Federation of Clinical Services via PHR
The value proposition for federation of clinical services is illustrated in Michael Porter's lecture. He contrasts the startling survival statistics across the nation's 139 heart transplant centers with the innovation of Rochester General Hospital outsourcing its cardiac surgery practice to Cleveland Clinic. Professor Porter points out that the staff are employees of Cleveland Clinic and purchasing benefits from the high volume of the Cleveland Clinic practice. Cardiac surgery may be only the beginning. The value of specialization and high volume should be increasingly evident as quality and outcomes data become publicly available. Here's just one example from HHS:
This chart illustrates how easy the Health and Human Services web site makes it to combine City and Problem prior to making a decision.
Today's hospital electronic health record is a silo of information that locks-in business processes to the detriment of both the hospital and the patient. Portable, full-strength* personal health records are a patient-centered alternative that enables community hospitals to continue to serve their local mission and teaching hospitals to extend their reach directly across the country and around the world. PHRs also facilitate interaction with family practices, rehabilitation facilities and home care agents - but this post is about hospitals.
Vendors of electronic health records will not support portable, full strength PHR until their institutional customers insist because it reduces customer lock-in. EHR and imaging systems (PACS) customers are well aware of the difficulties in migrating from one vendor to another but they continue to believe that "integration" is of primary importance and IT vendor lock-in is an acceptable compromise. Small practices and large hospitals alike should consider the true cost of business process lock-in as competition stiffens and costs continue to rise.
* A full strength PHR goes beyond the consumer focus of current PHRs to include diagnostic quality radiology, provably authentic digitally signed lab results and clinical reports and federated identity technology to enable single sign-on convenience for clinicians regardless of their IT provider.
Sunday, January 21, 2007
