Harvard Pilgrim CEO Charlie Baker says when Bill Gates professes that "Health Care Needs an Internet Revolution," as he did in a recent Wall Street Journal piece carrying that headline, he's making the mistake of treating a symptom instead of the disease.
The real issues -- or at least the most pressing ones -- are how doctors are trained and how they work, not how they are connected or not connected to one another by technology, according to Baker.
From Baker's blog today:
I know that some people think if we just connect the clinical information dots with IT solutions, the organizational issues will go away. But I’m not convinced that more online capabilities and digitized clinical information solves these problems. In the end, IT is just a tool. It’s how it gets used — and the motives, interests and expertise of the users — that makes it a great tool or a non-issue.
Moreover, Baker says it isn't so much what he thinks or what Gates thinks that matters: It's what doctors think, and doctors, by and large, are not buying into the grand vision of a seamlessly connected medical system. (A reality driven home to me every time I visit my primary care physician of 25 years and see his secretary slide a paper record of my exam into what I presume is a 25-year-old manila folder.)
Which isn't to say that Baker want Gates to mind his own business. On the contrary:
If Bill Gates is serious about this space, he’ll spend some time thinking about how we educate physicians, organize care delivery and study performance before he worries about IT. What he’ll discover is that we train clinicians to be autonomous performers — wedded to their patients and their departments first. … our care delivery system isn’t organized to treat chronic, complex cases, and we spend almost nothing as a nation on trying to understand how we implement the knowledge we already have about what works and what doesn’t on a day to day basis. (See my previous post on this topic.)
If he comes up with some ways to change these fundamentals first, it would then make sense to consider how an IT strategy can complement these insights. But hey — he’s a wicked smart guy — way smarter than me — and if he wants in to the health care space — to quote NYC Detective John McClain — one of my cinematic heroes — “Welcome to the Party Pal!” Happy to have you along.
Oh, sure, go ahead and suggest that Gates really isn't interested in improving healthcare as much as he's interested in improving software sales. You cynics. But I'd still like to hear what he has to say about Baker's little challenge.
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