ORLANDO – Government cannot fix healthcare. Neither can the insurance companies. Instead, it’s going to take everyone working together to take a big step forward.

“We have a vision for a smarter, more responsive healthcare system,” said Premier CEO Susan DeVore during a Friday morning keynote here at HIMSS19. “One that is consumer-centered, provider led, with data flowing seamlessly and being analyzed and effectively leveraged to guide decision making at the point of care.”

To get there, DeVore said the industry has to solve five interrelated problems.

First, healthcare organizations have to move from data overload to actionable data. “For years the buzzword that described the future of healthcare was big data,” Devore said. “Now that big data is here it’s overwhelming.” The various types include costs, supplies, outcomes, genomics, patient-reported, billing and scheduling – each is important, but they all “need to be understood, analyzed, normalized.”

Second, we need to move from that actionable data toward information for clinicians across the continuum. She likened the current state to two lenses, one looking at fee-for-service, the other at pop health, wherein quality, costs and outcomes matter. “These are different goals so it’s no wonder why looking at both is blurry and can give you a headache,” DeVore said. “Clinicians need a total performance architecture that can serve up data no matter where the patient shows up.”

That’s a nice segue into the third problem to solve: supporting those informed clinicians. She pointed to the major mergers of 2018 such as CVS-Aetna, Cigna+Expressecripts, Albertsons-Rite Aid as well as health systems pioneering new models. “The end result could be a sophisticated, risk-based entity, bypassing traditional third-party payers altogether,” DeVore said, highlighting the arrangement GM has with Henry Ford, which has saved some $300-$900 dollars a year per employee. “We need claims analytics, standardized ways to evaluate health and wellness, care management tools, and that’s just the beginning,” she said.

Fourth, healthcare needs a robust infrastructure with innovation and apps. DeVore recalled how former Google CEO Eric Schmidt said at HIMSS18 that healthcare lacks a killer app. “I disagree,” she said. “We have killer apps, they haven’t been effectively deployed.” But she explained that healthcare has to create better ways to use the apps already available. “Apps are key to unlocking ROI of the millions and millions we’ve all spent on EHRs.”

Finally, healthcare organizations must turn those innovative apps into liquid, interoperable information. Calling this one “the herd of elephants in the room,” DeVore said that making data liquid and accessible at any time for predictive analytics and clinical decision support is not science fiction. “Data is the key that unlocks their transformative power,” she added. “This is the most urgent challenge to address in the world of health IT.”

She explained that the new rules Health and Human Services proposed during HIMSS19 offer hope and serve as a starting point because the to make the above happen the industry needs open and transparent APIs and regulatory simplicity to put data into the hands of consumers so they, in turn, can wield greater comparative shopping power and vendors can no longer hold their information hostage.

“Providers have to be ready to get what they’ve been asking for and that will include coordinated structured investment plans for new tech, putting data governance in place, a data acquisition strategy and holding individual clinicians accountable to the outcomes we require,” DeVore said. “We have to do this — it’s the force that will give rise to the future we’re all working toward.”

Twitter: @SullyHIT
Email the writer: tom.sullivan@himssmedia.com