Baystate Health vice president and CIO Joel Vengco can hardly be accused of not fostering innovation. Formerly a VP at GE, Vengco is now a key figure at Springfield, MA-based Baystate's innovation hub, TechSpring. At TechSpring, Vengco hopes to see small and large vendors utilize the system's data assets and clinical expertise to quickly deliver solutions to healthcare's thornier problems into the marketplace.
Baystate doesn't take revenue share or a stake in the on-site companies, but instead benefits from a first-mover advantage on creative developments. "If it works as a product, I'm going to buy it, use it and benefit from it," Vengco told Healthcare Dive. "I may even be first out of the gate, which is a huge benefit for Baystate. To be first out of the gate with an innovative solution that nobody else has? That's pretty sweet."
But Vengco will also tell you for all the value in forward-thinking healthcare innovation—in the trendy wearables and sophisticated analytics tools—the industry is still putting the cart before the horse. Without efficient data extractability, Vengco says, much of what innovators across the industry are developing will be moot.
The expense to providers
"I would tell folks to be cautious about all the analytics [tools] that are out there," Vengo says. "There are a lot of great visualization tools, algorithms and models that are supposedly going to provide you with the next predictive capabilities. But at the end of the day, the biggest challenge that we have in healthcare is accessing the data."
Vengco compares the analytics tools to an engine and data to the fuel that runs that engine. And despite the glut of data streams coming out of different wearables, social media and other trendy streams right now, according to Vengco, "we have yet to access that data in a standard form in healthcare."
That's a risk for healthcare providers, especially when wooed by the glittering enthusiasm at last week's HIMSS conference in Chicago.
"Hospitals have the potential to spend money on things that are not going to necessarily work, like population health systems, that don't have this data," Vengco warned.
Vendors, Vengco says, have "misplaced their understanding of the value of the data." Instead of competing for market dominance in the form of data opacity, they should be competing on features, workflows and usability. That single misaligned incentive has left Vengco struggling to get a system's worth of different EHRs to communicate with one another.
"We live that every day, in terms of trying to figure out how to get all of those EHRs to really interoperate," Vengco said. "I don't have the means to get everybody on Cerner, nor does everyone want to get on Cerner. And that's okay. We have an HIE to try to connect them, but the vendors aren't as cooperative as you would hope."
What that means in practical terms is that the four-(soon to be five)-hospital system, which encompasses more than 80 medical practices, is left to fight with the vendors to make it affordable for smaller practices to open their data on the Pioneer Valley Information Exchange.
"My team is the one making the phone call to the vendor trying to get them to drop the price on the interface and the transacation fees on that interface," Vengco said. "It doesn't make sense to charge a five-doc practice $25,000 plus transaction fees for data exchange."
Vengco went a step further: "It should be free, quite honestly. Interoperability should be free."
The expense to vendors
The competitive advantage of data opacity is not the only vendor cost of moving to a more open system, although Vengco notes that the challenges are not unlike what the feds have already imposed on them with certification and meaningful use.
"To get [vendors] to a standards-based terminology set and to create standard APIs is going to cost them and it's going to be work," Vengco said.
But is it going to be a lot of work? Yes and no.
"The terminology piece is going to be work, but creating an API on top of their current platform, that's not a whole hell of a lot of work," Vengco said. "The master data management and the data terminology standard, that's a lot of work and that can be very expensive."
The challenge for vendors, Vengco says, is that they are trying to use EHRs for a different purpose than their original design dictates. The current iteration of electronic health records, Vengco says, "stems from decades of poor design." The technology was originally intended as a billing documentation system, but now the demands on it are clinical.
"Now we're trying to use [the technology] for something it wasn’t really designed for—decision support, analytics, pop health—all these things that weren't part of the design platform of these systems," Vengco said.