Even as efforts to reform the US healthcare system are underway, the focus on fragmentation and waste leaves out a key issue for the future of healthcare: how to use science-based methods for health promotion and care delivery.
A report from the IBM Institute for Business Value, IT-Enabled Personalized Healthcare, addresses this challenge of inadequate science in the US healthcare system by focusing on the future transformation to personalized healthcare (PHC) and on the health IT (HIT) challenges that must be overcome to enable this transformation.
The authors note five HIT challenges, each of which will require new or modified technological capabilities in order to facilitate the move to PHC.
IBM’s look at the future of the healthcare environment provides a good overview of the IT inefficiencies and challenges prevalent in the US healthcare system— essentially laying out an innovation roadmap for future technologies needed in this sector. One criticism of the report is that it assumes only one potential future—the transformation to PHC—and address only one aspect of the move to PHC, the necessary changes to HIT.
3 KEY FINDINGS
- The future of healthcare — personalized healthcare (PHC) — will require an open and robust health IT (HIT) environment.
- There are significant HIT-related challenges to achieving the transition to PHC.
- Some of these challenges can be met in the near future; others may take decades, as policies and regulations must also change.
The need for PHC
While issues of waste, fragmentation, and access have dominated healthcare debates in the US, very little attention has been paid to improving the science behind health promotion and care delivery. PHC would help deliver affordable, high-value healthcare tailored to the needs of individuals. PHC addresses a number of core healthcare issues, including:
- Motivating individuals to make better health choices
- Managing the rising number of people with chronic disease
- Promoting a greater focus on prevention and early detection
3 IT challenges to overcome
Challenge 1: Interoperability — The HIT environment is highly fragmented—with various research, infrastructure, care delivery, and administrative systems. These systems will need to change to create an environment where data can be accurately shared and communications can more easily flow within and between these systems.
Challenge 2: Tightly coupled applications and data — Just as systems must become more interoperable, data must also be decoupled from its originating IT applications and made more flexible. Applications and their underlying data are too intertwined—data stored as part of an EHR may not be usable by basic researchers to test the effectiveness of certain treatments via tapping the large sample sets available from real-world patients.
Challenge 3: Standards — In order for systems to be interoperable and data to be shared easily, universal standards for HIT must exist. Standards do exist for many aspects of the healthcare system, but some are conflicting or too restrictive.
3 BUSINESS IMPLICATIONS
- Healthcare innovations — often focused mainly on care delivery — will be required in all aspects of the future PHC system. Innovations in administration and basic research will be just as important as changes in care delivery. IT companies that do not currently operate in the healthcare space or that can’t foresee ways to participate in care delivery still may find room to enter this sector.
- Many of the innovations called for will require just as much policy intervention as technological intervention to make them happen. With the fate of the US healthcare system a hotly debated topic, the regulatory aspect of healthcare will largely control decisions about the future of healthcare. Companies looking forward to PHC may need to join lobbying efforts to help ensure these technologies can be implemented.
- Privacy concerns will play a large role as an obstacle to moving toward PHC. Many of the new data and care delivery capabilities needed for PHC will need public buy-in to ensure that patients are comfortable with the amount of data collected and the way that it is aggregated over a person’s lifetime. Clearly articulating the benefits of this data collection will be important for companies designing these systems.