The Danger of the List

The most dangerous tool in healthcare today is the “List” (prove me wrong).

Back in the day, Neal Patterson (Cerner founder, CEO) would say time and time again that the most dangerous item in healthcare was the “Pen”. The idea was that a provider capturing or directing healthcare in a non-digital format was at best a self created data silo and at worse unintelligible and created potential dangerous patient care engagements.

We have largely removed the pen from healthcare (yet the fax remains, Long Live the Fax Machine).

The wave of digitization across most venues of care over the past 15 years has largely relegated the Pen to the dustbin of memory (downtime procedures and cyber attacks aside).

There is now a second order effect of companies building population health, patient engagement, analytic, or a combination thereof tool sets. These can be powerful applications that ultimately produce just another list for how you should engage.

The challenge created for healthcare providers is no longer “Who” but “How.”

How do I action this list? What actions and in what sequence should I engage this list? What happens if I miss someone on the list, and how do I know? How do I know that the actions being done by different providers over time are helping make the patient better??How do I know his sequence of activities is getting the best result, and how to easily change to test different models?

Healthcare is personal and it is too important to NOT work hard to change for the better.

The good news is that there is increasing investment in enabling the “How” and not just identifying the “Who”.

Salesforce launched Health Cloud in 2015 and then in 2021 launched version 2.0. Notable features in the second iteration are more complexity, longer implementation timelines, and higher per user fees (just kidding … I think).

HubSpot recently announced HIPAA and Sensitive Data tools this month creating a not so subtle nod to their plans to grow in the healthcare space.

Innovaccer is really good at creating a really good list. I expect part of the investment thesis in buying Cured was to be better at making it easier to action that list (in a consumer oriented fashion).?

If you distill these announcements and other similar organizations, it appears that the orchestration concept is being pulled from a traditional CRM concept with the goal of directing providers and EMR actions. There is certainly value in this approach as it should bring a more consumer-centric mindset but still unproven in its ability to enable scalable, iterative change that needs to happen across care processes.

Enter Awell . They seem to have really grabbed the mantel of this concept and feel like they are probably going the fastest in this space. Awell is doing a great job of galvanizing the provider community around this concept with their CareOps movement.

Awell released a BLOG written by Jonathan Belanger earlier this week entitled “You are using your EHR wrong (and what to do about it).?

This commentary speaks the PROBLEM and SOLUTION. In the blog post, Jonathan makes a compelling argument that health organizations need agile, modular systems that enable flexibility in how they experiment and design (and the improve, iterate, and launch again) care processes. Awell provides an elegant mechanism to define, coordinate and drive actions across aspects of the system. This is incredibly important as providers look to move from the “who” to the “how” and do with speed and flexibility so as to make each iteration that much more effective.

At the end of the day, if we replaced the PEN with a digital LIST have we really made things better? I would argue yes … even if most of the benefit is by enabling the system to be a position to actively invest in the “How” at scale and speed.

Let’s set our sights on enabling the “HOW” and continue to make healthcare personal and for each person and better than it was yesterday.