Despite the hype and the potential, healthcare isn’t likely to be digitally transformed in the near future, said American College of Cardiology Chief Innovation Officer John Rumsfeld, MD, PhD, at MedAxiom’s Fall 2019 CV Transforum conference in Dana Point, Calif.
Physicians have been grappling with predictions of imminent digital transformation for almost a decade and, for cardiology in particular, the reality has fallen short, Rumsfeld explained. “Cardiology is inherently a high-tech field,” Rumsfeld said. “The problem is not that we haven’t had the advances in science, medicine and technology—it’s that we haven’t allowed the system to also evolve in the same period.”
The U.S. health system is an outlier on the global stage with regard to both costs and outcomes, Rumsfeld added, pointing to unnecessary variation in quality of care, risk factor management and health outcomes.
Healthcare also hasn’t followed the pattern of other industries with regard to digital transformation. As an example, Rumsfeld cited data from a Cisco survey to reveal how digital technology has positively impacted several key metrics in retail settings. In contrast, healthcare’s response has lagged.
‘Solutions in search of a problem’
While there are “pockets” of digital transformation and cardiologists are hearing a lot of hype from Silicon Valley, most clinicians aren’t seeing the promised changes. “I don’t see it when I’m in clinic on Thursdays at the VA in Denver,” Rumsfeld said. “I just don’t feel that transformation.”
That doesn’t mean Silicon Valley isn’t trying. Investors poured approximately $15 billion into digital health startups in 2017 and 2018. In Rumsfeld's view, the jump to capitalize on the digital health trend has resulted in “way too many technology solutions in search of a problem,” with hundreds of new companies moving forward without the expertise they need to craft a viable medical tool.
“It’s a kaleidoscope of technology,” he said. “It’s difficult to know where we should jump in. Which of these are the ones we should use? Which are solving a problem we want to solve?”
What’s often missing from both established and new tech companies, Rumsfeld said, is the engagement of clinical partners who could help create and design usable products.
Fix the EHR roadblock
One way to move forward would be to recognize where healthcare failed in the past, Rumsfeld suggested. And if there’s one technology with which clinicians have a universal bone to pick, it’s the EHR.
“The EHR was not digital transformation—or at least not successful digital transformation,” Rumsfeld said. “Yes, it’s a digital technology, but unless your metric of success is a better billing platform, I’d argue pretty strongly that it’s not an example of digital transformation.”
If anything, today’s EHR is a roadblock that is holding medicine back, Rumsfeld said. “We’re $36 billion deep into a reporting system that once promised to improve efficiency and cut errors,” he explained, “but studies have shown that EHRs have actually perpetuated medical errors instead of reducing them.” He sees the EHR as an obstacle that is siphoning away time when physicians could be seeing patients. And, he says, by blocking application programming interfaces, the EHR is actually preventing potentially useful digital tools from being integrated into clinical workflows.
For the remote monitoring, virtual care and AI-driven solutions that have become the proof points for digital transformation to take hold, the tech and clinical worlds will need to partner, Rumsfeld said. One thing’s for sure, he adds, “If digital health is the future—and many of us believe it—the future is not here yet.”