Healthcare is complicated. There's no getting around it. Which is why hospital leaders should be extremely skeptical of individual technologies that say they can fix it, says Lynda Chin, MD, executive director for real-world education detection and intervention at The University of Texas System and professor at Dell Medical School.
The challenges of healthcare are "so big and complex that no little solution is going to solve them," said Chin. "We do need these innovative technologies to fill the gaps – but what we don't talk enough about is how do you integrate that back. Because the patient is not going to get what they need if it's not integrated and connected through every other component."
In a recent article in the New England Journal of Medicine, Chin and her UT colleagues explained how they developed a pilot project to help build that patient-centric ecosystem of care.
The pilot involved and "Amazon-like" platform, "purpose-built for hosting market-available digital health products from a variety of companies," according to the article.
The aim was to "expand the options accessible to both providers and patients by serving as a convenient single source for many digital health products," while also enabling interoperability across those technologies and integration with traditional care delivery services.
Once on the platform, a provider could have easy access to "multiple vetted products, thereby minimizing the time, effort, and expertise required to adopt digital health tools" – something that could be a boon for "resource-constrained providers."
The project had many participants: The UT System, acting as a convener, "engaged PricewaterhouseCoopers to customize its cloud-based information interchange as the designated digital health platform" and tapped AT&T to provide internet of things capabilities on an end-to-end secure communication network.
The UT Health School of Public Health in Brownsville served as a local shared-service office to interface with community partners, and UT enlisted providers, retail partners and community groups to participate in the ecosystem.
The overarching theme of the initiative, according to the article: "Care delivery is not equivalent to a retail transaction. There is no single device, app, or piece of data in isolation that will deliver benefits to patients. Therefore, the various digital health products that can be made accessible through a common platform would still need to be stitched together and integrated into a coherent care delivery program."
'Don't just think about shiny, bright objects'
In Boston, next week, Chin will deliver an afternoon keynote at the HIMSS Big Data and Healthcare Analytics Forum in Boston. She'll discuss how projects such as this one are key to harnessing the power of data and analytics for more effective and efficient care.
"It's very clear to me we're going to need a different way to get the data together," she explained. "That was part of the motivation to take on a need – chronic disease – that clearly would benefit from data that isn't just limited to data that isn't just limited to the electronic health record. And a lot of that data resides outside the traditional healthcare system."
Rather than a "one-to-one bilateral relationship," the aim was to create an "open ecosystem" – flexible, multi-lateral, with multiple technology and healthcare stakeholders, she said.
"I saw too much of a focus on individual solutions," Chin explained. With all of healthcare's many challenges, it needs more than just "here's my app," she said.
The aim of the UT pilot was to conceive of a new approach: "What does a patient-centric ecosystem look like?"
The good news is "we've learned from this project is that it is doable," said Chin. "Not that it's easy, but I don't think anything in healthcare is easy.
"The conversation that I hope these preliminary results can get everyone to think about is that it's not good enough to think about that point solution that can fill the gap, like virtual care or remote monitoring," she added.
"It doesn't do justice to say that's all we need. Virtual care will never replace emergency care or primary care in an office setting. It should never be either/or. We need to think more about the continuum of care, the spectrum."
In other words, "don't just think about shiny, bright objects," she said. "We can make a great car, like Tesla. But if there's no highway system and no charging station, it's not going to get you anywhere."
The HIMSS Big Data & Healthcare Analytics Forum is scheduled for Oct. 22-23, 2018, in Boston. Register here.
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