Athenahealth CEO Jonathan Bush's Quest: A Healthcare Internet

Experiences as Army medic, ambulance driver, and failed healthcare practice manager gave Bush the idea for a new way of structuring healthcare.

David F Carr, Editor, InformationWeek Government/Healthcare

November 19, 2013

2 Min Read
Jonathan Bush.<br />

Overall, the current regulatory environment tends to preserve the status quo, protecting institutions such as large hospital systems that dominate the markets in which they operate and suppressing the forces of technological and organizational disruption, Bush argued. "We have a tendency as a society to stifle the things we care about the most," Bush said. "The things that move least fast are the things we put the most protections around." Even the government's attempts to control costs, such as the standardized fees imposed by the Center for Medicaid Services, amount to counterproductive "price fixing" in his book.

Innovation in healthcare instead requires the emergence of "a healthcare Internet" that would disaggregate many of the services currently performed under the umbrella of a hospital and allow new players to emerge, he said. Some of that is happening anyway, in halting steps, he said. For example, now that medical images are digital, the specialists who read and interpret them don't necessarily need to be within the walls of the hospital -- they could be anywhere in the world. One of the firms Athenahealth works with, Radisphere, is trying to capitalize on that idea, turning radiology into a cloud service. There are starting to be cloud-based services for dermatology, psychology, and second opinions.

When Bush talks about hospitals, it's important to understand that they aren't his primary customers -- Athenahealth serves physicians and groups of physicians, many of whom are affiliated with hospitals, but its software and services are for "ambulatory" or walk-in patients, not for the care of patients in hospital beds.

Still, the next challenge for Athenahealth is to "do a better job of stitching the cloud into the hospital. The hospital is actually a giant bazaar of activities that are being done for patients, both inpatient and outpatient," Bush said, and because of this artificial bundling they're being performed "massively below scale." Hospitals need to be permeated with cloud services that will add flexibility, but "still give you the feeling of integration" and allow the hospital to enforce overall quality control.

"The idea of a PACS system, or radiology information management system, that only manages pictures that happen to have been taken at that hospital -- rather than all the images taken of that patient at whatever hospital -- is kooky, it's a 1980s, pre-Internet idea," Bush said.

Hospitals need to adapt to a world in which the bazaar of healthcare services will be a mall, not a monopoly, he said.

Follow David F. Carr on Twitter @davidfcarr or Google+. He is the author of Social Collaboration For Dummies (October 2013).

Healthcare providers must look beyond Meaningful Use regulations and start asking: Is my site as useful as Amazon? Also in the Patient Engagement issue of InformationWeek Healthcare: IT executives need to stay well informed about the strengths and limitations of comparative effectiveness research. (Free registration required.)

About the Author(s)

David F Carr

Editor, InformationWeek Government/Healthcare

David F. Carr oversees InformationWeek's coverage of government and healthcare IT. He previously led coverage of social business and education technologies and continues to contribute in those areas. He is the editor of Social Collaboration for Dummies (Wiley, Oct. 2013) and was the social business track chair for UBM's E2 conference in 2012 and 2013. He is a frequent speaker and panel moderator at industry events. David is a former Technology Editor of Baseline Magazine and Internet World magazine and has freelanced for publications including CIO Magazine, CIO Insight, and Defense Systems. He has also worked as a web consultant and is the author of several WordPress plugins, including Facebook Tab Manager and RSVPMaker. David works from a home office in Coral Springs, Florida. Contact him at [email protected]and follow him at @davidfcarr.

Never Miss a Beat: Get a snapshot of the issues affecting the IT industry straight to your inbox.

You May Also Like

More Insights