It's hard to predict just how the effort to move medical records from paper to digital will shape up.
That said, a collection of business students recently gave it their best shot. As part of an annual "war game" exercise, students from such schools as Penn's Wharton School of Business took on the roles of key industry players in an effort to imagine how the battle to digitize America's health records will play out.
Among their predictions: entrenched interests will slow change, industry players will have to consolidate, and the financial pressure will need to be increased to get the industry to fully move to digital records.
"Adoption will come at a much slower speed than I think people would like," said Leonard Fuld, the consultant who organizes the yearly war games event. "Entrenched interests will resist electronic medical records for a much longer time."
Even if the intransigence abates, the industry will be able to move only so fast, Fuld said.
"If truly they gain momentum to move ahead, there's actually going to be a manpower shortage to make all that happen," Fuld said, echoing an issue raised in the first part of CNET News' three-day special report on the digital records push.
One of the other predictions is that the massive flow of dollars into this space will spur merger activity.
"It's almost a foregone conclusion there is going to be some mergers within the marketplace," Fuld said, saying that the students believed that the health care-specific tech companies such as Allscripts and Cerner might be attractive to larger firms wanting a piece of the action.
"They can't do this alone," Fuld said.
The war game exercise featured students from four schools: Penn's Wharton School of Business, the Columbia University School of Business, MIT's Sloan School of Management, and Northwestern's Kellogg School of Management
Fuld said students' past predictions on other topics have often proved prescient.
Below is a short video Fuld's organization produced with excerpts from the April event.
With billions in stimulus dollars available to help doctors and hospitals digitize their health records, it stands to reason that tech companies want to make spending that money as easy as possible.
Several of the players--Allscripts, Cisco, Citrix, Dell, Intel, Intuit, Microsoft, and Nuance Communications--have teamed up in an alliance aimed at educating doctors on the many tools available to help set up electronic health records.
The EHR Stimulus Alliance is pulling out all the stops, with a road tour, Webcasts, telephone hotline, and other tools all aimed at demystifying the technology and showing case studies of where it has worked.
President Obama's stimulus package provides on the order of $20 billion for health care technology, with the central focus being nudging hospitals and doctors to move their records from manila folders to computers. Even with the money, though, it's seen as a daunting task.
"The EHR Stimulus Alliance is a unified movement toward turning the national dialogue surrounding the EHR transition into action," Nuance Healthcare President John Shagoury said in a statement. "Each of the partners involved has unique solutions that are crucial to EHR implementation. In our case, because most doctors speak at least three times faster than they type, speech recognition technology helps increase the meaningful use and efficiency of EHRs by decreasing physician reliance on the keyboard and mouse."
The alliance hopes to reach half a million doctors with its message.
Although the alliance represents a number of the big names in tech, there are a lot of other players in the electronic health records business, including Cerner, General Electric, eClinicalWorks, McKesson, and NextGen, as well as start-ups such as Medsphere. Other tech players also pushing hard for their piece of the industry include IBM and storage giant EMC.
By the way, I and some colleagues will have a ton more to say on this topic next week as CNET News takes an in-depth look at the push toward electronic health records.
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A screenshot of the Mayo Clinic Health Manager, which uses Microsoft's HealthVault technology.
(Credit: Microsoft)The Mayo Clinic on Tuesday said it will build a personal health record service based on Microsoft's HealthVault technology.
The product, Mayo Clinic Health Manager, will initially focus on general pediatric and adult health issues, immunization records, pregnancy, and asthma. In the coming months, the clinic will add tools to help manage chronic conditions, such as Type 2 diabetes, high cholesterol, and high blood pressure.
"Mayo Clinic Health Manager can help patients share information more easily with their doctors and manage their own health better between office visits," said Mayo Clinic doctor Sidna Tulledge-Scheitel, who also serves as medical director of Mayo Clinic Global Products and Services.
People don't need to be a patient of the clinic to use the new tool, Microsoft said. Microsoft's HealthVault is designed to allow people to store many different kinds of health records, including digital information from its partners, data from in-home medical devices, as well as information entered directly by the patient.
Although the effort is 18 months years old, Microsoft is just getting off the ground, in terms of getting hospitals and doctors signed up. Among its recent deals is one with NewYork-Presbyterian Hospital.
In addition to the battle to get access to the data it needs, HealthVault finds itself competing against rival services, including Google Health, as well as personal health records offered by insurance plans and others.
An example of the kind of health records that NewYork-Presbyterian Hospital will make available to patients using Microsoft's HealthVault and Amalga technologies.
(Credit: Microsoft/CNET)In a win for Microsoft's health care business, NewYork-Presbyterian Hospital said it will use the software maker's technology as part of a push to make digital health records available to its patients.
The hospital system will start making health records available online, initially to cardiac and cardiothoracic patients. Customers can view their records online, opt to copy them into a personal health record and then, if they wish, share that record with other health care providers.
Boyer
(Credit: Microsoft/CNET)"These really are the patients' records," said Aurelia Boyer, a former practicing nurse, who now serves as NY Presbyterian's CIO. "It is really their data. it is not the hospital's."
However, that's a big shift for the industry, Boyer acknowledges. "Doctors and hospitals have kept those records sort of under lock and key."
The deal also marks the first time that a Microsoft customer has gone with both its Amalga technology for managing the provider's own records and at the same time tapped HealthVault to provide patient access. Microsoft but said at the time it would need to line up health care providers to provide people with the impetus to sign up for an account.
The federal government has included billions of stimulus dollars to help spur the health care industry toward digital health records.
Google is also taking aim at the space and has partnered with IBM.
Last week, GE and Intel announced a $250 million joint effort in the digital health arena, with their effort heavily focused on helping people treating and living with chronic illnesses.
At NY Presbyterian, Boyer said that the hospital has put the infrastructure in place to handle large numbers of patients, but wants to start slow to make sure it has the human factors right--educating patients, making sure they know how to secure records, etc.
"We want to make sure we watch our process and we do it well with the patients," she said. Digital heath records, she said, is a part of a broader effort to improve care using technology.
"We are attracted to empowering the patients, helping them move to health and managing their health and not just focusing on such a single episode of care," Boyer said.
Opening back health records to the patient should also help the physicians who refer people in to hospitals such as NY Presbyterian.
"Now my referring physician, if giving right permissions, can look into my Amalga record," said Steve Shihadeh, a vice president in Microsoft's healthcare unit. "One of their big complaints is I send the patient in...and I don't really know what has happened to my patient."
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