October 2, 2022

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Hospitals have begun a long-awaited transition from walled citadels of healing to networks using digital information to connect different nodes of health care, Jonathan Bush, chief executive officer of athenahealth, Inc., said Monday.

Over the last year, hospitals that invested tens of millions of dollars on electronic health records and other digital systems designed to capture patient information are now developing the capacity to share the data with retail pharmacies, clinics and digital devices.

This exchange of health data is just beginning, but it marks an “inflection point” that will likely change the role of the hospital from the dominant institution in health care to one of many providers of specialized services organized around patients’ needs.

“Maybe the hospital of the future is a network,” Bush said.

The rest of the network is made up of new health providers popping up to provide services that were once the domain of the hospital, from pharmacies that offer immunizations and urgent care to smartphone apps that can be used remotely to check vital signs, share radiologic images or monitor wound healing.

Bush, a famously animated speaker whose company provides a range of health care services from electronic health records to medical practice management tools, addressed an audience of hospital executives and consultants at the U.S. News Hospital of Tomorrow Conference in Washington, D.C.

He sketched out the evolution of the transition from paper medical records to electronic systems that “did in digital form what we used to see in analog,” allowing physicians to look at medical images, share data within the walls of the hospital, and convert clinical information to billing records. “New fountains of digital information began pouring out in every part of the hospital,” he said.

Then came the push to complete the transition to digital health records. “As the mandate came from on high,” Bush said, “We saw an enormous expansion of ownership around the hospitals,” with hospitals hiring doctors in record numbers and the creation of information systems “across the spectrum of care to get everything in and allow it to connect.”

The goal was safeguard the information, which was regarded as an asset, he said. “If I have a system that communicates really well with me, but doesn’t communicate with anyone else, maybe I’ll recover my costs better.”

As hard as they tried to “cap the wells with minimum leakage,” Bush said, the flow couldn’t be contained. Driven by competition from retail providers and other health services, new commercial models began to seem more relevant to hospitals. Among others, Bush cited Kayak, which transformed the airlines reservation business by revamping the trip-planning process around the consumers’ needs.

“Now hospitals have turned the other way,” he said. “Instead of trying to get animals on the ark, they’re establishing connections off the ark,” sharing the very thing they used to see as a proprietary asset–information about a person’s condition and medications.

“The floodgates are starting to break,” he said.

In a panel discussion following Bush’s keynote, moderator Chas Roades, chief research officer of the Advisory Board Company, challenged the participants–Farzad Mostashari, CEO of Aledade, Alex Gourley, CEO of Walgreen Co., and Michael Robinson, vice-president of U.S. Health and Life Sciences at Microsoft–to address the plight of hospitals that are not ready to make this transformation.

“What do we do with the hospital of today?” he asked.

Bush said that they’re going to have to change, and change fast. “Either the market is doing to do it to these guys or they are going to do it themselves,” he said. “The only way this won’t be your death knell is taking this on yourselves.”

Mostashari offered a similar assessment, paraphrasing author Ernest Hemingway. “A man goes broke slowly and then suddenly,” he said. “There are hospitals that are going to lose money.”

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