A Bright Future, but a Rocky Road Ahead

As I gaze into my crystal ball early in 2013, I see a bright future, and a rocky road ahead. Truth be told, I really do have a crystal ball on my office desk. Its been there for years. When questioned by clients or guests I would explain that its an essential tool for any health executive. My crystal ball is just as accurate a predictor of future events as any strategic plan or visioning document I’ve seen for the past two decades.

For those of us who believe in eHealth, the EHR and other manifestations of information technology in health care, the future is a scary and uncertain place. Like it or not, that’s where we’re going. The road to the future is a rocky one, with lots of blind curves. But there’s a glow on the horizon. The Emerald (or silicon) City beckons.

The road to the future will be owned by those who thrive on challenges, overcome obstacles and take risks. Innovative and entrepreneurial minds will blaze the trail and guide the way for the rest of us. But we also need leaders who enable the entrepreneurs; leaders who will ensure that entrepreneurs receive the necessary funding, opportunities and rewards.

There’s a big difference between leadership and entrepreneurship. The general is rarely on the front lines of the battle. He is well back, taking in the big view of the terrain, examining intelligence and mobilizing the forces to take advantage of opportunities as they arise. The general needs a bird’s eye view of the battlefield. The entrepreneur is the sargent, corporal or private on the front lines who through guts, determination and innovative thought and action sees the opportunity, breaks through the line and changes the course of the battle. We need both to succeed.

So that glow on the horizon… what is it and how should our health leaders and entrepreneurs respond? Three trends are shaping up as big opportunities for vendors and health information professionals in general: consumerization, replacement of the aging legacy infrastructure, and the emergence of big data and health analytics.

Enabling consumer empowerment through information and communications technology has been discussed at length in this journal. This is a green field where we have just started to scratch the surface of opportunities. Personal health records, mobile applications, and social media are all areas where entrepreneurs and the health care establishment need to come together. Being a ground-up endeavour, entrepreneurs need to develop applications that engage and excite the consumer. Health leaders need to remove systemic barriers and enable integration of consumer technologies into the larger health ICT infrastructure. Together, entrepreneurs and health leaders can enable the consumer to make better lifestyle choices, better treatment choices, helping both themselves and the provincial treasuries that must fund the alternative.

Over the past 30 years hospitals have been leading the way towards electronic medical records, decision support systems, and the integration of medical devices into the ICT infrastructure. The acute care sector is one area where we have been extraordinarily successful with automation. As we move to more integrated health information infrastructures, its becoming apparent that we need to upgrade the technology in our acute care environments gradually replacing an aging infrastructure with standards-based interoperable products. This retrofitting of the acute care world will create opportunities for entrepreneurs, but will create challenges for health leaders who must fund the upgrades. New business models such as cloud computing are needed to help inject private capital into these systems, and achieve greater economies of scale that will relieve financial pressures for health institutions and regions. This includes innovations in procurement processes where there is a need to ensure mutual and appropriate sharing of risk and reward.

Big data is fast becoming a big subject as the public and private sectors realize the value of the resource being created by our health systems and data repositories. The management of mountains of data, combined with the analytics to mine meaningful information from that data will create new opportunities not only for entrepreneurs, but for all organizations, public and private, that will use the information. Given the sensitivities of the privacy implications of big data, our health leaders must consider the risks and rewards, and strike a balance between the two.

Many of us started down the path of eHealth in the 1990’s when we thought that cell phones, eMail, client/server computing and 56 bit encryption were pretty cool things. Nobody could have predicted the explosion of social media, mobile computing, big data or the cloud. Many of us are hampered by our devotion to the ways of the past, and loathe to change in ways that will help us along that rocky road.

Where will we find the explorers and adventurers who will blaze the trail for us? They’re working away in the incubators and the labs springing up in academic institutions and knowledge parks around the world. Where will we find the leaders who will set the stage for innovation and achievement? They’re here, among us now, creating the conditions for entrepreneurial and innovative solutions.

Somewhere, in some young mind, is the germ of the idea that will govern how we will live and communicate 10 years from now. We have no clue what it is. It will sneak up on us. But we’ll know it when we see it.

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