Innovation in healthcare IT is dead (hopefully only temporarily)

Ok, maybe not dead but certainly in a coma and on life support.

I just got back from HIMSS ’10 in Atlanta. While the energy was great, the people I met were very cool, and the venue and staff made the event quite enjoyable, I left underwhelmed by the substance of what’s being offered and a little worried about one of my favorite industries (health IT). Since I spend plenty of time outside of healthcare IT doing technology strategy work in the financial, web 2.0, and government sectors I see many business plans and new product offerings regularly.

I am continually amazed by what’s coming out in other industries but I’m afraid that CCHIT over the past few years and the government’s recent involvement in meaningful use and certification has made our health IT industry focus on checklists and “common denominator” design and development. At HIMSS, and probably not through the fault of vendors alone, the majority of what I saw and heard about was meaningful use and certification and not innovation and new ways of solving common health IT problems. If you look at the 25 primary meaningful use requirements do you see anything in the list that would actually spur innovation to help reduce cost or improve quality? Or, did it do the opposite and set the bar in a way as to make sure that if vendors just produced an electronic typewriter and the government mandated its use that you’ll over time reduce costs in healthcare?

In private conversations with vendor after vendor I kept hearing a common theme: all our customers, sales folks, marketing folks, product requirements folks, etc. want to talk about is the 25 initial meaningful use (MU) items. They said they haven’t talked about anything else for months. They also said that they see 2009, 2010, and 2011 probably being consumed with just MU and certification discussions and associated work. It’s like the oxygen has been sucked out of the room by MU. MU is clearly important, but at what cost?

I’m afraid we’ll end up with our own “lost decade” after people realize that the building of minimal electronic typewriters (EMRs that meet MU) won’t actually solve our cost or quality problems. We will go through billions of dollars and end up with more physicians and hospitals using computers (which would have happened anyway at a natural pace without any government involvement). What we won’t have is the collective intelligence of the community working on innovation — they’ll just be focusing on making sure they meet the checklist items instead of thinking of new business models and techniques that can compete in the marketplace. Because all new technology or technique will need to be put through the MU and certification wringer young entrepreneurs will not be looking at healthcare as the place to innovate; strategists and angel investors will be telling people not to get into the market because it’s too expensive (like we tell people not to get into med devices).

I hope that I’m completely wrong, but I’m probably not.

Here’s a case in point. The Telemedicine 2.0, Health 2.0, and mHealth (mobile health) movements are pretty strong and vibrant. As an advisory board member on several of these companies I’ve been in meetings where even their sales, product managers, developers, etc are being asked to spend time looking at MU and certification. Some of the Health 2.0 and mHealth companies don’t even have viable business models yet, can’t afford to finish their products and bring them to market easily, and aren’t getting enough investor attention but they have to think about MU and certification? Instead of focusing on customers and making money, countless hours are being expended at most companies worrying about things that shouldn’t matter to a startup and that’s harming innovation.

MU and certification are here and they aren’t going anywhere so there’s no point complaining about it. The question is how to deal with it effectively and keep people focused on what is known versus what is conjecture. With all the rush to get the first certification we’ve forgotten about maintenance releases. What about agile systems that need to be updated regularly (like cloud providers) — will they need to be re-certified for each release? These are simple questions that are being discussed in meetings ad nauseum even though there’s very little information to answer the questions.

If you’re an executive, product manager, marketing person, part of the sales staff, or a developer, what do you think about innovation in the midst of MU and certification? How are you handling it and what advice would you give to your peers?