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Finishing up 2017, Looking Forward to 2018

This month was an active one. I attended the MedMo17 conference in New York, sponsored by MedStartr, published an article on clinical variation, saw lots of momentum around healthcare data, analytics and social determinants of health as valid data points in care delivery, and got to experience it all first hand coordinating things in the aftermath of my mother's car accident.

The MedMo17 conference featured some great presentations around enabling physician care coordination and communication, and block chain secure data flows to enable wider data sharing. The presenters and audience at this and the other leading conferences in November and December discussed additional topics in genomics, personalized care, and data analytics, and to a person all have the energy and enthusiasm to push the change agenda. There are some very exciting developments on the horizon.

This is great news because its is clear we are still working through layers of disbelief, inertia and discovery. These building blocks of change need wider physician and hospital acceptance and investment to see broad-based impact. In addition to my piece on care variation, HITLAB published a piece analyzing how care variations are creating losses for hospitals. The call to action I gleaned from their piece was for less beds, less facilities, and more focus on care giving and population health minded care coordination. The MedMo17 presentations also weighed in on how clinical workflows are inefficient and communications lagging, and as a result are significant drivers of variation in care delivery. At the same time we lament the breakdown in current processes, we also acknowledged new sources of data from social or environmental settings. Social workers and related professionals that have direct but informal patient contact to become part of the care delivery value chain if healthcare services are more broadly defined to include access to quality food, clean water and air quality too. How many companies are incorporating public policy and the funded epidemiology reports into their medical management protocols and priorities? Read "Improving Population Health Outcomes By Investing In Community Prevention" Social determinants of health (SDoH) gained momentum as well with a Health Leaders piece discussing an example where Lumeris helped a hospital system incorporate financial data to improve care delivery decision making.

Another timely article in HealthIT news discussed practical development of population health protocols and data capture, and I found the points about keeping the data simple and actionable to be most pertinent. Along these lines of simplicity and actionable, it was also noted during the HITLAB Summit in NYC that there is growing physician frustration with point-specific digital health offerings. The emerging preference is for a broad range of tool design support that drives interoperability, streamlines analytics, and drives data issue resolution, as opposed to creating more confusion.

There is a lot of work to be done, no two ways about it. I have been experiencing the dysfunction first hand recently. I have spent the past 10 days coping with drug and care delivery decisions for my mother, who was badly injured in a car accident. The lack of awareness between physicians even though there exists a common EHR, the lack of drug information, the complete breakdown of communications between care delivery teams, between floors, between facilities….It really leaves me very frustrated at the current state of things. Let’s not discuss my ire over the waste and costs supporting the new buildings and related extravagance.

That said, we know the problems, there is energy and enthusiasm in the disruptors, and there is momentum to make changes. I have hope that efforts like FHIR for data interoperability and clinical decision making, and continued advances in related healthcare data analytics that are simplified and actionable will drive significant improvement in 2018, and will continue or accelerate adoption of value-based care.

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