“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 year by a CEO of a large Health Care System. He was a member of the American Hospital Association’s Long Range Policy Committee. And I had just shared with them a message that might be summarized in five words: “Big Changes Ahead – Get Ready!” One year later, I have a one word answer: “healthymagination”.
“Powering health visions” has remained my mantra. That means creating visions that can out run trends. Health care in the US will soon move from being hospital-centric to being home-centric; health will become a customized strategic planning exercise with a 120 year forward facing horizon; new technology will 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”; killer applications will suck up your varied health data, organize and customize it, and assist you in your future decision making; this killer application will flip the entire health care system toward active prevention versus passive data aggregation; and finally, this organizing online scaffold, which I call the Lifespan Planning Record, will 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, Intel Corporation and General Manager, Digital Health, in my Conference Room in New York. Some months later I shared the same concerns in the same location with David Brailer, charged with building out a virtual Medical Highway for President Bush, and 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 (now retired) of the AARP, John Sefrins of the American Cancer Society, and of the American Heart Association; medical association leaders like Mike Maves of the AMA, John Russell (now retired) 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, and here we are 5 years later reflecting on the question above. What this hospital CEO was asking, as he clarified it in person last year, 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’s 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.
Over the past years, I’ve wondered aloud 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, and trends often do catch up with even the most aggressive visioning. For example these recent headlines: “GE and Intel Working on …Home Health Care”, and 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 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)
GE, fresh off its Winter Olympics “gold medal” Ad spend on branding its new “healthymagination”, will likely take the lead, because they have an excellent presence in hospitals and homes, and are well positioned to bridge the two. And they’re excited. It’s the “Carousel of Progress all over again. Says Jeff Immelt, head of GE, ” 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’s left the station now. The only question that remains is when traditional health professionals will climb aboard?
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. Sept. 28,29, 2006.
4. Future of Family Medicine. Expert Panels. Leewood, Kansas. 2006.
5. GE and Intel To Form Alliance. www.intel.com/pressroom/kits/healthcare/ge_alliance.
6. Lohr S. GE and Intel Working on Remote Monitors to Provide Home Health Care. NYT.B3. April 3,2009. http://www.nytimes.com/2009/04/03/health/03health.html