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Healthcare: Disruption vs. Change

10/27/2016 11:15 AM

My routine has changed, but the search for what's going on in health IT remains.  This morning I was searching around trying to get caught up and found Brian Eastwood's musings on "A Shift From Disruption to Change" on Chilimark Research.

His basic point is one of semantics, with statements like 'Disruption is a hodgepodge of effective but disconnected point solutions' and 'Change is full-scale implementation' and 'Disruption is talk. Change is action.'

If you read my 'buzzwords' article you know how I feel about them.  In fact when I hear 'disruption'  All I can think of is Klingons (the old Klingons without the bony ridges who are apparently an embarrassment to ones with the bony ridges.  Interstellar racism at its best.) shooting at old James Tiberius Kirk (with disruptors).  On the other hand When I hear Change all I think of is Obama and the ACA debacle, but I digress.

Mr. Eastwood's underlying principle is sound.  Disruption is a path to a good thing, but not the end, in and of itself.  Change with systemic provable results is what we are after.  We here at Sentia Health have always taken a holistic view in the solutions we provide.  You've read in this very blog how we provide the entire solution, not simply another widget to hang on your tool belt.  We've likened ourselves to the various industrial revolutions in that when our model is adopted, business as we know it will be as fundamentally changed as it was from 1760 to 1820.  We propose to have ONE system per industry that does everything that industry is interested in doing.  In this case we are talking about healthcare and we have a system that will do everything that we don't actually need a doctor or practitioner to do.  All of the patient encounter documentation is easily generated with Bing/Google style searches of the SNOMED_CT database, and is rendered in a plain, easily read SOAP note with no visible codes shown or needed.  With this documentation, We can pay for a patient's claim, in near real time and cut about 1/3 of the cost out of healthcare with this increased, non-human efficiency.  Actually we calculate the savings to be about 45% with the demise of the external EMR, the billing department, the medical coder and all the internal waste and greed of the traditional insurance company.  

So yes, Mr. Eastwood is absolutely correct.  Take out all the people and all the systems and all the monkey motion except the doctor and the patient and replace it all with one automated solution that is easy to use and where everything just works and happens automatically.  In fact, I submit that this monolithic solution is the only way to actually accomplish our goals.  Otherwise we will continue to be stuck in this disparate integration nightmare of trying to have a scheduling system, an EMR, an Insurance company, and all the literally thousands of other systems that go into making healthcare 'go' today.  In fact, the medical coder and insurance adjudicator is just a slow, error prone, expensive stab at integration.  We've solved that particular problem with no people and do it instantly.

So yes, Mr. Eastwood, what we need is change, not disruption.  No, Mr. Obama, we don't need more and more government layered on top of a fundamentally flawed system.  We need efficiency.

Speaking of Klingons what we are really trying to accomplish is to live in Gene Roddenberry's Star Trek Universe where people are freed to think and innovate instead of compete for scarce resources so we can all just get along.  Like the First Industrial  Revolution, we are using our brains to increase average income and standard of living for every person on the planet and free them of the drudgery of punching a clock.  Like the First Industrial Revolution, we are creating systems that automate tedious tasks.  This is the only path forward.  This is the only way we can continue to increase growth without working harder and harder.

Here is your call to action: Call your senator.  Call your congressperson.  Call the neighbors and wake the kids.  Demand that we embrace change and growth and eschew disruption.  Heck, call me and tell me I have rocks in my head, but if you do, you better tell me why, and it can't be 'inertia.'

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