SANTA CLARA — At the 13th Health 2.0 Annual Fall Conference here on Tuesday, co-founder Indu Subaiya thought back to its founding dream, way back in 2007: a healthcare space shaped by technologies that are user-centered, data-driven and play well with each other.
"Fast-forward 13 years and in many ways that dream is reality," she said.
Innovative, consumer-facing apps and platforms are proliferating by the day. FHIR and other API protocols are creating an ecosystem that's much more interoperable, even if there's still a long way to go on interoperability.
At the same time, of course, there are questions that need asking. Is tech getting too personalized and too user-centered? Does it know too much about us? Where is the line on privacy and data control and ownership?
As basic modes of healthcare start to shift, with more and more momentum behind startup companies that start with a platform stacking services and care delivery component on top, it's important to be clear about how they're operating, Subaiya said.
Are you monetizing patient data? What is the relationship of your bottom line to the health of a population? What is your obligation to the whole patient?
The conversation isn't just about apps anymore, she said. It's about robust, patient-centered platforms that are changing the calculus for care delivery in a consumer-centered age.
But while there's a lot of money sloshing around the sector, and a lot of innovative envelope-pushing occurring in Silicon Valley, it's worth noting that "in the trenches of care delivery, not much has changed," said Health 2.0 co-founder Matthew Holt.
Sure, Allscripts, Cerner and Epic all have their app stores. But there's a whole lot of room left to help improve clinicians' workflow and boost the patient experience, he said.
And after decades of hidebound inefficiencies, new companies with new ideas are "storming the battlements, going over the ramparts, maybe they're already in the moat," Holt said. "We're going to see a lot of change."
The near future will be powered by technology platforms, "always on, always monitoring, always measuring," he said. But there will necessarily be different tools tailored for different people, depending on their health or the acuity of their illness.
A crucial next development is to decide on the policy landscape that's needed to capitalize on these new innovations, Subaiya said.
For all the talk on the campaign trail these days about the Affordable Care Act and Medicare for All, she said, "I'm less worried about who pays for it and more in how we incentivize."
The fact that CMS now reimburses for 40 telehealth codes, 12 mental and behavioral health codes and four for remote patient monitoring is encouraging.
But it's just a start. There's much more to do, said Subaiya. And part of that has to do with continuing to bridge the gap between traditional — often skeptical — provider organizations and the healthcare startups approaching them with new and different ideas.
A common refrain these companies hear from overburdened health systems is "you don't understand my pain," she said.
The answer from tech startups should be: "Your pain is a misaligned incentive system," she explained. "I understand [it] very well, and I'm going to compete with it."