Last night I participated on a panel of entrepreneurs at the MIT Enterprise Forum Innovation Series event “Healthcare Innovation After Obamacare”. It was a sold-out event, reflecting the high level of interest in this topic in the Kendall Square-centered entrepreneurial ecosystem.
The highlight of the event for me was the keynote presentation by Christina Severin, the CEO of the Beth Israel Deaconess Care Organization (BIDCO, a Pioneer ACO with about 100,000 patients). She painted a very vivid picture of how complex it is for an ACO that has entered into shared financial risk contracts (no more fee-for-service) with four different payor organizations, including CMS. And how important it is for ACO management to work hard to improve and manage its cost structure to the budget levels agreed with its payors, so as not to financially suffer (and hopefully benefit).
Of high importance is solving the information processing and data integration challenges, which are daunting. The HITECH Act has provided an impressive amount of funding for the implementation of technology to address the issues of EMR data automation and the exchange of that data among providers. Both EMR vendors and the providers are working very hard to implement the required levels of “Meaningful Use”, but the effort is absorbing a tremendous amount of not only money, but also provider resources, to meet the upcoming milestone requirements. This effort is, in the interim, actually leaving relatively few resources and bandwidth to deal with the other areas of innovation, leaving the entrepreneurial community fostering the current wave of tremendous innovation in a kind of curious continuing dawn-like situation until the 800-pound gorillas in the EMR jungle and their customers, the providers, have achieved more progress in “Meaningful Use”.
Of equal importance is the achievement of payor-mandated quality metrics in a number of areas, including patient engagement and experience as well as readmissions following discharge for a number of key (and expensive) conditions such as CHF, which in turn means that patient engagement and post-discharge care transition are receiving a lot of attention.
It struck me as I was listening that patient engagement (currently mostly manifested as a patient information portal enabling a patient to access EMR data such as lab results, make appointments, and other similar things) and care transition coordination and patient monitoring (to improve outcomes and reduce readmissions) are typically treated as separate topics. What if they could be combined such that a patient is not just passively viewing data about themselves, but could actively participate in their own care plan for recovery? That sort of patient engagement would probably result in a better outcome for the patient during their post-discharge care transition period, and in turn would probably result in fewer readmissions. Now that is an area of innovation that merits provider resources.
That is the focus of iGetBetter. I think we are on the right track.
Win Burke, President and CEO