The Department of Defense announced today the release of a cloud computing strategy that will move the department’s current network applications from a duplicative, cumbersome, and costly set of application silos to an end state designed to create a more agile, secure, and cost effective service environment that can rapidly respond to changing mission needs. In addition, the Defense Information Systems Agency (DISA) has been named as the enterprise cloud service broker to help maintain mission assurance and information interoperability within this new strategy.
Chris: 10 Ways the ACA Ruling Could Stimulate Health Care IT
As many in healthcare IT knows by now, Obama’s Patient Protection and Affordable Care Act were upheld in a 5-4 decision on June 28th. What does this mean to the cloud? Here’s an interesting rundown of 10 items that resonate well - these are all things I’ve been working on at BML over the past year:
- Health Insurance Exchanges (HIX) will proliferate (think Expedia for Insurance)
- Accountable Care Organizations (ACOs) will increase demand for HIXs (providers have never been incentivized to work together before it was always a competitive advantage to “own” a patient) This is creating statewide Health Information Exchanges (HIEs) as mandated by Meaningful Use
- Big data demands will surge. Patient intelligence and outcome management require a level of business intelligence and data mining that makes it clear the fields of data science and clinical informatics are at a nascent stage
- Telehealth will expand. Emergency rooms and in-patient services will initially rise in demand as 33 million more people are required to have insurance. There’s a virtual killing to be made in telehealth, no pun intended.
- Patient centered medical homes will evolve. Remote monitoring and mobile health apps (mHealth) are already becoming available today. Expect a boom in this area as doctors are encouraged to focus on outcomes instead of fee for service due to the ACO.
- Predictive analytics will become a big spend item in order to reduce readmissions. Not everyone is aware that for chronic diseases - if a patient is readmitted there are regulatory, incentive, and watchdog programs that prevent the system from getting reimbursed for visits beyond the first discharge if they happen too close together. Indeed, in some cases systems can be fined for the lack of quality outcome management. To reduce litigation also is a big driver, thus expect more predictive analytics - another nascent industry at best.
- More EHR adoption. Meaningful use is pushing systems to use them, and there’s been an uptake as fines start to kick in if healthcare organizations don’t start using them over time. Sadly, a majority of major EHRs are still based on legacy technology. From derivative archaic MUMPS databases to user experiences that clearly didn’t have any clinicians involved in the user acceptance testing EHRs are 15 years behind every other industry’s technology. Expect more cloud options to appear and major EHRs that don’t evolve to be disintermediated.
- There will be a surge in healthcare IT jobs. Virtualization doesn’t decrease the need for skilled workers, it increases it as people manage more the VMs proliferate, especially in multi-tenant hypervisor environments. There’s this fear that cloud technology threatens the jobs of IT workers as well - it’s quite naive when people say “so and so installed a cloud app and then fired half of their staff”. Simply doesn’t work that way - you use cloud to do more with your current workforce, and that’s the need - the “work” in health IT is expanding geometrically and if you don’t leverage cloud your IT workforce will as well.
- Chronic disease monitoring will push innovation and monitoring. Risky patients in an ACO world are not forsaken, but the risk does get stratified such that they can get more healthcare resources dedicated to them. The best approach is a system that allows doctors to monitor chronic disease patients smoothly and also assess their level of compliance with treatment and discharge instructions - mobile health apps and stores like Happtique are making this easiers. Doctors can actually be reimbursed for prescribing health management applications now.
- Revenue cycle management capabilities will surge. Already most revenue cycle departments in major healthcare systems are a mess when it comes to application topology. This isn’t any better in the payer world. The whole process has to be under the hood now from pre-certification to final payment. This means it’ll be easier for patients to understand their invoices as they aren’t getting double billed any longer by an insurance company and an impatient provider, however, most providers do not have mature enough revenue cycle departments to handle this new level of sophistication.