'Digital Transformation' Required for Quality

ROSEMONT. ILL. — Health care providers' ability to continue to improve patient safety and quality hinges on their embrace of digital technology, according to medical economist Jeffrey C. Bauer, Ph.D.

“We've reached the limits of the human mind to process all the information that's out there, and we have absolutely passed the limits of the paper trail. I cannot see progress without moving to a total digital transformation,” Dr. Bauer said in a plenary session at the Joint Commission national conference on quality and patient safety.

He called diversification “the defining characteristic of U.S. health care in the foreseeable future” and predicted it would produce “more change between the decade that began 3 years ago and 2015 than between 1965 and 2005…. The only way we can deal with that complexity … is with data systems. Without the technologies, we won't get there; with the technologies, we can do some really exciting things.”

He noted the following trends as signs of health care diversification:

▸ The shift from “one size fits all” to personalized medicine based on the unparalleled pace of findings in molecular science, genetics, and other medical research.

As an example, Dr. Bauer cited the relatively new discovery that breast cancer is not a single disease but a group of molecularly distinct neoplasms. “We can't give safe, quality care if we can't begin to use all of this information to match the right patient to the right drug,” he said.

The growth of personalized medicine also brings the recognition that many chronic diseases are latent in a person's genetic composition and must be “managed throughout our lifetime, not only when they appear in an acute state,” said Dr. Bauer, who is a management consulting partner with Affiliated Computer Services, Dallas.

▸ The increasing viability of remote medicine—for example, robotic devices at the patient's bedside, telepharmacy, and telemedicine—could provide a workable answer to the growing shortage of health care professionals.

“We cannot produce physicians, nurses, respiratory therapists and occupational therapists fast enough to meet the shortages we've got in this country,” he said. “What we need is the informatics and the digital transformation work processes that very much have to be tied to safe and appropriate care.”

▸ Demographic changes, including the possibility that by 2040 about half of the U.S. population will be people born in other countries, could be accompanied by a “host of new genetic conditions and different cultural practices.”

Rather than breaking down medical data merely by race, researchers and providers will need to understand the complex demographics of disease patterns within races (for example, differences in cancer incidence among Asian-American subgroups, such as Filipino, Chinese, Japanese, Korean, and Vietnamese populations). “We need technology to keep up with that information,” he said.

▸ Increased competition among health care providers could occur in a constrained market, where “the real issue is doing it right all the time as inexpensively as possible.”

A health care environment that is becoming one of “nonpayment for non-performance” means “we're not to do old things in new ways, we're to do new things in new ways,” he said, and that means integrated systems. The most effective organizations are “fully integrated, so that when someone needs information, they can get it,” he said.

Mr. Bauer advocated an approach to thinking about the future of health care that forecasts probabilities and possibilities rather than accepts predictions as inevitable outcomes.

“It's best for you to approach the future of health care in general and quality and safety in particular with the idea of looking at the factors that could make things better, the same, or worse and then imagine how you can intervene to promote the chances of things getting better,” he said.

ROSEMONT. ILL. — Health care providers' ability to continue to improve patient safety and quality hinges on their embrace of digital technology, according to medical economist Jeffrey C. Bauer, Ph.D.

“We've reached the limits of the human mind to process all the information that's out there, and we have absolutely passed the limits of the paper trail. I cannot see progress without moving to a total digital transformation,” Dr. Bauer said in a plenary session at the Joint Commission national conference on quality and patient safety.

He called diversification “the defining characteristic of U.S. health care in the foreseeable future” and predicted it would produce “more change between the decade that began 3 years ago and 2015 than between 1965 and 2005…. The only way we can deal with that complexity … is with data systems. Without the technologies, we won't get there; with the technologies, we can do some really exciting things.”

He noted the following trends as signs of health care diversification:

▸ The shift from “one size fits all” to personalized medicine based on the unparalleled pace of findings in molecular science, genetics, and other medical research.

As an example, Dr. Bauer cited the relatively new discovery that breast cancer is not a single disease but a group of molecularly distinct neoplasms. “We can't give safe, quality care if we can't begin to use all of this information to match the right patient to the right drug,” he said.

The growth of personalized medicine also brings the recognition that many chronic diseases are latent in a person's genetic composition and must be “managed throughout our lifetime, not only when they appear in an acute state,” said Dr. Bauer, who is a management consulting partner with Affiliated Computer Services, Dallas.

▸ The increasing viability of remote medicine—for example, robotic devices at the patient's bedside, telepharmacy, and telemedicine—could provide a workable answer to the growing shortage of health care professionals.

“We cannot produce physicians, nurses, respiratory therapists and occupational therapists fast enough to meet the shortages we've got in this country,” he said. “What we need is the informatics and the digital transformation work processes that very much have to be tied to safe and appropriate care.”

▸ Demographic changes, including the possibility that by 2040 about half of the U.S. population will be people born in other countries, could be accompanied by a “host of new genetic conditions and different cultural practices.”

Rather than breaking down medical data merely by race, researchers and providers will need to understand the complex demographics of disease patterns within races (for example, differences in cancer incidence among Asian-American subgroups, such as Filipino, Chinese, Japanese, Korean, and Vietnamese populations). “We need technology to keep up with that information,” he said.

▸ Increased competition among health care providers could occur in a constrained market, where “the real issue is doing it right all the time as inexpensively as possible.”

A health care environment that is becoming one of “nonpayment for non-performance” means “we're not to do old things in new ways, we're to do new things in new ways,” he said, and that means integrated systems. The most effective organizations are “fully integrated, so that when someone needs information, they can get it,” he said.

Mr. Bauer advocated an approach to thinking about the future of health care that forecasts probabilities and possibilities rather than accepts predictions as inevitable outcomes.

“It's best for you to approach the future of health care in general and quality and safety in particular with the idea of looking at the factors that could make things better, the same, or worse and then imagine how you can intervene to promote the chances of things getting better,” he said.

ROSEMONT. ILL. — Health care providers' ability to continue to improve patient safety and quality hinges on their embrace of digital technology, according to medical economist Jeffrey C. Bauer, Ph.D.

“We've reached the limits of the human mind to process all the information that's out there, and we have absolutely passed the limits of the paper trail. I cannot see progress without moving to a total digital transformation,” Dr. Bauer said in a plenary session at the Joint Commission national conference on quality and patient safety.

He called diversification “the defining characteristic of U.S. health care in the foreseeable future” and predicted it would produce “more change between the decade that began 3 years ago and 2015 than between 1965 and 2005…. The only way we can deal with that complexity … is with data systems. Without the technologies, we won't get there; with the technologies, we can do some really exciting things.”

He noted the following trends as signs of health care diversification:

▸ The shift from “one size fits all” to personalized medicine based on the unparalleled pace of findings in molecular science, genetics, and other medical research.

As an example, Dr. Bauer cited the relatively new discovery that breast cancer is not a single disease but a group of molecularly distinct neoplasms. “We can't give safe, quality care if we can't begin to use all of this information to match the right patient to the right drug,” he said.

The growth of personalized medicine also brings the recognition that many chronic diseases are latent in a person's genetic composition and must be “managed throughout our lifetime, not only when they appear in an acute state,” said Dr. Bauer, who is a management consulting partner with Affiliated Computer Services, Dallas.

▸ The increasing viability of remote medicine—for example, robotic devices at the patient's bedside, telepharmacy, and telemedicine—could provide a workable answer to the growing shortage of health care professionals.

“We cannot produce physicians, nurses, respiratory therapists and occupational therapists fast enough to meet the shortages we've got in this country,” he said. “What we need is the informatics and the digital transformation work processes that very much have to be tied to safe and appropriate care.”

▸ Demographic changes, including the possibility that by 2040 about half of the U.S. population will be people born in other countries, could be accompanied by a “host of new genetic conditions and different cultural practices.”

Rather than breaking down medical data merely by race, researchers and providers will need to understand the complex demographics of disease patterns within races (for example, differences in cancer incidence among Asian-American subgroups, such as Filipino, Chinese, Japanese, Korean, and Vietnamese populations). “We need technology to keep up with that information,” he said.

▸ Increased competition among health care providers could occur in a constrained market, where “the real issue is doing it right all the time as inexpensively as possible.”

A health care environment that is becoming one of “nonpayment for non-performance” means “we're not to do old things in new ways, we're to do new things in new ways,” he said, and that means integrated systems. The most effective organizations are “fully integrated, so that when someone needs information, they can get it,” he said.

Mr. Bauer advocated an approach to thinking about the future of health care that forecasts probabilities and possibilities rather than accepts predictions as inevitable outcomes.

“It's best for you to approach the future of health care in general and quality and safety in particular with the idea of looking at the factors that could make things better, the same, or worse and then imagine how you can intervene to promote the chances of things getting better,” he said.