Health IT has reached a tipping point. The dust is beginning to settle after a multi-billion dollar federal investment in the EHR, and it's becoming clear that not a lot has changed — or at least not as much as legislators might have hoped.
Still, GE Healthcare's president and CEO of Healthcare IT, Jan De Witte, is excited for the future.
"Up until now, healthcare has invested a lot in IT, after realizing its importance in the modern day delivery of care and while some say it's the end of the wave, I think it's just the beginning," he says. Here, Mr. De Witte talks about some of the biggest challenges and opportunities in the field right now.
Note: Answers have been edited for length and clarity.
Question: What are the biggest challenges you see in health IT today?
Jan De Witte: At this point, the biggest challenge in health IT is to sift through the hundreds of things you could be doing and work through the handful you should be doing. There are hundreds of companies that offer services but customers need to be focused on things that will deliver value, rather than great gadgets and quick fix solutions that aren't comprehensive. For example, we're continually focused on developing the tools that turn information into value. Hospitals have to make decisions on where to spend their money, so it's important to help hospitals get value for everything they do and ultimately yield a positive return on investment.
Additionally, if you look at this industry, there's a lot of opportunity for health IT to fundamentally change healthcare. But there may be one stumbling block, and that's data standards — open data standards and interoperability are key. The industry is still in a place where many big players are protective of their data. While there are great solutions out there, sometimes the solutions can't get to the data because people keep their systems closed. We see this in other industries, it's not abnormal. But in healthcare, it's a serious problem.
Q: What has been the most important problem in health IT in 2014?
JDW: The health IT industry at this point has valid concerns around data privacy and data security. But, this can't get in the way of innovation. There are cloud providers doing a lot of work to become HIPAA compliant, but you have a lot of people in the healthcare community still hesitant. Over the next couple of years, CIOs in hospitals will realize that cloud providers will have more scale and therefore be even more of an attractive option for providers looking to streamline operations.
Q: What's the big deal over the "cloud?"
JDW: "Cloud" is a big buzzword and it's changing how people use information technology.
First, the cloud will provide healthcare an efficient way to deal with the data they already have. If you look at a typical hospital and talk to the CIO, half of its budget goes into data storage. This is only getting worse as more and more data gets piled up. Cloud-solutions provide a cost-efficient way to store data.
Second, the cloud allows people to collaborate around data. The cloud allows mobility, and that is increasingly becoming huge in healthcare. Healthcare is a decision-making industry: It's about people taking inputs and vitals and trying to figure out a diagnosis. Cloud technologies will allow more brains to be put together to work on the same problem.
Third, the cloud will allow a new generation of analytics: turning data into insight.
Q: What is the current role of consumer data in healthcare?
JDW: While it's exciting to hear about the opportunities that consumer data presents with the advent of things like wearables, etc., we are being hit with a tsunami of data, and there's a lot of rubble that comes with a tsunami.
Today the challenge for healthcare is not to generate more data, but it's figuring out how to properly distill all that data and make use of it. When patients bring clinicians wearable data, it's not clear what it means. How did you take your blood pressure? Is it your data? Someone else's? Yes, it's data, but we won't realize the promise and potential of that data unless we are able to gather insights needed to better diagnose and treat patients.
Existing data needs to be mined and used, and it will deliver tremendous improvement for healthcare. For instance, 75 cents of every dollar goes to chronic disease management. That's 15 percent of disease that pretty much make up the total spend. Take diabetes — you start dealing with diabetes, and what I want to know as a provider within my network is: who are the pre-diabetics? Who has high blood sugar? I don't need a daily metric to figure it out, but I need them to visit their primary care physician once a year and have blood work done, then ensure they meaningfully engage with a chronic care physician to talk about eating, activity and other habits.
Doing the basic cohorts, risk analytics, and then engaging patients to follow more of a wellness plan is the holy grail of next five to 10 years.
Q: What has been the single most important development in health IT this year, and what will it look like in 2015?
JDW: In 2014, if I look at what has been on everyone's mind, it's the meaningful use deadline of this quarter. It's mundane, but it's huge. This deadline essentially closes the first inning of digitization in healthcare. More than 90 percent of acute care facilities and more than 80 percent of the ambulatory care facilities have some sort of EMR. The industry has digitized, and that's a huge investment in terms of money, effort and governmental involvement. It's a huge milestone in the industry and a necessary evil. CEOs realize they have a lot of data after EMR implementation, but not much has changed yet.
That will be the next thing in 2015: The industry will flip from digitization to analytics and workflow. Those are the two ways you make healthcare better: better clinical and operational decisions. Leaders will use health IT to enable the next wave of healthcare delivery, and in 2015 that will be the driver for value-based care.
Q: Where do you see the health IT field headed in the future?
JDW: The future is bright since everyone understands the crucial role IT plays in the future of healthcare. The five categories that correspond to 70 percent of where value can be generated in healthcare are imaging, care delivery management, workflow management, population health management and financial management. These five areas are where we've invested in our technology development, which are the areas of importance for our customers.
We invest a significant amount in enterprise imaging and in diagnostic workflow capabilities because there's huge improvement potential still in helping healthcare make the right diagnosis at the right time. Anything that follows will be money well spent.
Healthcare is still very wasteful in basic operations. If you look into hospitals' utilization and productivity, there's some double-digit of improvement potential in anything that you touch. By bringing in basic workflow and scheduling optimization analytics, you can liberate 20 to 30 percent of capability in healthcare to deliver care.
For financial management, hospitals today are taking on financial risk but sometimes don't know where their money is going. If they're even somewhat wrong, black turns into red very rapidly. Margin management, analytics and risk management are all helpful; there will be a better need for people to manage margins to succeed.
Workforce makes up 65 percent of a hospital's cost, but it is largely not well-managed. You have doctors doing the work of nurses, because the nurse capacity isn't planned. You have people in overtime, and then you have idle capacity because it's not planned correctly.
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Life after healthcare: Why CIOs do, and don't, leave the industry