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We desperately need the Civica Rx model for digital health transformation

My office is full of travel mugs, brightly colored pens and various tchotchkes that I’ve accumulated from digital health companies over the last five years as chief innovation officer at Presbyterian Healthcare Services. It’s not because I can’t manage to keep my office clean. Rather, it’s a symptom of a broken market, one that is burdened by a laborious implementation process that delays the adoption of new digital health tools.

Digital health developers must spend their time courting me with trinkets in the hope that my health system will select their product and begin the arduous process of what I call the “adoption gauntlet” to integrate their product into our system. The current digital healthcare market gives all participants no other option.

The pace at which any health system can adopt new digital systems and shepherd them to implementation is glacially slow due to the adoption gauntlet. It takes an average health system up to two years to actually start using a new technology application because of three time-consuming tasks: contracting, security review and implementation. Today these tasks are not standardized, and every health system has its own unique process. Even piloting a new digital health tool requires this multistep review. For comparison, health systems do not conduct their own safety review of every drug they offer; they rely on a trusted third-party, the Federal Drug Administration, to assure them of a product’s safety. Digital health tools need a similar standard.

Additionally, the complexities of adopting digital health tools create a monumental switching cost, which means many health systems cannot even consider better technology because they have already sunk considerable resources and time into one application. It also means that every deal with a health system is high stakes for tech entrepreneurs who are forced to spend precious time getting attention through marketing, instead of focusing their efforts on product research and design. These significant inefficiencies limit digital transformation and leave many desirable tools stranded.

These tools are stranded because the digital revolution that has advanced every other industry in the world missed healthcare. Without a common data language, a technology lingua franca, health systems will continue to experience the same marginal gains from new technologies and platforms, instead of an industry-wide transformation. The lack of a digital health lingua franca is appallingly inconvenient for patients and providers. Clients are still tasked with providing full medical histories when they go to a new doctor. I know doctors who are still walking paper medical records between buildings today. Because of a lack of a common data language, health data is siloed and stored in the native dialect of each system provider.

Improved interoperability has been the white whale of healthcare for far too long. This has remained an unsolvable problem as providers have not found a solution that incorporates both an industry-wide, trust-based solution with an organizing structure that prioritizes benefits to members and patients. Interoperability becomes a realistic goal if health systems work together to develop a solution. If health systems want to achieve the kind of digital transformation that improves patient outcomes and lowers costs, they must pool their resources, agree on standardization and create technological change at scale. Digital health solutions should not be mandated by the government and they should not come from companies looking to provide dividends to their investors.

In other words, we need the Civica Rx of digital health transformation. To fix this broken landscape, we need to democratize data transformation and create a common public infrastructure for healthcare data. Civica Rx has demonstrated how the model can work: health systems banded together to develop a new business framework, like a health utility. They’re also focused on building trust and lowering costs, not generating profits for Wall Street.

If applied to digital health, this would allow health systems to finally unlock interoperability, and then use that common data language to create an app marketplace that would allow health systems, providers and patients to speak fluently with each other and download digital health tools as easily as we download apps to our own smartphones. Our patients deserve better, and our providers deserve better. If we act around the common good, we could have tremendous impact.


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