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3/5/2013
09:14 AM
Chris Murphy
Chris Murphy
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HIMSS: Should Healthcare Be More Like Airline Industry?

Such a comparison says not only that the healthcare industry must change, but also that those changes will be dramatic and gut wrenching.

The boldest thing I heard at my first day at HIMSS 13, the big healthcare IT event this week in New Orleans, was that the healthcare industry needs to be more like the airline industry. What could healthcare learn from a financially strapped industry that people love to hate?

It's the fact that U.S. commercial airlines carried 52% more people in 2010 than they did in 1995, and yet they employed 2% fewer people. It's that airlines did away with unprofitable luxuries such as meals in coach and filled excess flight capacity. It's that airlines shed lots of jobs at front counters and reservation call centers and replaced them with kiosks and online bookings.

"We do a bunch of their work for them -- and we like it," said Warner Thomas, CEO of Louisiana's big Ochsner Health System, during his HIMSS opening keynote. People today would howl in protest if they lost the ability to look online for their own flights and could do it only by phone, Thomas said. "How do we get people to make more of their own appointments for us, to check their own results?" he said.

[ In related news from HIMSS, some major EHR vendors are moving to break down walls between products. See EHR Vendors Form Alliance On Data Sharing. ]

Comparing the airline industry to the healthcare industry was an inspired choice by Thomas. It says not only that the healthcare industry must change, but also that those changes will be dramatic and gut wrenching. Thomas also pointed to banks' use of ATMs to let customers do self service, and to retailers such as Amazon.com and Wal-Mart using analytics to acquire a better understanding of their customers and their own operations.

Thomas laid out the big number: Healthcare must be 15% to 20% cheaper. That's not going to happen without pain and radical change. "It's going to take changes in how we do business," he said.

One example of this radical change I saw on the HIMSS show floor was the startup HealthSpot. It offers a telemedicine kiosk for remote patient-doctor interaction that includes not only video, but also a blood pressure cuff, thermometer, stethoscope and other tools a patient could use on himself with the supervision of a remote clinician. As I walked the HIMSS floor, though, I was struck by how few ideas like HealthSpot I saw that involved really radical changes to the way customers interact with their healthcare providers.

In his keynote Thomas laid out three results he expects healthcare IT to deliver: safer, higher-quality care; lower costs; and happier, more productive physicians and other caregivers.

I doubt that last one will always be possible. Getting to that future state of healthcare, one that costs as much as one-fifth less, won't always make people working in the industry -- or getting service from the industry -- happy. The airline industry has had to make some very hard choices about what services it can and can't provide. Healthcare has many more of those sometimes unpopular decisions ahead of it.

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lgarey@techweb.com
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lgarey@techweb.com,
User Rank: Apprentice
3/5/2013 | 3:37:25 PM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
Chris, Do you think that if the HC industry doesn't make these changes on its own, an entity like Wal-Mart is going to do it for them, and in a way they may not like? Already we see people going to MinuteClinics at CVS as opposed to going through the hassle of making an appointment with an overbooked primary care physician. It seems like an industry ripe for a proven cost-slasher to come in and make waves. Let's just hope it's NOT an airline. Can you just imagine the lost xrays and late appointments? Lorna Garey, IW Report
EVVJSK
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EVVJSK,
User Rank: Apprentice
3/5/2013 | 4:58:58 PM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
"Thomas laid out the big number: Healthcare must be 15% to 20% cheaper. That's not going to happen without pain and radical change. "It's going to take changes in how we do business," he said. "
If more people paid Medicare-like negotiated rates for services, Healthcare would be 15 - 20 % cheaper !
Laurianne
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Laurianne,
User Rank: Author
3/5/2013 | 5:01:32 PM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
In all seriousness, I hate to contemplate the healthcare equivalents of "no more pretzels."

Laurianne McLaughlin
InformationWeek
Andrew Hornback
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Andrew Hornback,
User Rank: Apprentice
3/6/2013 | 3:01:14 AM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
If you want to reduce the cost of healthcare by 15-20%, I think the first place to look would be the mitigation and limitation of risk.

With regards to things like self-serve kiosks - how do they mitigate the risks assumed by the health care provider? You're essentially putting basic, triage level tasks in the hands of the consumer (an amateur, if you can call them that). Even when guided remotely by a health care professional, simple things like incorrect placement of a blood pressure cuff can cause diagnostic issues.

The second, and perhaps most important factor that I see, is that you need to get the consumer involved in what they're doing. When you have a consumer operating an ATM, they have interest in that it's their money that they're working with. When you have a consumer searching on-line for a flight, it's usually a trip that they're looking to take themselves.

Once you reduce risks (which reduces the cost of malpractice insurance) and get the patient more involved in their own health care, you'll start to see results.

Andrew Hornback
InformationWeek Contributor
Thomas Claburn
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Thomas Claburn,
User Rank: Author
3/6/2013 | 5:03:28 AM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
Or being told to leave the hospital because you're wearing a controversial t-shirt.
ChrisMurphy
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ChrisMurphy,
User Rank: Author
3/6/2013 | 12:11:28 PM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
i think you hit on a key piece of getting people interested and involved in their healthcare. but that's going to come as we all absorb more of the cost and financial risk. one way to do get them involved is convenience -- used this web portal to enter your information at home, and you'll be whisked into the doctor's office more quickly.
cbabcock
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cbabcock,
User Rank: Strategist
3/7/2013 | 12:09:40 AM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
Getting consumers involved in their own health care can work better than many people think, if the health care providers really want it to. One real obstacle is the health care industry's tendency to engage in translucent, not transparent, practices, which leaves decision-making power mainly in the hands of doctors and other professionals. Not enough real information and choice is shared with the patient.It will be a major change to make the information transparent.Charlie Babcock, InformationWeek editor at large
Michael Endler
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Michael Endler,
User Rank: Author
3/7/2013 | 5:24:29 AM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
This sort of scenario came up during Cisco's Internet of Things shindig last month in San Jose. One participant asked what it would mean, for example, if IBM cures cancer. Cisco's futurists have described a lot of the ways healthcare could change that echo this article. On the one hand, check-up kiosks at the supermarket are just the beginning. At some point, basic health data could be continuously monitored by sensor-enabled objects in our daily environments-- a bathroom mirror, for example, according to Cisco. This information could detect illness earlier and more efficiently, enable better coverage in under-served areas and, when combined with other technologies, lead to much longer and healthier lives. It could also cut down a lot of overhead costs, once the infrastructure is in place. But then there's the dark side of the equation. Who owns all the data that's collected? What can be done with it? A corporation isn't going to invest in this sort of technology out of purely altruistic motives, after all. That said, most of the people Cisco gathered came from large, multinational corporations, and they weren't shying away from these concerns. If they're starting the conversation with an acknowledgement of the more dystopian possibilities, that's at least a little encouraging.
Michael Endler, IW Associate Editor
louisrosa
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louisrosa,
User Rank: Apprentice
3/10/2013 | 2:00:58 AM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
the airlines do not have to carry everyone, just those that can pay the freight.
jaysimmons
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jaysimmons,
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3/11/2013 | 7:14:44 PM
re: HIMSS: Should Healthcare Be More Like Airline Industry?
With the greater convenience afforded to consumers, risks also need to be taken into account and more importantly the allocation of blame pertaining to these risks. As Andrew said above, the consumer isnG«÷t trained to take health measurements by themselves and even with a health care professional available for assistance, many things can still go wrong. In that case who would assume the risk, the consumer, the health care professional onsite, or the healthcare provider remotely?

Jay Simmons
Information Week Contributor
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