This post was originally published on the HIMSS blog on May 8, 2015.
Whether it’s electronic medical records, computerized physician order entry, or e-prescribing, clinics and hospitals have historically approached health information technology (HIT) purchases as they would any other major piece of medical equipment — find it, buy it, and then figure out how to re-engineer the nature and flow of clinical care in order to use it.
Twenty years ago I did the same when I made the case to the San Francisco Board of Supervisors that a major investment in an electronic health system for our county hospital and clinics to share clinical data was a necessary capital investment. The budget was approved, the vendor was chosen, and we implemented the system only to realize that we hadn’t thought about the intensely personal perspective of care delivery — the “people processes” of care.
Today, of course, we know that technology cannot be considered in isolation. With the help of initiatives like HX360, health system CEOs are developing organization-wide strategies to take advantage of technology and process redesign at the same time. Entrepreneurs have caught on too. More than 80 early-stage companies entered the recent HX360 Innovation Challenge, colocated at the 2015 Healthcare Information and Management Systems Society (HIMSS) Annual Conference, and each leverages technology to make care delivery more efficient, higher quality, or more patient-centered.
As medical centers are built (or rebuilt), they too are looking at technology in a whole new light. This summer the Martin Luther King Jr. Community Medical Center (MLK) will open a state-of-the-art campus in South Los Angeles that will focus on keeping people healthy instead of keeping them in the hospital. To accomplish this, the center has invested heavily in technology platforms that help staff manage the health of populations, develop and maintain relationships with patients and caregivers, and collaborate in teams to manage illness. MLK will also stay on the cutting edge through relationships with the University of California, Los Angeles and AVIA — a provider-led accelerator that works with health systems to identify needs and implement emerging tech-enabled solutions.
Investors have also seen the light and are playing a big role in the evolution of HIT. In late 2010 my organization, the California Health Care Foundation, pioneered a program-related investment initiative to make direct investments in health care services and technology companies, with the goal of supporting sustainable, scalable models for improving access to care and lowering cost of care in public hospitals and community clinics. Since then the CHCF Health Innovation Fund has made nine investments in companies that leverage technology to expand the capabilities of the care team.
One early-stage investment, Direct Dermatology, a telemedicine company that provides remote dermatology consultations, quickly demonstrated how technology can expand access to convenient and affordable care. Using a basic digital camera, a doctor photographs the patient’s skin condition, uploads the images to a secure website, and receives a consult report in two days or less. Used by the Health Plan of San Joaquin, Adventist Health Community Care, and others in California, this service not only expands a clinic’s capacity to treat patients, it does so while preserving the physician’s workflow and saving patients from having to make an appointment with a specialist.
Another investee, iRhythm Technologies, makes an outpatient cardiac monitor. Piloted by San Francisco General Hospital, which receives more than 700 outpatient referrals a year to evaluate suspected cardiac arrhythmias, the iRhythm ZIO Patch was shown to reduce the delays in diagnosis that were typical with prolonged Holter monitor studies. Not only did the product reduce the time from appointment to report, it also reduced workflow strain experienced by physicians, nurses, and lab technicians.
Our most recent investment is in Seamless Medical Systems (acquired by GetWellNetwork), a company whose software allows patients to enter demographic information, provide clinical history, and complete risk assessments and surveys — all on an iPad at the point of care, eliminating the need for paper forms. This improves efficiency and ensures that providers have the correct information, and it leverages the iPad to deliver personalized health education to patients with engaging information on prevention, treatment adherence, and wellness.
The potential for these companies to disrupt the health care status quo while helping patients get into the system and get what they need clinically moves us toward a more patient-centered delivery system and allows providers to do the work they were trained for. I look forward to presenting on June 17 at the upcoming National Healthcare Innovation Summit, organized by HIMSS, and cohosted by AVIA and the Network for Excellence in Health Innovation (NEHI), where I will share more about the start-ups CHCF has invested in and how we have seen these technology and services companies tailor their solutions to address the needs of underserved markets.
Sandra R. Hernández, MD, is president and CEO of the California Health Care Foundation. Prior to joining CHCF, Sandra was CEO of The San Francisco Foundation, which she led for 16 years. She previously served as director of public health for the City and County of San Francisco. She also cochaired San Francisco’s Universal Healthcare Council, which designed Healthy San Francisco. It was the first time a local government in the US attempted to provide health care for all of its constituents.
In February 2018, Sandra was appointed by Governor Jerry Brown to the Covered California board of directors. She also serves on the Betty Irene Moore School of Nursing Advisory Council at UC Davis and on the UC Regents Health Services Committee. Sandra is an assistant clinical professor at the UCSF School of Medicine. She practiced at San Francisco General Hospital in the HIV/AIDS Clinic from 1984 to 2016.
Sandra is a graduate of Yale University, the Tufts School of Medicine, and the certificate program for senior executives in state and local government at Harvard University’s John F. Kennedy School of Government.