When Medicine is a Slow-Moving Ship, We Need Tugboats

There is a disconnect between the speed of technology development and the adoption of the technology. This is not a novel concept; the technology adoption curve is well-documented.?

There is no space where this is most apparent than in healthcare. Perhaps this should not be surprising, given how the practice of medicine is grounded in science, which, despite the incredible rate of advances, still requires hypotheses to be formed, tested, re-tested, challenged, and then somehow finally widely accepted.

In medicine, novel drugs are adopted rather quickly, due in large part to the massive money machines behind these drugs, with resources poured into sales and marketing and armies of medical liaisons disseminating the science directly to the physicians.?

But when it comes to healthcare technology outside of interventions, medicine is a slow-moving ship. Hell, it took the HITECH Act – literally financial incentives – to get doctors and healthcare organizations to ubiquitously adopt electronic medical records, which should have been a no brainer.

Everyone I know who has interacted with the healthcare system recently knows just how frustrating and discombobulating it is, but the solutions to the problems facing every day Americans are being developed, and many already exist. The core problem lies in the lack of adoption.

Here are two personal anecdotes from my life just in the past few months that make me want to scream, because as somewhat of an insider, I know the technology to fix these holes exists – I know because I’ve literally seen it in action at my company and others in the industry – but the lack of adoption is clearly where the current gaps are.

Story one may resonate with many of you. I went to an academic medical center to see a specialist for a consultation about an issue that, frankly, I do not really trust my PCP to handle. I called the AMC to ask how they want me to get my historical records from my PCP to them. I bet you can guess that they told me to have them faxed. FAX! I asked them point blank, “Wouldn’t it be easier to use the Health Information Exchange? Then you would have my records digitally.” They flat out told me no, that fax was easier. When I asked the doctor if he got my records, he said he had not seen them. If the AMC was using the Health Information Exchange to receive records, the PCP could open my chart and my historical records should be there. It’s a good thing I had anticipated this and came with my records printed…

Story number two is much more frustrating for me, because I could see how if you weren’t an advocate of your own care, mistakes could be made. My wife gave birth to a beautiful baby boy in February. She delivered with her OB/GYN at a top Academic Medical Center in NYC through which her OB was affiliated. Now, I know the AMC is familiar with the HIE network. My wife had to consent to her information being made available through the Carequality HIE network. Yet, on at least two occasions the AMC seemed to plead ignorance about not having certain information relevant to my wife’s care, information which would have been in her chart from her OB, and via CVS pharmacy records. At one point, my wife recognized they may not have this information, which prompted her to have to speak up and ask about it. I won’t divulge the details for her privacy, but these relatively minor flubs could have become major issues had we not picked up on the hospital’s lack of visibility into the historical charts. It required my wife to mention these things and advocate for herself to ensure she got the requisite care. If she hadn’t, it stands to reason these things could have slipped through the cracks and potentially put my son and wife in harm’s way.

As someone who knows that the technology exists for the AMC to have had the information that they needed without asking my wife, or having had her mention it herself, it frustrated me to watch them languish as if they were back in a time when health data interoperability was much more impeded.

Novel health tech companies are springing up everywhere, using AI and other innovative technologies to solve healthcare’s biggest problems. Every day, more and more of these solutions advance beyond beta and pilot mode and begin to prove that they can solve problems.

The problem that they can’t solve on their own is adoption.

With blockbuster drugs, it still takes enormous resources to drive physician adoption and achieve significant market penetration. Technology companies usually do not have the same luxury as global pharmaceutical companies of having nearly unlimited resources to dump into sales, marketing, and education.

Without a coordinated effort from champions, economic buyers, and key personnel, technologies will languish and fail to break through pilot mode and into status quo.

Medicine is a slow-moving ship, and without tugboats, these technologies that can solve key problems will fail to do so. Identifying key physician champions is a great first step, but winning over key administrators and other business personnel within healthcare organizations is critical. Most orgs now have a Chief Technology Officer, a Chief Information Officer, a Chief Data Offier. These are critical champions as well. Tech organizations must identify many “tugboats” to help bring their peers along to drive adoption.

Otherwise, for example, we’ll never fully be able to destroy the fax machine and fully leverage technology that exists for data interoperability, among many other problems where the solutions exist today, but adoption has lagged.