New-to-healthcare technology brings significant disruption to the traditional healthcare technology market for one simple reason, laid out in a recent article in TechCrunch, Money Ball for Medicine – Business Models for Healthcare: “By definition, the legacy HealthIT vendors have optimized their solutions around the legacy reimbursement and delivery models that have created the hyperinflation in healthcare crushing family, business, and government budgets.”

Lean and Six Sigma techniques, data analytics, business events and process technology will be used to break the reimbursement model and its attendant software norms.

This is a veritable sea change. What was locked into paper records is now being captured for the first time in electronic medical records (EMRs). By itself, this is simply shifting from paper to an electronic record. That won’t be enough. Smart healthcare will go further and manage many data sources simultaneously. It will be able to sort through this new avalanche of data to find the information, often a combination of data from multiple systems, which can predict problems and allow for intervention before an expensive crisis occurs. This borrows from the way banks detect credit card fraud and is easily applied to avoiding healthcare mistakes and intervening early.

Digital technology also underpins the collaboration necessary for cross-network accountable care described by Seattle Children’s Dr. Jeffries in Healthcare, You Can’t Improve What You Don’t Measure. The rise of social media means that what has progressed from paper to fax to email is now moving to enterprise social networks as the most secure and effective way to draw together the patient and a network of healthcare providers, or to connect health insurance to healthcare delivery. While reform was designed to reward cooperation, Medicare, Medicaid and insurers have the power to incent this to continue, even without legislation.

As Dr. Howard Landa, Chief Medical Information Officer at Alameda County Medical Center, and Association of Medical Directors of Information Systems President calls it, “…looking at the entire population and their health rather than focusing on the provision of clinical care.” Landa forecasts that, “…clinical decision support will extend beyond alerts and reminders to presenting information in a more efficient, timely and usable manner so that we can do the right things with the right information in the right moments that matter.”

Beyond technology, there have historically been limited methods for advances in process, treatment or technology in one healthcare organization to be readily compared, understood, and adopted elsewhere. Analytics performed for both improvement projects and patient care need to be “attached” to standardized healthcare work. This has been done in other industries through the use of frameworks like ITIL for information technology, SCOR for supply chain management and APQC’s PCF for enterprise-level process management. A healthcare framework is the key ingredient for communication. Responding to this, the latest requirements put out by the Federal Government’s National Coordinator, Dr. Farzad Mostashari, make it clear that collaboration must be available across organizational boundaries.

“The framework opens the door to process improvement, a structure for social conversations, and managing metrics and events. The organizations that understand this will be the leaders of the future,” says APQC’s Executive Director of Research Services Ron Webb. Webb is actively engaging healthcare professionals to bring about such a framework.

All of these changes go far beyond legislated reform and relate more to the healthcare dynamics that, as Dr. Landa says, “…are driven by an aging population, provider shortages and a burning need to align payment with quality.” Digitization is the reality of healthcare that has little to do with politics.