Interoperability has a been a buzzword in healthcare for about a decade, but sometimes it doesn’t seem like we’ve gotten that far. In this podcast, Rhapsody’s EVP of Product & Strategy, Drew Ivan and I discuss interoperability: its past, present and future.
Here’s what we covered:
0:20 What is interoperability anyway?
2:50 Why do we hear about interoperability so much in healthcare? Is it an issues in other industries?
5:11 How does interoperability in the US compare to the situation elsewhere?
6:51 Does interoperability matter to patients?
9:20 Has interoperability failed in the past? What new models are being tried?
11:54 What’s the business model for interoperability?
13:42 Are there any downsides? Does interoperability create any new problems?
14:54 How will interoperability evolve in the coming year?
The announcement that Amazon will work with JP Morgan Chase and Berkshire Hathaway to create a new healthcare organization for employees has health plans and providers running scared. Initial press coverage has focused on the impact of this group on the market value of CVS, United Healthcare and the like –but how many people really care about that?
CareCentrix CEO John Driscoll has the right idea when he suggests that Amazon should compel provider organizations to put the patient first –for real, not just rhetorically. His three specific suggestions are good ones: mandate self-service scheduling, introduce a universal patient portal, and improve the quality of provider reviews. As simple and straightforward as those sound, they would require Amazon and its partners to overcome serious resistance. It will be fascinating to watch what happens.
Assuming Amazon can make those basic but challenging changes come to pass, I have two additional, ambitious suggestions to help patients:
Ensure that patients receive clear, consistent, actionable follow-up information when they leave a doctor’s appointment or are discharged from the hospital.
Use the full set of information available about a patient to anticipate their needs and help them navigate the system.
The first idea is a simple one, which should be happening anyway, and occasionally does. The challenge is to get the provider system to care enough about what happens upon discharge and provide the tools, training, information and support to enable more seamless and empowering transitions. I was shocked at how poor the discharge instructions were after my release from the emergency department a few months ago, after I was struck by a car. I received basically nothing and had to count on family and clients in the medical system to help me. I know I’m not the only one who’s had this experience.
The second idea is broader and vaguer, but starts to draw on the expertise of Amazon’s partners who are in the financial services and insurance industries and have a lot of information about their customers. The consortium could help patients chart their financial path through the healthcare system, helping them identify what insurance to select, how much to save in their HSA and FSA, and where and when to get their care. It could be a virtual concierge for patients, relying big data and machine learning to provide insights and continuous improvement.
If these suggestions were implemented they would have a high impact, even though they would not completely transform the system. It seems like about the right level for this group to shoot for. If they try to be bolder they will likely fail.
Synzi is a new technology company focused on helping healthcare organizations provide virtual care. The Synzi platform enables on-demand video interactions, including for those with limited knowledge of English and for patients with hearing loss.
I sat down with Synzi CEO Lee Horner at last week’s JP Morgan Healthcare Conference to discuss telehealth and Synzi’s role.
(0:10) People with multiple chronic conditions are responsible for much of the healthcare spending in this country. What are some of the key challenges they face in maintaining their health?
(1:18) What role can telehealth play? How does it work in practice?
(2:44) What populations are most suited to telehealth? Which less so?
(4:09) What’s the value of telehealth beyond the traditional nurse phone call?
(5:55) Who pays the bill? What’s the value proposition?
(8:03) Do you offer archiving of the video visits?
(8:47) When customers archive do they make the archives available to patients?
(9:30) Synzi is a new company but it came out of Stratus, which had language services as well as tele heath. How do those fit together?
(11:10) What does the future hold for telehealth for people with chronic conditions?
SilkRoad Technology co-founder Brian Platz has turned his attention to blockchain, with Fluree, a new Public Benefit Corporation that has introduced a scalable blockchain database for decentralized applications. Fluree is not healthcare specific, but there is a lot of potential for blockchain.
In this podcast interview we covered the following:
(0:10) What is a scalable blockchain database and why is it important?
(1:58) What are some of the most pressing database needs in healthcare? How different are they from the issues faced by other industries?
(3:07) What are some of the healthcare use cases for Fluree?
(5:15) You mention transparency and consensus as key attributes of block chain. Does that contradict healthcare’s needs for privacy and security?
(6:35) Who will leverage the technology in healthcare? Who is likely to be left behind?
(7:46) What impact, if any, will healthcare consumers and patients see as a result of Fluree?
(8:51) Why is Fluree organized as a Public Benefit Corporation?
I’m a big fan and customer of Amazon, having placed thousands of orders since 1998. I understand why retailers (and other businesses) quake in their boots at the thought of Amazon disrupting them. As a healthcare insider, I also understand why healthcare companies are especially nervous. Deep down, we understand that US healthcare is tremendously wasteful and inefficient and that Amazon could make the industry look bad and eat its lunch.
Still, I’m not convinced that Amazon is going to take over the pharmacy business, the latest topic of discussion. The Wall Street Journal (Amazon’s push into pharmacy is full of promise and pitfalls) has a piece and we’re also told that CVS’s play for Aetna is a direct result of the Amazon threat.
My own recent experience with Amazon left a bitter taste in my mouth and provided a glimpse of just how hard pharmacy could be. I don’t usually take painkillers, but the past three weeks have been an exception. Since getting hit by a car while crossing the street, I have been a pretty good customer for OTC pain meds. On a recent Sunday I noticed I was running out of ibuprofen, and rather than asking family members to do one more errand, I used Amazon to place a same-day order.
I pressed the button around 9 am, and was promised that my order would be at my doorstep by 9 pm. By around noon the item was “out for delivery” but it hadn’t arrived by 8:30 pm and I was starting to get a little worried. Nine o’clock came and went, and Amazon switched my status to “delayed.” Finally I had to ask my wife to go out to the pharmacy, which luckily for us is close by and open late. I would have had a difficult night without my refill.
Eventually Amazon canceled the order and said my address was undeliverable –a weird claim for a home that receives Amazon shipments nearly every day.
Most of the skepticism about Amazon’s entry into pharmacy focuses on new complexities like third-party payment, which are admittedly pretty serious. But my own experience shows that Amazon’s current infrastructure isn’t robust enough for the basics, so I definitely won’t be among the first to sign up for AmazonRx.
Of course Amazon isn’t the only one with shipment woes, and this experience was an exception to my usual good ones. Still, it gives me pause.