is both exciting and daunting for all of the key stakeholders—
providers, payers, patients, and government. Adding even
more disruption to this new world is health information
technology (HIT), a promise and a reality that will
eventually enable population health management,
personalized care, disease prevention, and
unparalleled access to information.
provi
gov
go
v
It is at the center of this perfect storm of
change and confusion that S&H has begun to
strategically build and leverage core capabilities for
the emerging eHealth market. The Sudler eHealth
Group was formed to work with HIT companies as a
strategic communication navigator, helping them
understand the complex dynamics in today’s
healthcare market and supporting their efforts
to educate, train, and communicate with
healthcare providers and patients. The formation
of the Sudler eHealth Group represents a significant
and innovative business development initiative: we are
utilizing the agency’s vast “traditional pharma” experience to
tap into a booming new – and capital-rich – market at a time
when our traditional clients are reducing their budgets and re-examining their financial positions. S&H
will be at the forefront of our industry by infusing important physician and patient perspectives and
introducing the concept of evidence-based technology (our term) in order to support efforts with end
users, decision makers and care organizations.
pa
atient
e
techno ogy
technolog
ogy patient
To kick off our new eHealth Group, Sudler recently held a one-day Health + Technology Summit
focused on starting the conversation between healthcare providers and IT companies while providing
Sudler with insights and observations that have informed our new business strategy in the emerging
eHealth market. The Summit participants included technology companies Google, Intel, Practice
Fusion and GE; physicians from Harvard, Columbia, and Cornell; patient advocates; industry drivers
such as Forrester Research; and press representatives from MedAdNews, Pharmaceutical Executive,
PharmaVoice, PM 360, and Advertising Age.
The following represents some of our insights and conversations from the Health + Technology Summit
held in New York City on November 17, 2011. These insights will shape Sudler’s marketing and
business development tools for our HIT business prospects.
nt
2
The key to
real change
in healthcare
delivery, and the
systems that
support care, is
understanding
the crucial role
gatekeeper
physicians play
in driving the
convergence of
all stakeholders—
patients, payors,
providers, and
The Premise
There are unprecedented motivating factors in the ongoing eHealth revolution. Drivers
toward success include business opportunities, government incentives and legislative
policies, increasing price pressures on the health delivery networks, and a growing patient
population with overwhelming demands for greater access and quality of health information
and care. Yet there are also challenging obstacles to success—from misaligned stakeholder
incentives and deeply entrenched bureaucracies to a lack of unification across technology
platforms.
A primary and often overlooked consideration for evolving healthcare technology companies
is the role of physicians as either tacit or overt approvers of product procurement, uptake, and
use. Innovations in healthcare techniques and technologies, from the use of stethoscopes to the
adoption of new drug therapies, succeed or fail based on physician acceptance and application.
Physicians play an elevated role for all stakeholders as sources of critical information and the
keepers of the point of care, and this important gatekeeper activity is, in turn, driven by proven
patient benefits.
There has been an incredible rise in the quality and quantity of medical information and
health resources available for patients and a dramatic increase in the sophistication of payer
organizations, yet it is the personal interaction between physician and patient that remains the
principal interaction in healthcare.
Including physicians and healthcare providers in the conversation will result in healthcare
technology systems that are both quality outcome driven and sustainable.
government.
As the keepers
of the point of
care, physicians
will ultimately
determine the
eHealth winners.
Creating the
Context
The Health + Technology Summit focused
on ways in which health information
technology (HIT) companies can improve
market success. For purposes of this white
paper, HIT broadly describes the technology
platforms and digital systems designed to
improve record keeping and collaboration
among all healthcare participants, including
electronic health records (EHRs), electronic
medical records (EMRs), mobile applications,
remote monitoring, patient applications,
telemedicine, and innumerable web
properties. HIT is the means to effective
physician engagement in the evolving
eHealth landscape.
What follows is the consensus reached by
the Summit participants regarding strategies
for effectively gaining physician engagement
and achieving broader HIT adoption among
all healthcare stakeholders
There was broad agreement that the eHealth
transformation is part of a positive change
in healthcare. However, the definition of
success was widely debated.
Thanks to the incentives included in the
Health Information Technology for Economic
and Clinical Health Act (HITECH) of February
2009 and the more comprehensive
healthcare reforms of the Patient Protection
and Affordable Care Act (PPACA) of 2010,
substantial efforts have been committed to
transitioning healthcare from a fragmented
and procedure-based system toward a wellcoordinated, results-oriented, sustainable,
and cost-effective model of care.
3
Globally, we are on the precipice of an
enormous transformation in healthcare
management, medical practice, patient
treatment, and healthcare environment.
Underscoring this change is HIT and its
promise to facilitate:
n Improved treatment quality and outcomes;
n Fewer medical errors;
n Lower healthcare costs;
n Increased efficiencies; and
n Expanded access.
HITECH authorized nearly $27 billion in
incentives to stimulate the adoption and
meaningful use of EMRs and EHRs by
physicians.1 This represents one of the
largest investments ever in healthcare. In
North America alone, a 9.7% growth in the
EMR market is expected (from $7.4B in
2010 to $9.8B in 2013).
This focus and funding from the Federal
government is a crucial start but the overall
growth and broad-scale HIT adoption
among stakeholders has been slow and
methodical. A combination of technological,
financial, and even emotional issues is at the
core of this slow transformation. The ways
in which patients, caregivers, and other
stakeholders approach healthcare have
already changed dramatically. Yet we are far
from realizing the potential benefits
of change.
$
$27 billion
Summit
Highlights
There was emphatic consensus that
physicians are still the primary purveyors
of information and key decision makers.
Physicians remain in the position
of determining whether the latest
pharmacological invention will be prescribed,
whether treatment algorithms will be
followed, and whether an EMR/EHR or
mobile application will be purchased and
adopted. As such, much of the discussion at
the summit centered on physician adoption
of new technologies:
n Will physicians support reform of the
current healthcare paradigm by adopting
new HIT?
n Would they embrace a technologyenhanced relationship with their patients
and colleagues on secure web-based
platforms?
n Do they feel displaced by, and therefore
competitive with, self-diagnostic mobile
applications and patients advising patients
online?
n Will physicians consider a new role as a
partner in care and share this role with
patients, allowing this relationship to be
supported by technology that acts as
both the conduit and infrastructure
of care?
We must start by recognizing that
transformation is a challenge for physicians.
According to Cassandra Sinclair, S&H
National Managing Director, Canada
and North American eHealth Strategist,
“Physicians are trained to make evidencebased decisions while considering every
possibility. We know that through evidencebased and clinically validated information,
change does happen. Engaging physicians
in the right way, with the right information,
and in a language that conveys something
relevant is key to starting the conversation
with them.”
4
Primary Findings and Key Discussion Points
I. Physicians love technology,
but not equally
Physicians are major adopters of technology but they are very selective about
how and what they adopt for their practices. In order to engage physicians,
HIT companies should consider adopting and learning from pharmaceutical
marketing successes by providing “evidence-based technology.”
II. Healthcare meets
technology disruption
Digital technology forever alters and fractionalizes entire market sectors.
Healthcare, while lagging behind in its digital evolution, is no exception to
this experience.
III. Patients have been
empowered
Patients are undergoing a major generational and technological shift.
Unprecedented access to medical information combined with social collaboration
is empowering patients to take more direct control of their healthcare.
IV. ACOs could be the
game changer
Accountable Care Organizations (ACOs) could change the playing field, moving
incentives from simple usage to successful treatment.2
Throughout the Summit, we uncovered other
intrinsic characteristics needed to understand
and realize successful physician adoption, as
well as some of the key underlying concerns
that influence fulsome integration of HIT.
Areas of consensus affecting the broad
adoption of HIT, and EMRs specifically, were
focused on workflow, education, and training
issues, as well as the general anxieties of
many physicians.
Our objectives should be to (1) determine
what HIT companies can learn from these
issues to most effectively adapt their
development and marketing strategies; and
(2) to help these companies leverage an
understanding of the key needs of primary
influencers to succeed in the evolving
marketplace.
5
I.
Physicians
love
technology,
but not
equally
From the use of advanced imaging
equipment to early integration of iPads in the
hospital setting, physicians are among the
highest adopters of new technology. As many
as 75% of US physicians have purchased
an Apple mobile device, and 30% of US
physicians say they use an iPad to access
electronic health records, view radiology
images, or communicate with patients.3
However, physician adoption of EMRs
and other HIT has been lackluster at
best. Why?
Elizabeth Boehm, Principal Analyst, Forrester
Research, talking about how the lack of
adoption is related to the fee-for-service
model, explained, “Mismatched or illogical
incentives are a barrier to adoption –
clinicians aren’t getting paid for the use of
technology, they are paid for face-to-face
interactions with patients.” The financial
incentives of HITECH address this, to a
degree, by compensating for meaningful
use, such as the use of HIT by providers to
achieve significant improvements in care, but
this is at odds with the traditional fee-forservice reimbursement model.
This argument was supported by Dr. Mark
Callahan, Chief Medical Officer at Mount
Sinai Hospital, New York, “Physicians will
incorporate technology if they can bill for
it. And they will adopt technology when it’s
better for patients. But physicians aren’t yet
convinced that it’s better for workflow.”
It is not just the financial model that
challenges increased uptake, but the user
experience of the new technology that is
often overlooked or undervalued by HIT
companies. According to Dr. Sachin Jain,
Brigham and Women’s Hospital, and former
Special Assistant to the National Coordinator
for Health Information Technology, “Usability
is an enormous issue. The systems have
to be easily usable by physicians, but the
reality is that they are designed by computer
programmers. They have to function in
the real world of the clinical workflow.” HIT
companies need to realize that, as early
adopters, physicians expect consumerfriendly, intuitive interfaces (eg, the iPad),
whereas HIT interfaces tend to require more
training and technical acumen.
Even with the $27 billion in incentives
available for physicians and hospitals for
adopting HIT, early estimates suggest that
only 35%-40% of physician offices are using
some form of EHR, with many of those not
yet realizing the full capabilities. Still, this is
promising and a significant increase from
pre-HITECH levels of 20%-25%.4
The stated goal of the Office of the
National Coordinator for Health Information
Technology is to revolutionize the work
of health professionals and healthcare
institutions, and to make them and the
healthcare system hugely more effective and
efficient.5 Even simple changes can reap
big rewards: “New standards for electronic
funds transfers in healthcare, required by the
Affordable Care Act, will reduce up to $4.5
billion of administrative costs for doctors
and hospitals, private health plans, states
and other government health plans over
the next ten years, according to estimates
included in new rules published today by
the U.S. Department of Health and Human
Services (HHS).”6
Yet there is still a gap between meaningful
use vis-a-vis the stimulus bill and valuable,
business-altering use in the day-to-day
clinical setting. The objectives of decreasing
healthcare costs and increasing quality care
are misaligned with the current profit model
of healthcare. Confronting this issue will be
necessary if these objectives are to be met.
6
Most HIT
companies have
yet to adopt the
pharma/device
marketing model
or reach this
level of customer
understanding,
and their failure
to provide
sufficient training
often results in
physicians either
discarding or
underusing their
products, or never
understanding
the products’ full
capabilities.
Physician HIT Adoption and
Meaningful Use Barriers
When we talk about HIT, we often think
about it in terms of benefit to patients,
providers, and the system. Dr. Jeremy
Nobel, Harvard School of Public Health,
noted that when companies, government,
and others speak about HIT, they tend
not to explain how it will make the lives of
physicians better….“HIT is not just records
and translating paper into a digital format.
This is why physicians are skeptical about
its value. The rewards to physicians don’t
accrue to the physicians, they accrue to
others. Physicians see it as not benefiting
them. As we push forward, we have to
focus on payment reform; there need to be
incentives. The value is not obvious right
now in its current form.”
Another issue for physicians is the
actual purchase of the technology. Dr.
Jain explained that “physicians are not
trained on how to buy electronic health
records, or any technology for that matter.”
Tying back to their consumer-slanted
sensibilities, physicians typically look for
basic functionality that they find interesting,
and then determine if it qualifies for the
HITECH incentives. Requirements beyond
that basic appeal, such as compatibility with
existing programs and staff accessibility,
are often left unexplored. Unfortunately, this
approach often results in reduced usability
and dissatisfaction with the technology
experience.
One of the biggest challenges, according to
Dr. Jain, is that once the EMR is purchased,
the necessary training on its full use and
integration into clinical practice is typically
not widely available. Many physicians wind
up spending hours trying to integrate their
records into this mysterious new system
without ever seeing the real potential for
benefits in patient care or access to
quality data.
Physicians on the panel noted that the
amount of time it takes to customize EMRs
into their actual practice ends up costing
them significant money. In larger institutions,
they have staff dedicated to this work, but
in smaller practices the realities are different;
the smaller practices require significant
assistance and connectivity. However, most
EMR vendors only offer limited assistance
and training.
The panel of clinicians contrasted this scenario
to their adoption of new pharmaceutical
and device products, which is supported
by pharmaceutical reps and device
manufacturers who visit their offices and
provide technical training.
Dr. Jain noted, “Taking time from patient care
to incorporate HIT is difficult and physicians
need meaningful support.” Summit
participants further agreed that the required
customer service, training and workflow
integration were lacking among most HIT
businesses.
The challenges around broad-based and
localized connectivity, security of data,
data storage, and long-term purchasing
commitment were also discussed. Louisa
Holland, co-CEO, the Americas, Sudler &
Hennessey, summarized, “Because of the
many barriers that impede adoption and
ease of use, technology can be perceived
by physicians as an obstacle to care.
Physicians are wary of anything that gets in
the way of their hands-on clinical care and,
unfortunately, many technology ‘solutions’
have not been developed for ease of use
in the care setting. Ease of data entry and
data access, as well as platform connectivity
are all major hurdles that seem to interfere
with physicians’ typical practice routines. To
overcome these challenges, HIT providers
need to ensure that their technology fits
easily into the care setting, and that they
provide ongoing support to the clinician.”
7
Similar to the
way in which
pharmaceutical
companies
achieve
adoption of new
therapeutic
modalities, if
HIT is to be
incorporated
into the practice
of medicine in
a holistic way,
technology
companies need
to present the
same sort of
So how do we move from stimulusdriven adaptation of technology
to broad-scale collaboration and
meaningful, value-added adoption?
It’s crucial that HIT companies focus on
developing systems that take into account
the needs of the stakeholders, gathering
physician involvement and employing user
testing early in the development phase. This
should be followed by education, training,
and integration support post-adoption to
drive ongoing, profitable use.
Physicians are trained in and understand
evidence-based medicine. They make
decisions regularly by applying clinical and
practical evidence. They read the drug
studies, review the trial data, and then
observe outcomes in their practice. We
propose that HIT companies employ a
similar approach, what Sudler & Hennessey
has termed “evidence-based technology,” to
demonstrate the value of the technology in a
manner that would significantly improve the
speed of adoption by physicians.
II.
Healthcare
meets
technology
disruption
In its relatively short history, digital
technology has fractionalized every industry
it’s touched by decentralizing power and
realigning incentives. This doesn’t simply
mean it breaks everything apart into an
unrecognizable mess. What it means,
according to R. Shane Kennedy, Managing
Director for Digital at Sudler & Hennessey,
is that “digital upends the existing business
model and empowers the users more than
the existing industry leaders. This is by
now a familiar pattern that has been seen
in diverse industries such as music, travel,
publishing, and banking.”
No market appears to be immune to this
change, and the result has typically been a
renaissance for users in the following ways:
evidence in order
n Easier access;
to drive physician
n More choices;
decision-making.
n Greater interaction;
n Added personalization; and
n Better outcomes.
These benefits align closely with the overall
promises of HIT. Healthcare is certainly
undergoing its own digital evolution which,
coupled with the potential for broader
HIT adoption, will lead to a true industry
transformation. So what can we learn
from other recent technology-driven
market transformations, and how can HIT
companies benefit?
8
Case Study Change for the Record
The music industry was one of the first to be revolutionized by digital
technology. The old market was based on major labels controlling
every facet of the business, essentially determining for the masses
what the public would be able to listen to. It was based on top-selling
artists, full-album sales, platinum-level success, and controlled access
to selected artists.
Digital changed all that. From the tumultuous rise and fall of Napster
to the stabilizing platform of iTunes to the latest shift toward highly
customizable subscription and ad-based services like Pandora and
Spotify, the music industry is now about accessibility, variety, and
flexibility. Users have wide access to artists and music of all kinds,
signed or unsigned, at any time, on all devices, on demand. We have
the ability to buy single tracks or unlimited subscriptions, broad
access to self-published musicians, and streaming online channels—all
hallmarks of this massive transformation.
Case Study Change on a Dime
The consumer finance market has also undergone a wholesale
transformation in user experience. Where we once only used
handwritten checks, visited the teller for cash, and called a
representative for our balances, we can now do everything
online and even from our smartphones. ATMs are ubiquitous,
often outnumbering or supplanting live tellers; in fact, some
banks penalize their customers for using live support rather than
visiting the automated machines, charging an added service fee
for the human interaction. Mobile bill paying and photographing
checks for immediate deposit have also become standard practice.
And companies like Square and Dwolla are now circumventing
traditional credit card processes by offering applications and
devices that allow individual business owners to use their iPhones
to swipe credit cards on the spot.
9
Healthcare Digital Evolution: The
Prescription for Change
As healthcare undergoes its own digital
evolution, physicians and other stakeholders
are driven toward a more rapid uptake of
technology.
Patients are accessing healthcare
information at an unprecedented level. A
Kantar Media survey found that among
those cell-phone customers using their
devices to go online, a quarter of them, or
around 19.3 million, go online for healthrelated information. And thanks to Google,
Patients Like Me, and even Facebook,
patients can research, discuss, and even
self-diagnose conditions formerly limited to
medical journals and reference manuals.
iPhone apps monitor blood pressure and
glucose levels, while sites like ZocDoc allow
for immediate appointment access and the
ranking of physicians by their own patients.
Meanwhile, those at the Health + Technology
Summit agreed that physicians are using
technology in their practices more than ever.
Manhattan Research reports that 81% of US
physicians own a smartphone, while 75%
own an Apple device (be it an iPhone, iPad,
or iPod). Use of the iPad in clinical settings is
on the rise, with 30% of doctors owning one
and another 28% indicating plans to get one
within the next six months.
Physicians are already very familiar with
superior user experiences, not only
from using personal products but from
professional experience, as well. For
example, Apple has a new section in the
iTunes store for apps that cater to HCPs.
The physician-friendly division has apps in
six categories: reference, education, EMR
and patient monitoring, imaging, point-ofcare, and personal care (for consumers).
So virtually all of the healthcare stakeholders
have experienced some of the benefits,
efficiencies, and results of the digital shift in
their personal lives. And they’re seeing the
benefits of digital in a healthcare context
as well. These experiences are certainly
critical for the eventual broad adoption of
HIT. Yet, from the personal viewpoint of
most stakeholders, HIT is still a black box
delivering little of the digital promise to
healthcare compared with what has been
seen in other industries that have been
dramatically transformed by the digital
revolution.
Dr. Nobel threaded together how
experiences from other sectors are similar
yet different from the current healthcare
transformations resulting from technology
and innovation: “Healthcare in the US is
different from banking, retail, travel, etc,
in that there has been very little economic
reward for use of innovative technologies
that reduce care costs or improve patient
satisfaction. That is changing now, albeit
slowly; but it is changing. As that change
accelerates, we will see a tipping point in the
same way as we’ve seen in other industries.”
Healthcare is a high-tech industry where
improving quality and access must also
be accompanied by a decrease in costs.
Good quality care can actually be less
costly because more accurate diagnoses
are made with fewer treatment errors, lower
complication rates, faster recovery, less
invasive treatment, and an overall reduced
need for treatment.7
The central insight here is that technology
will game change the quality, access and
cost trifecta sought in healthcare but
for technology companies to lead this
revolution they must not only develop a
deeper knowledge of how to communicate
to physicians but also develop a deeper
understanding of clinical workflow and
business environment demands.
10
III.
Patients
have been
empowered
The role of the patient was robustly debated
at the Summit. Changes in patient behavior
resulting from access to broad and deep
healthcare information and supportive social
networks have, in turn, changed the way
medicine is practiced.
According to the Pew Internet and American
Life Project, of the 74% of people who use
the Internet, 80% have looked online for
health information, including information
on specific diseases or treatments. That
translates to 59% of all adults.8 Consumers
are investing in and spending more time
understanding their health than ever before.
Technology has given people the ability
to make discoveries they never could
have otherwise, and the expectations of
patients have changed accordingly. The
Internet is the new clinic. From Google and
Wikipedia to the National Institutes of Health,
Clinicaltrials.gov, and Patients Like Me,
nearly every aspect of healthcare is available
online.
Empowered by these technology-driven
general health information resources,
more and more patients are now also
demanding access to their personal health
records. However, a divide exists between
those physicians who support full patient
access to healthcare records and those
who vehemently oppose such access. But
the proportion of physicians who do not
support EMR access is declining. According
to Cassandra Sinclair, who interviewed
physicians in 2010 about patient access
to medical data, “The responses were very
diverse. Clearly there were those physicians
who felt access would improve adherence
and reduce diagnostic/treatment stress,
while others were the antithesis, stating that
access would only result in more anxiety
and potentially an unwillingness to have
treatment. Remarkable differences were also
seen between primary care physicians and
specialists.”
Another recent survey, published in
the Journal of the American College of
Physicians, showed that opinions about the
benefits of open access to health information
were still varied among physicians, and the
mixed sentiment on access was echoed
throughout the Summit; however, patient
response in the journal survey was more
enthusiastic about this access.9 Patient
enthusiasm will continue to drive changes in
healthcare.
According to Dr. David Wiljer, Director of
Knowledge Management and Innovation,
Oncology Education, at Princess Margaret
Hospital, Toronto, Canada, “Patients are
driving change, sharing stories, questioning
healthcare and voicing concerns about
putting their healthcare data online. They are
conducting research studies and actually
sharing health ideas and problems, they
are even giving direction to biomedical
researchers. This is a significant change in
the way that information flows—a paradigm
shift. Knowledge goes to patients and
patients want access to data, they don’t
want to wait; and this has fundamentally
changed the way medicine is practiced and
what information sources patients are using
to have these conversations.”
Of course, the way in which information
is consumed and shared varies through
the generations. Millennials value personal
referrals while diagnosing themselves and
their friends prior to seeking professional
medical services. Boomers and Gen Xers
investigate different treatment options and
potential diagnoses while seeking the bestin-class physicians and institutions. The
Silent Generation still prefers the one-toone interaction with their family physician,
although this relationship is becoming more
and more rare. Increasingly, telemedicine
11
Patients are
demanding
access to
relevant, timely,
personalized
information and
a care team they
can engage with
is helping this group maintain this type of
physician relationship in both rural and
suburban areas.
The expanding availability of health
information, the desire for more control,
and the advent of ACOs requiring patient
reporting will increasingly mean that
patients play an ever larger role in their own
healthcare. To succeed in this transformation
and effectively generate full-scale HIT
adoption, technology companies need to
incorporate the needs of patients into their
software solutions.
in multiple ways—
and on multiple
devices—to
receive the care
and coordination
they require.
IV.
Accountable
Care
Organizations
(ACOs) could
be the game
changer
A major topic of discussion for attendees at
the summit was ACOs. In particular, there
was robust debate around the question:
Will ACOs, aided by technology, be a game
changer for healthcare in the US?
The AMA defines an ACO as “an
organization of physicians and other
healthcare providers held accountable for
the overall quality and cost of care delivered
to a defined population of traditional feefor-service Medicare beneficiaries who are
assigned by the Centers for Medicare and
Medicaid Services (CMS) to an ACO. The
theory behind the ACO concept is that
effective delivery and coordination of care
(and thus cost savings) is difficult to achieve
without integration among the providers that
deliver patient care.”2 With ACOs, much of
the economic risk will move to the providers
as they seek to control the overall patient
success rate. This, in turn, will increase the
demand for new HIT solutions that help
physicians manage the overall process and
help to reduce costs and improve quality,
safety, and, ultimately, patient health.
Treating patients, tracking their progress,
and monitoring their resulting data will
be essential to the success of ACOs.
As such, EMRs are a critical foundation
for clinical care and the sharing of health
data. However, Ms. Boehm of Forrester
Research noted that EMRs are not the
only consideration for ACO success.
ACOs can be complex, and accountable
care requires effort from both the patient
and the physician. “The patient assumes
responsibility for better self-care and
health tracking. The clinician must take
responsibility for better education and clearer
information before, during, and after the
clinical visit, in order to improve the overall
coordination of care.”
The prospect of tracking results was also
an issue for many physicians on the panel.
They agreed that, with the meaningful
use of EMRs and ACOs, physicians can
now be tracked and, frankly, that level
of accountability is scary to them. Along
with this new level of accountability come
changes in documentation, redistribution
of compensation, and legal concerns.10
According to Dr. Callahan, “Physicians are
still afraid that electronic records are going to
come back to bite them, eventually.”
Clearly, the ACO mandate will only be
fulfilled with the full use and integration of
HIT into the practice of medicine. In fact,
the catch-22 is that ACOs won’t work
fully without meaningful use of EMRs and
broader infrastructure connectivity. This
means that HIT companies must educate
physicians in accordance with ACO practice
management strategies outlined in the new
legislation. This is a big opportunity for those
technology companies that can figure out
how to do this best, and do it first.
12
Physicians are critical to HIT
adoption: Here’s how
In today’s healthcare world, there is an enormous demand for change. That demand for
change is a direct result of the grand tension between the tripartite objectives of healthcare:
quality care versus broad access and delivery versus cost-based outcomes.
What is unique about this moment in time is that HIT has emerged as a transformational
mechanism to alleviate this tension. HIT has the ability to touch on and bring together all
stakeholders — providers, patients, payers, and politicians — none of whom can overcome
these conflicts on their own.
The critical insight of the Health + Technology Summit was that successful adoption of
technology within the healthcare industry relies on engagement, buy-in and acceptance
by the broad physician community. S&H summarized the findings of the Summit into five
strategic imperatives for HIT companies:
n Physicians need to be engaged by HIT companies as partners, not just users.
n In order to communicate effectively to physicians, HIT companies must take a more
evidence-based approach by presenting clinical data, offering educational materials, and
facilitating peer-to-peer communications to motivate the individual changes that will
lead to wholesale change across the industry.
n Physician engagement and successful adoption of technology in healthcare will only come
to those HIT companies that can translate overly technical obstacles into easily workable
benefits. The concept of efficiency isn’t enough — physicians want outcomes.
n New physician-patient partnerships must incorporate discussions about how technology can
affect and improve health, and how it can enable and broaden healthcare conversations.
This is true for prevention, diagnostics, treatment, and Rx adherence.
n Dialogue, evidence-based communications, and meaningful outcomes are the foundation of
the classic professional promotion model in healthcare. Use them.
13
For more information on how the Sudler eHealth Group can help your company evolve, adapt,
and navigate the healthcare evolution or for information on the next Sudler Health + Technology
Summit, please contact:
R. Shane Kennedy
Managing Director, Digital
Shane.Kennedy@sudler.com
Cassandra Sinclair
National Managing Director, Canada and North American eHealth Strategist
Cassandra.Sinclair@sudler.com
References
1. Blumenthal, D and Marilyn Tavenner. The “Meaningful Use” Regulation for Electronic Health Records N Engl J Med
2010; 363:501-504 August 5, 2010
2. For the purpose of our discussion an Accountable Care Organization (ACO) will be defined as “A group of health
care providers who give coordinated care, chronic disease management, and thereby improve the quality of care
patients get. The organization’s payment is tied to achieving health care quality goals and outcomes that result
in cost savings.” www.healthcare.gov
3. Manhattan Research “Taking the Pulse®” US v11.0” Q1 2011 Phone and Online Survey.
4. Office of the National Coordinator for Health Information Technology (ONCHIT), 2011.
5. The Age of Meaningful Use. A Message from Dr David Blumenthal, the National Coordinator for Health
Information Technology. 2011.
6. Healthcare IT News, Diana Manos, Senior Editor. 2012.
7. Porter, Michel and Elizabeth Teisberg. Redefining Health Care: Creating Value-Based Competition on Results.
Watertown, MA: Harvard Business Press. 2006
8. The Engaged E-patient Population. Pew Internet & American Life Project. 2008.
9. Walker J, et al. Inviting Patients to Read their Doctors’ Notes: Patients and Doctors Look Ahead. Patient and
Physician Survey. American College of Physicians, 2011.
10. For additional information on new documentation requirements, stages of meaningful use and next phases of
implementation please visit www.healthit.hhs.gov