Healthcare, Meet Your Manual

Healthcare has an information problem. 

We perform so much clinical research and sit on such treasure troves of data in our EHRS, yet often, the right information fails to flow where it’s needed most. Doctors on one software system can’t talk to doctors on another. Vulnerable patients go without time-sensitive, critical care because they’re un-activated by providers or the “smart systems” where their clinical information resides. Yet Amazon and Netflix can predict with startling accuracy what book or movie we might like to watch, then download it for us instantly.

Why do we stand for this level of disconnect in healthcare, when we enjoy connection and convenience in much more ephemeral domains? I would gladly trade my Amazon “Recommendations for You” or Netflix suggestions for a better connection to my health information.

It’s my company, athenahealth’s, mission to bridge the health information gap, and to put our network--one of the largest data sets in the entire healthcare industry—to work for healthcare’s current and future leaders. Leaders need new approaches and solutions to help their organizations thrive through change. It’s something I wish I had had when I went into the healthcare business twenty-five years ago.

When I was one of the idea men behind a chain of birthing clinics in San Diego, I ran into all the problems that medical practices typically do. Few of them were related to medical care. They were things like getting our claims paid, making payroll, navigating mercurial regulatory and insurance rules, and getting information to flow so that I could connect my OBs to other providers. And yes, we tried to pay witness to the simple, honest beauty of the birthing process that our practices were designed to facilitate. That last part, though, often felt like luxury.  

Those problems haven’t disappeared in the intervening years. In fact, they’ve escalated. 

Healthcare is staring down some hairy challenges, from the arrival of value-based care to shrinking reimbursement rates. Providers are being asked to do more with less. And patients are getting squeezed from all sides, paying higher rates for services that do not resemble the consumer shopping experience they enjoy in all other aspects of their lives. Add to that changing evidence-based clinical guidelines, and more informed patients of the WebMD generation who are pushing their providers—rightly—to explain their care plans and spend more time with them. The fully engaged doctor and healthcare executive are beginning to look like an endangered species.

We know that healthcare organizations of all shapes and sizes are beginning—gradually, and with mixed success—to redefine themselves in response to some these challenges. The information model for healthcare must change to meet this shift, too. Even the most innovative practitioners and organizations are operating on islands, and will grow tired of bowling alone. Many more don’t even know where to start. They need real-time information to learn from and share with one another. Everyone is approaching the issue of staying solvent—and relevant—in the emerging Health 3.0 world differently.

In the absence of a manual, physicians and their leaders must get connected to real-time data and to their peers. 

At athenahealth, we’re connected. We connect 81 million unique patient records, 80,000 providers, and process over 5 billion transactions annually on our network.  We can see who has submitted a claim cleanly, or who has successfully triangulated quality, cost, and value– then inject that knowledge into the network so others can reap the benefit. All of that information forms a living portrait of healthcare across America. For twenty years, we’ve been students of that portrait, studying the habits of high-performing health systems and drivers of effective physician leadership and engagement. And we have studied trends tied to public health. We know that providers are prescribing fewer opiates to patients and in lower doses than previous years. When the CDC issued an alert about the risk of zika virus earlier this summer, we knew how many of our providers’ female patients were vulnerable.

When you assimilate this kind of data over nearly two decades, you bear witness to some incredible stories of humanity and ingenuity. We’ve identified some of our brightest and boldest clients, who have pushed the definitions of what it means to practice medicine in the modern age. They are the ones who have cracked the code on chronic care management, protected their providers from burnout, and risen above the administrative maelstrom to remain present during the moments of care.

We’ve decided that it’s time to share those stories, and our own data, for good. So we’ve launched athenaInsight, an editorial hub that will publish timely news and analysis, and convene conversation and experts, on the topics healthcare needs to discuss now. My hope is that our reporting will influence the way that providers and leaders understand healthcare today, while they continue to build the healthcare of tomorrow.  Because we believe that network knowledge is power. And beginning today, we’re in the knowledge-sharing business. If we do our job right, the insights we enjoy every day will, over time, become the industry’s. You be the judge.