Reimagining the Healthcare Economy Through Information

We have proven that we can invent COVID-19 vaccines at warp speed. It’s a scientific achievement realized by mobilizing bench chemists, researchers, modelers, clinical trial managers, and regulators. These high-tech workers slept, ate, and toiled around the clock, working collaboratively and leveraging information and technologies to create medical miracles, squeezing years of work into just a few months.

We’ve got vaccines. Getting vaccinated is another matter.

It is amazing how one aspect of our response to COVID-19 appears fueled by light-speed technology, while another seems to be powered by a spinning hamster wheel. It’s curious that we can do great things in the lab to save lives, but we can’t effectively or efficiently coordinate the delivery of information, care, or medicines to consumers.

It’s part of a pattern that shows not enough thought has been given to the most basic coordination of information. After almost 11 months of dealing with the virus, we are still scrambling. At the outset of the pandemic, it was a mad dash to secure personal protective equipment for our frontline healthcare providers, essential workers, and households. Then we saw a run on toilet paper and other supermarket supplies, with the images of empty store shelves a stark reminder of how demand could quickly outstrip the capacity of our supply chains. Now, we are confounded by the frustration of scheduling COVID-19 vaccine appointments or having them canceled when there isn’t enough vaccine to administer.

Bottom line: our health information and delivery systems are not structured to prioritize consumers. Trying to secure a vaccine appointment is like swimming upstream, a tension-generating reminder of the fact that the health system isn’t set up to cater to patients.

Health system communications aren’t even modern. “It’s no secret that many providers and payers relied heavily on the use of fax machines and printed documentation,” said Paul Joiner, chief operating officer of health information network Availity, in a recent interview with Healthcare IT News. As the pandemic “disrupted operations for payers and providers, with many employees and staff members working from home, the willingness to collaborate advanced significantly,” Joiner added. “The old way of sending transactions, clinical documentation, and policy changes transformed overnight.”

And yet, many doctors continue to defend the use of the fax machine, citing HIPAA regulations and concerns of malware or ransomware. This continues to act as a stumbling block in an ailing system, where information needs to be put to active use directing and supporting action as part of an interventional medical care movement that people with health risks desperately need. People are at risk of dying, yet fax machines putt-putt along, alive and well.

What keeps consumers and patients from life-extending essentials is a failure of coordinating and communicating information; in a sense, weaponizing it against disease. Effectively sharing information helped power the innovation that resulted in novel vaccines. However, failing to coordinate how information is inputted, accessed, and applied fuels the anxiety we’re all feeling right now as people who should be protected from Covid-19 — those with life-threatening medical conditions, schoolteachers, people 65 and older, and others — struggle to get vaccinated.

Driving innovation is not the underlying problem; it is organizing information.

Most product shortages are created by poor planning colliding with public need, or worse, people panicking. Forget about moving pills, ampules, or devices on massive pallets from around the world to patients’ hospital bedsides. We have to reimagine how we move people’s medical information off paper charts and onto cloud-based systems so that health professionals — from providers to epidemiologists — can better serve patients with the needed level of coordination and urgency.

Now, as we rebuild our economic system, we have the opportunity to revisit how we coordinate the organization and delivery of healthcare that comprises 18 percent of the United States gross domestic product (GDP).

If we rally our information, tech muscle, and energies toward this one public health challenge alone, it will translate into billions in savings from reduced hospital costs, physician visits, and insurance bills, lifting the burden on taxpayers — both employers and families. It will also save people’s lives.

Remove the Information Sword of Damocles From Patient Care

To incentivize overhauling our health information systems, we need to make medical information available to consumers. That means upping the ante on cybersecurity to protect consumers and advance their health needs. It does not mean using data against them by denying consumers long-term care and coverage.

Many people shy away from confronting health challenges or sharing their personal data for fear their medical records will be held over them like the sword of Damocles. Is penalizing people for being unhealthy at one stage in their life journey worth punishing them in the future? Isn’t helping them to get healthy the ultimate win-win-win, reducing costs and waste and keeping them alive longer?

Information cannot be a vehicle for medical exclusion but should be a means to create healthier people and provide them with better, well-coordinated care.

Let us look at COVID-19 as a wake-up call. At some point, employers and insurers will find that encouraging self-care and disease intervention is a savvy, responsible business model. Digital health tools are readily available to support this. Telemedicine, health apps, remote monitoring tools, and other AI-based technologies contribute to healthier people who can access targeted medicines and individualized dosing.

It may be anathema to the holders of the system’s information keys to place consumers in the driver’s seat of wellness and self-care by giving them access to their own information. That’s got to change. “You cannot deliver on the promise of digital transformation with traditional IT,” reminds Edward W. Marx, chief digital officer, Tech Mahindra Health & Life Sciences, who also served as the chief information officer at Cleveland Clinic.

While we remember our supermarket runs for toilet paper, continue to stockpile masks and gloves, and struggle to set up our appointments for vaccination, we need to look beyond these snafus at what drives the system — information. COVID-19 reinforces that information technology is the foundation for countless public health solutions. It’s time we acted on that realization.