Ending siloed medical software is a joint responsibility

Although providers and vendors have fallen short so far, each will need to cooperate if new healthcare technologies are to proliferate.
By Dave Muoio
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Much like any other industry in the digital age, the healthcare sector is exploding with new technologies. Novel tools from health systems, IT vendors and startups are looking to tackle physician burnout, patient engagement, workflow efficiency, data management and other longstanding issues plaguing care.

Unlike many of its contemporaries, however, healthcare’s technology platforms have been especially bogged down by unique challenges like patient privacy, clinical validity, interoperability and more. The result, according to vendor and provider panelists speaking today at Boston’s MassForward: A vision for 2030, is a segmented ecosystem stifling access to new technologies for providers and patients alike.

“We still live in a world where there are so many customized versions of software servicing not only single hospitals, but many different departments within a hospital,” Mary Anne Heino, CEO of Lantheus Medical Imaging, said during the panel. “So it really does become one-off fixes continually instead of [stopping and rebuilding] to have a single medical record that can speak across platforms and accept from many different catalogues.”

In addressing the shortcomings of provider-focused technologies, medical vendors sitting on the panel were quick to accept much of the blame. PatientPing SVP Brian Manning — who described the last 15 years of siloed, clunky software offerings as “unacceptable” — noted that medical software vendors and app makers are more often designing their products with user experience and physician workflows front in mind. Still, he said he’d like to see more of his contemporaries building products

“The old school, go play golf with the CIO, and then the CIO pushes it down to 3,000 employees whether they like it or not — that model is changing, you can’t sell that way anymore. You’ve got to sell it to the user, you’ve got to show the demo, you’ve got to make it work,” Manning said.

“But I think what we need … is a next generation of technologies that works sort of like the internet did on top of Windows, and really connects the universe health systems and providers. Once we have that sort of infrastructure built — and I think we’re getting there — I think you’ll see all kinds of value-added apps,” he said. “It’s about a lot of different technology vendors that are working closely with Epics and Cerners and Allscripts and all those guys, [and] finding ways to bring value in connectivity so if the orthopedics line brings on an application that’ll talk to the application that works in the cardiology service line.”

But that’s not to say that providers have been without blame, Dr. Satchit Balsari, an assistant professor at Harvard Medical School and Beth Israel Deaconess Medical Center, said. Despite bemoaning the number of health tech startups that don’t bother appointing a CMO until their product has already been completed, Balsari admitted that clinicians and institutions haven’t done enough to lead entrepreneurs.

“As with the EHR ecosystem, the medical fraternity is to blame. We need to step up and drive this space,” he said. "And [in terms of] the workforce, I think that med schools need to think years ahead. … Doctors need to be equipped to understand this language and contribute significantly to it.”

Dr. Erin Jospe, CMO of Kyruus, added her own support for vendor and provider cross pollination, but warned the former against unconditional compliance with the whims of entrenched clinicians.

“[Vendors], make yourself available to the people experiencing the problems. And instead of just going in and pitching what your idea is, just shut up for a minute and try and elicit what the problem is. What is it that people are struggling with?” Dr. Erin Jospe, CMO of Kyruus, said during the panel. “You always want to service the customer, [but] they’ll tell you what their solution is and it can be really tempting to just follow what that is and say stop. That could absolutely be the direction we’re going in, but so often I’ve seen the paving of the cowpaths, where people have learned to circumvent the technologies that they have, and you then go and build a process that replicates their circumnavigation instead of [addressing] what the original problem was.”

And it’s true that provider organizations have made their own missteps in tech development and deployment. John Brownstein, chief innovation officer at Boston Children’s Hospital, noted that while his institution has had an innovation initiative in place for nearly a decade, its strategy has not always been conducive to generating technologies that could have a broader impact.

“The first few years of that innovation program were really based on this idea of creating a culture of innovation and building applications to meet tweaks and needs in specific niche areas,” he said. “The problem with that is that we ended up in this ecosystem of pilots that would often die on the vine, so we had to reimagine our innovation program at the hospital to not be so focused on this sort of one-off applications that really get siloed, don’t have any extensibility to other parts of the hospital, let alone the ecosystem, and really focus on big opportunities that really can be transformational across the entire hospital and pediatrics broadly. So, we have way fewer number of opportunities, but when we pick those opportunities we go full on.”

In spite of past missteps, the panelists stressed the need for providers and vendors to maintain a focus on these goals moving forward. Not doing so will keep the industry from realizing the full potential of innovative advances like artificial intelligence or voice-first technologies, and, most importantly, will limit patients’ access to the best care possible.

“We need to step back and understand that unless we crack the code … we may be building tools that are still not available or valuable to the population we are trying to serve,” Heino said.

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