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Three Ways AI Can Improve Physicians’ Workflow

Posted on November 26, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

For far too many physicians, EHRs and other important health IT seem to get in the way of getting the job done. But according to one pair of physician-authors, emerging AI technology has the potential to improve physician workflow instead.

“We see opportunities for AI to be a solution for—rather than a contributor to—burnout among physicians and achieving the Quadruple Aim of improving health, enhancing the experience of care, reducing cost and attaining joy in work for health professionals,” wrote AMA chief medical information officer Michael Hodgkins, MD, MPH and Shantanu Nundy, MD, director of the Human Diagnosis Project.

In an article for the journal Health Affairs, Drs. Hodgkins and Nundy outlined three ways in which AI could be used to make physicians’ work easier and more satisfying. They include:

  • Delivering educational information to the point of care: At present, most educational efforts targeting physicians don’t do a good job of keeping physicians up to date, as they aren’t targeted enough, the article asserts. However, by using AI, healthcare organizations can offer personalized content to physicians by reviewing their existing research habits. By analyzing practice data, online search queries and assessments, AI can provide a streamlined infostream offering only what they need.
  • Producing clinical documentation: The authors argue that AI will someday be able to complete clinical documentation tasks on the physicians’ behalf. In their view, these AI applications will analyze a given physician’s free-text narrative, extract relevant information and insert the information into the right data fields in their EHR. (Researchers are testing out some concrete approaches for doing this.)
  • Collecting information needed for quality-measurement reporting: Hodgkins and Nundy envision a scenario in which AI tools spare doctors the need to perform hours of redundant quality reporting duties. As in the documentation example, such tools would review clinical documents and extract needed information, though this time in search of meeting external requirements. They would then populate data fields in need of completion on submission forms.

These are comparatively straightforward applications of AI. In addition to the trio of possibilities suggested above, AI could eventually deliver clinical decision support on the fly, speed and improve the accuracy of medical image interpretation and more.

In the meantime, however, it’s hard to disagree with these authors that physicians could benefit a great deal from AI tools that make basic clinical workflow faster and less draining.

2019 CPT Codes To Cover Remote Monitoring And Digital Care Coordination

Posted on September 10, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The American Medical Association has released CPT code set changes 2019, and among them are some new options specific to digital health practices.

While providing such codes is a no-brainer — and if anything, the AMA is late to the party – it’s still a bit of noteworthy news, as it could have an impact on the progress of digital care.  After all, the new codes to make it easier to capture the value of some activities providers may be self-funding at present. They can also help physicians track the amount of time they spend on remote monitoring and digital care coordination more easily.

The 2019 release includes 335 changes to the existing code set, such as new and revised codes for adaptive behavior analysis, skin biopsy and central nervous system assessments. The new release also includes five new digital care-related codes.

The 2019 code set includes three new remote patient monitoring codes meant to capture how clinicians connect with patients at home and gather data from care management and coordination, and two new “interprofessional” Internet consult codes for reporting on care coordination discussions between a consulting physician and the treating physician

It’s good to see the AMA follow up with this issue. To date, there have been few effective ways to capture the benefits of interactive care online or even via email exchanges between physician and patient.

As a result, providers have been trapped in a vicious circle in which virtual care doesn’t get documented adequately, payers don’t reimburse because they don’t have the data needed to evaluate its effectiveness and providers don’t keep offering such services because they don’t get paid for performing them.

With the emergence of just five new CPT codes, however, things could begin to change for the better. For example, if physicians are getting paid to consult digitally with their peers on patient care, that gives vendors incentives to support these activities with better technology. This, in turn, can produce better results. Now we’re talking about a virtuous circle instead.

Obviously, it will take a lot more codes to document virtual care processes adequately. The introduction of these five new codes represents a very tentative first step at best. Still, it’s good to see the AMA avoid the chicken-and egg-problem and simply begin to lay the tracks for better-documented digital care. We’ve got to start somewhere.

 

AMA Hopes To Drive Healthcare AI

Posted on July 6, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Last month, the AMA adopted a new policy setting standards for its approach to the use of AI. Now, the question is how much leverage it will actually have on the use in the practice of medicine.

In its policy statement, the trade group said it would work to set standards on how AI can improve patient outcomes and physicians’ professional satisfaction. It also hopes to see that physicians get a say-so in the development, design, validation implementation of healthcare AI tools.

More specifically, the AMA said it would promote the development of well-designed, clinically-validated standards for healthcare AI, including that they:

  • Are designed and evaluated using best-practices user-centered design
  • Address bias and avoid introducing or exacerbating healthcare disparities when testing or deploying new AI tools
  • Safeguard patients’ and other individuals’ privacy and preserve security and integrity of personal information

That being said, I find myself wondering whether the AMA will have the chance to play a significant role in the evolution of AI tools. It certainly has a fair amount of competition.

It’s certainly worth noting that the organization is knee-deep in the development of digital health solutions. Its ventures include the MATTER incubator, which brings physicians and entrepreneurs together to solve healthcare problems; biotech incubator Sling Health, which is run by medical students; Health2047, which brings helps healthcare organizations and entrepreneurs work together and Xcertia, an AMA-backed non-profit which has developed a mobile health app framework.

On the other hand, the group certainly has a lot of competition for doctors’ attention. Over the last year or two, the use of AI in healthcare has gone from a nifty idea to a practical one, and many health systems are deploying platforms that integrate AI features. These platforms include tools helping doctors collaborate with care teams, avoid errors and identify oncoming crises within the patient population.

If you’re wondering why I’m bringing all this up, here’s why. Ordinarily, I wouldn’t bother to discuss an AMA policy statement — some of them are less interesting than watching grass grow — but in this case, it’s worth thinking about for a bit.

When you look at the big picture, it matters who drive the train when it comes to healthcare AI. If physicians take the lead, as the AMA would obviously prefer, we may be able to avoid the deployment of user-hostile platforms like many of the first-generation EHRs.

If hospitals end up dictating how physicians use AI technology, it might mean that we see another round of kludgy interfaces, lousy decision-support options and time-consuming documentation extras which will give physicians an unwanted feeling of deja-vu. Not to mention doctors who refuse to use it and try to upend efforts to use AI in healthcare.

Of course, some hospitals will have learned from their mistakes, but I’m guessing that many may not, and things could go downhill from there. Regardless, let’s hope that AI tools don’t become the next albatross hung around doctors’ necks.

AMA Says Med Students Don’t Get Enough EHR Training

Posted on June 20, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Whether or not doctors like it, the U.S. healthcare industry has embraced EHR technology, and in most cases, medical groups depend on it for a number of reasons. Now, the industry may be taking the next step in this direction, with the AMA deciding that it’s time to enshrine EHR use as part of medical education.

At its recent annual meeting, the AMA released a new policy embracing two somewhat contradictory notions. On the one hand, it encouraged med schools to train students on using EHR technology, while on the other, underscored the need for future doctors to get their faces out of the computer screen and engage with patients.

According to the trade group, some medical schools actually limit student access to EHRs. The AMA contends that this is a bad idea. “Medical students and residents need to learn how to ensure quality clinical documentation within an electronic health record,” said AMA board member and medical student Karthik Sarma in a prepared statement. “There is a clear need for medical students to have access to – and learn how to properly use – EHRs well before they enter practice.”

That being said, the group’s report on this subject concedes that there’s a long way to go in making this happen. For example, it notes that many med school faculty members aren’t offering students and residents much of a role model for the appropriate use of and practices in working with EHRs.

To address this problem, the new policy urges medical schools and residency programs to design clinical documentation and EHR training. It also recommends that the training be evaluated to be sure that it’s useful for future medical practice.

The AMA also suggests that med schools and residency programs provide faculty members with EHR professional development options. These lessons will help faculty serve as better role models on EHR use during interactions between physicians and patients.

That being said, there is an inherent tension between these goals and the realities of EHR use. Yes, training students to create good clinical documentation makes sense. At the same time, there are good reasons to worry about the effects of EHRs on student and resident relationships with patients. Unfortunately, this problem seems to be unavoidable as things stand today. Either you train budding physicians to be clinical documentation experts or you encourage them to use EHRs as little as possible during patient encounters.

In short, we’ve already learned that we can’t have both at the same time. So what’s the point of telling medical students that they should try to do the impossible?

The Bad and the Ugly of Prior Authorization and How Technology Will Fix It

Posted on May 16, 2018 I Written By

The following is a guest blog post by Karen Tirozzi, VP of Solutions, ZappRx.

Specialty drugs, which are usually defined by their complex instructions, special handling requirements or delivery mechanisms, are typically priced much higher than traditional drugs and cost more than the average American family’s salary. These medications are priced higher for a variety of reasons such as manufacturing costs, smaller patient populations and patient services like IV administration or at-home care required to support patients who will take these medicines.

Due to the costly nature of these treatments, payers insist on a comprehensive prior authorization (PA) process to ensure qualified patients are receiving the medications they need. The PA process involves cumbersome paperwork and fax machines and are a huge burden to physician’s and their staff. Physicians have even resorted to hiring extra, dedicated staff just to process these prescriptions as nurses, NP’s, PA’s and medical assistants tend to fall victim to the prior authorization nightmare. According to a recent study, it is estimated that $85,276 was spent on personnel costs to address billing and insurance issues associated with prior authorization, which is approximately 10 percent of practice revenue.

To put just how inefficient the PA process into perspective, a recent AMA survey of 1,000 physicians providing 20 or more hours of care a week, showed that doctors receive an average of 37 PA requests a week, which took an average of 16.4 hours to process. Extrapolate 16.4 hours a week over a year and clinicians are spending around 41% of their time annually doing paperwork, making calls and or sending faxes just to navigate PA and get medications to their patients. It includes enrollment forms and signatures from the patient, which can be done while the patient is in the office, however, it’s often done through mail, which slows down the process even more. Providers also have trouble ensuring they have the right forms for the insurer’s preferred specialty pharmacy, as sending to the wrong pharmacy also causes delays. Providers are tangled in faxes and phone calls for weeks on end so that all parties have all the information they need to approve just one prescription. In 2018, how is it that the medical community still heavily relies on fax machines to process information and deliver life-saving drugs to patients.

A Brighter Future

Digitizing the entire prior authorization process will significantly reduce the administrative burden on clinicians and get patients their medications in a much more streamlined manner. Healthcare providers should be able to, in one place, order a specialty prescription, see the paperwork and signatures needed and follow its progress until it reaches the patient’s hands. The healthcare industry needs to start utilizing the technology available today to streamline workflows and decrease operational expenses, which in turn, can help save patients’ lives.

By embracing technology, clinicians can also leverage the rich data sets generated to better understand their patients’ needs, trends within the space they’re treating and ultimately, improve patient care. Data can also be used by pharmacies to understand how their medications are trending within the market and catch any snags that may cause delays. The potential for pharma companies to use this level of information to provide insights and improve products in real-time is invaluable.

Let’s take the next step

Inherently risk adverse and with siloed stakeholders, healthcare must begin taking steps toward change. With what the space has at its disposal from a next-generation technology standpoint, there is no excuse to remain chained to the fax machine.

The good news? Providers, pharmacists and biopharma have options to improve this cumbersome process today. Forward thinking innovators are beginning to break down silos and uncover new methods with technology to streamline the prior authorization process and get patients their specialty medications in days, not weeks.

About Karen Tirozzi
ZappRx Vice President, Solutions, Karen Tirozzi, leads a fast growing team that is focused on transforming the specialty pharmaceutical prescribing process. With a focus on client success, Karen and her team are innovating technologies to automate traditionally manual and cumbersome processes in an effort to save clinicians time and resources, and deliver lifesaving drugs to patients in a timely manner.  Having spent more than 15 years in the industry, Karen’s unique background in HIT and clinical social work serve as the basis for her ability to deliver successful programs in highly disruptive healthcare services and IT companies.

New Program Trains Physicians In Health Informatics Basics

Posted on January 18, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new program has emerged to help physicians make better use of the massive flow of health information they encounter on a day-to-day basis. With any luck, it will not only improve the skills of individual doctors but also seed institutions with clinicians who understand health IT in the practice of medicine.

The Indiana Training Program in Public and Population Health Informatics, which is supported by a five-year, $2.5 million award from the National Library of Medicine, focuses on public and population health issues. Launched in July 2017, it will support up to eight fellows annually.

The program is sponsored by Indiana University School of Medicine Richard M. Fairbanks School of Public Health at Indiana University-Purdue University Indianapolis and the Regenstrief Institute. Regenstrief, which is dedicated to healthcare quality improvement, supports healthcare research and works to bring scientific discoveries to bear on real-world problems.

For example, Regenstrief participates in the Healthcare Services Platform Consortium, which is addressing interoperability issues. There’s also the Regenstrief EHR Clinical Learning Platform, an AMA-backed program training medical student to cope with misidentified patient data, learn how different EHRs work and determine how to use them to coordinate care.

The Public and Population Health training, for its part, focuses on improving population health using advanced analytics, addressing public health problems such as opioid addiction, obesity and diabetes epidemics using health IT and supporting the implementation of ACOs.

According to Regenstrief, fellows who are accepted into the program will learn how to manage and analyze large data sets in healthcare public health organizations; use analytical methods to address population health management; translate basic and clinical research findings for use in population-based settings; creating health IT programs and tools for managing PHI; and using social and behavioral science approaches to solve PHI management problems.

Of course, training eight fellows per year is just a tiny drop in the bucket. Virtually all healthcare institutions need senior physician leaders to have some grasp of healthcare informatics or at least be capable of understanding data issues. Without having top clinical leaders who understand informatics principles, health data projects could end up at a standstill.

In addition, health systems need to train front-line IT staffers to better understand clinical issues — or hire them if necessary. That being said, finding healthcare data specialists is tricky at best, especially if you’re hoping to hire clinicians with this skill set.

Ultimately, it’s likely that health systems will need to train their own internal experts to lead health IT projects, ideally clinicians who have an aptitude for the subject. To do that, perhaps they can use the Regenstrief approach as a model.

Study Says Physicians Have Major Cybersecurity Problems

Posted on December 18, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

New research sponsored by the AMA and consulting firm Accenture has concluded that cyberattacks on medical practices are common – in fact, far more common than one might think.

Not only do these numbers suggest patient data is far more vulnerable than expected, it suggests that clinicians are often poorly educated about security and the implications of handling it badly. It’s fair to say that unless this trend is turned around, it could undermine industry efforts to build trusting relationships with patients and encourage them to engage in two-way data exchange.

The study found that most physicians (85%) think that sharing electronic protected health information is a good idea and that two-thirds believe that giving patients more access to their health data would improve care. One-third of respondents said that they share ePHI if they trust the vendors involved.

Thirty-seven percent get training content on security from their health IT vendor, and 50% said they trust these training providers are sure the content is adequate. However, this may be a mistake. While 87% of respondents said that their practice is HIPAA-compliant, the study also found that two-thirds of doctors still have basic questions about HIPAA. It’s clear, in other words, that trusted relationships aren’t doing the job here.

In fact, an eye-popping 83% of medical practices have experienced some form of cyberattack such as malware, phishing or viruses. Not surprisingly, 55% of physicians surveyed are very worried about future cyberattacks. Unfortunately, worrying is what many people do instead of taking action, and that may be what’s going on here.

What makes these lax attitudes all the more problematic is that when attacks occur, the effect can be very substantial. For example, 74% of respondents said that a cyberattack was likely to interrupt their clinical practice, and 29% of doctors working in medium-sized practices said that it could take up to a full day to recover from an attack, a crippling length of time for any small business.

So what are practices willing to do to avoid these problems? Among these respondents, 60% said they would pay someone to create a security framework to protect ePHI. Also, 49% of practices surveyed have in-house security staffers on board. However, it should be noted that three times more medium and large practices have such an officer in place compared to smaller medical groups, probably because security expertise is very pricey.

However, probably the most valuable thing they can do is the least expensive of the list. Every practice should require that physicians stay current at least on HIPAA and cybersecurity basics. If medical groups do this, at least they’ve established a baseline from which they can work on other security issues.

AMA Promotes Common Model For Health Data Organization

Posted on October 24, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

What do we really need to make the best use of shared patient data?  Some say that once we have adequate data sharing protocols in place (such as FHIR or Direct), organizing and using the data will be well within our capabilities. Other efforts assume that if we pulled together the right common data set, deciding how to exchange the data physically won’t be as big of an issue as it has been.

A new initiative from the American Medical Association seems to fall into the latter category The AMA has announced that it’s created a common data model which it says is missing in healthcare. The Integrated Health Model Initiative (IHMI), which has attracted the support of heavy hitters like IBM and Cerner, is a “shared framework for organizing health data, emphasizing patient-centric information, and refining data elements to those most predictive of achieving better outcomes,” according to an AMA statement.

The AMA and its partners said that the new model will include clinically-validated data elements which it says can speed up the development of improved data organization, management and analytics. Its initial focus will be on costly chronic diseases such as hypertension, diabetes and asthma.

The effort will include technical development efforts which will address interoperability problems, cumbersome or inadequate data structures and poor interface designs which forced physicians to click far too often, the trade group said.

From my standpoint, there’s a lot that’s hazy about this announcement, which was long on form but pretty short on substance.

For one thing, it’s not clear what Cerner, in particular, is getting out of this effort. It’s already an anchor member of the CommonWell Health Alliance which, having merged with rival group Carequality, arguably offers as mature an interoperability model as any out there today. Also, while even a giant like IBM needs continued press attention, I’m not sure how much benefit it will realize here.

Not only that, it’s hard to tell where the AMA and partners will take IHMI. The trade group has posted a set of data model specifications to its site. The group has also created a process wherein physicians review data elements and missions and decide whether they meet clinical applicability and consistency requirements. In addition, it’s creating technical and clinical communities focused on key sub-areas of interest. But it’s still not clear what all of this means and why it’s important.

Ultimately, the initial press release is as much a buzzword cloud as it is a statement of intent. Pardon my cynicism, but I doubt even a group with the AMA’s clout can fix interoperability problems, streamline data structures and foster more elegant UI design in health IT in one fell swoop.

The announcement does do something useful regardless, however. While I’m not personally qualified to say whether it will take universally accepted standards for data exchange, a widely-used reference set for health data or both, I believe someone should address these questions. As proposed interoperability solutions pop up on both sides, perhaps we’ll get some answers.

 

Say It One More Time: EHRs Are Hard To Use

Posted on September 19, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

I don’t know about you, but I was totes surprised to hear about another study pointing out that doctors have good reasons to hate their EHR. OK, not really surprised – just a bit sadder on their account – but I admit I’m awed that any single software system can be (often deservedly) hated this much and in this many ways.

This time around, the parties calling out EHR flaws were the American Medical Association and the University of Wisconsin, which just published a paper in the Annals of Family Medicine looking at how primary care physicians use their EHR.

To conduct their study, researchers focused on how 142 family physicians in southeastern Wisconsin used their Epic system. The team dug into Epic event logging records covering a three-year period, sorting out whether the activities in question involved direct patient care or administrative functions.

When they analyzed the data, the researchers found that clinicians spent 5.9 hours of an 11.4-hour workday interacting with the EHR. Clerical and administrative tasks such as documentation, order entry, billing and coding and system security accounted about 44% of EHR time and inbox management roughly another 24% percent.

As the U of W article authors see it, this analysis can help practices make better use of clinicians’ time. “EHR event logs can identify areas of EHR-related work that could be delegated,” they conclude, “thus reducing workload, improving professional satisfaction, and decreasing burnout.”

The AMA, for its part, was not as detached. In a related press release, the trade group argued that the long hours clinicians spend interacting with EHRs are due to poor system design. Honestly, I think it’s a bit of a stretch to connect the study results directly to this conclusion, but of course, the group isn’t wrong about the low levels of usability most EHRs foist on doctors.

To address EHR design flaws, the AMA says, there are eight priorities vendors should consider, including that the systems should:

  • Enhance physicians’ ability to provide high-quality care
  • Support team-based care
  • Promote care coordination
  • Offer modular, configurable products
  • Reduce cognitive workload
  • Promote data liquidity
  • Facilitate digital and mobile patient engagement
  • Integrate user input into EHR product design and post-implementation feedback

I’m not sure all of these points are as helpful as they could be. For example, there are approximately a zillion ways in which an EHR could enhance the ability to provide high-quality care, so without details, it’s a bit of a wash. I’d say the same thing about the digital/mobile patient engagement goal.

On the other hand, I like the idea of reducing cognitive workload (which, in cognitive psychology, refers to the total amount of mental effort being used in working memory). There’s certainly evidence, both within and outside medicine, which underscores the problems that can occur if professionals have too much to process. I’m confident vendors can afford design experts who can address this issue directly.

Ultimately, though, it’s not important that the AMA churns out a perfect list of usability testing criteria. In fact, they shouldn’t have to be telling vendors what they need at this point. It’s a shame EHR vendors still haven’t gotten the usability job done.

Retail Clinics Are Not the Enemy, Inconvenience Is!

Posted on June 16, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Check out this incredible insight that Gabriel Perna shared on Twitter:

What a great insight and something that most of the entrenched healthcare people don’t understand. Retail clinics are not the enemy, inconvenience is.

In many ways, it reminds me of the approach that taxi cabs took to Uber and Lyft. Taxis described them as evil as opposed to understanding why consumers wanted to use Uber and Lyft instead of a taxi cab. If the taxi cab industry would have understood the conveniences that Uber and Lyft provided customers, they could have replicated it and made Uber and Lyft disappear (or at least they could have battled them more effective than they’ve done to date).

Gabriel Perna further describes the issues of retail clinics and AMA’s approach to retail clinics in his article and this excerpt:

There are many reasons for this phenomenon [growth of retail clinics], but more than anything though, retail clinics are convenient and many physician offices are not. Because of this, the AMA shouldn’t be trying to treat the retail clinics as some kind of foreign invader, but rather use their rise to prominence as a way to guide physician practices forward. For instance, getting in to see a doctor shouldn’t be a three-week endeavor, especially when the patient is sick and needs attention immediately. However, that’s what has happened. Personally, I’ve been told “the doctor doesn’t have anything open for at least a month” more times than I can count.

It’s simple supply and demand. If you or your child needs to see someone immediately because of an illness and your doctor’s office can’t take in you for a week, and there happens to be a retail clinic down the street, guess where you’re going? Any hesitations you may have over your care being fragmented, the limited ability of your retail clinic physician, or anything else will go out the window pretty quickly.

I agree completely with the idea that convenience is key. However, what Gabriel doesn’t point out is that the fact that doctors have a 3 week waiting list for patients is why they don’t care about offering convenience to their patients. They have enough patients and so they don’t see why they should change.

You can imagine the taxi cab industry was in a similar position. They had plenty of people using their taxi service. They didn’t see how this new entrant could cause them trouble because they were unsafe and whatever other reasons they rationalized why the new entrant wouldn’t be accepted by the masses. Are we seeing the same thing with retail clinics vs traditional healthcare? I think so. Will it eventually catch up to them? I think so.

What’s even more interesting in healthcare is that retail clinics are just one thing that’s attacking the status quo. Telemedicine is as well. Home health apps and sensors are. AI is. etc etc etc. All of these have the potential to really disrupt the way we consume healthcare.

The question remains: Will traditional healthcare system be disrupted or will they embrace these changes and make them new tools in how they offer care? It took the taxi cab industry years to adapt and build an app that worked like Uber and Lyft. However, it was too late for them. I don’t think it’s too late for healthcare, but it’s getting close.