Ravi Krishnan

The four rungs of the healthcare IT value ladder

January 16, 2013 6:00 AM EST

Being a health IT professional can be an incredibly rewarding job. I’m proud of the role my peers and I play in building and innovating the future of healthcare. Especially because the ultimate goal in the work that we do is to improve the care that patients receive, which of course includes ourselves, our families, and our friends.

I recently experienced the loss of a dear friend to cancer. Watching his fierce, yet ultimately unsuccessful, fight against the disease has made me pause and consider how we assess and calibrate the value of IT in health care. Frankly, I think we still have a way to go, and that we are still on the lower rungs of a multi-step value ladder. To me, the ladder has four rungs:

Inform
Technology applications, software systems, and IT tools inform the healthcare world of day-to-day transactions, care delivery mechanisms, drugs/formularies, illnesses, symptoms and causes, and survival rates, in addition to all the ancillary healthcare operations and administration functions in the care delivery supply chain. Examples of this rung of the ladder include claims, ePharmacy, provider maintenance, content/document optimization, and systems integration applications.

Educate
The second rung is where IT can add to the awareness and transparency of healthcare practitioners by providing collaboration tools, open knowledge portals, and data integration platforms that enable medically-relevant data (personal health information, drug information, etc.) to be universally accessible and visible beyond logical, functional, organizational, geographic, and/or systemic borders. The prolific electronic health record (EHR) and health information exchange (HIE) solutions of the day are perfect examples of this category. They offer an exponential boost to the healthcare industry’s ability to educate and be educated. From the consumer’s standpoint, there are a myriad of social networking platforms that enable patients, caregivers, and supporters to harmonize their experiences, knowledge, and perspectives to create a universal global support group.

Assist-to-Cure
Now we’re getting to the higher rungs where technology tools enable care providers in delivering care. This is where the rubber meets the road and we as technologists are active cast members in the care delivery show. These can range from implantable devices like programmable pacemakers to decision-support software and systems that help accelerate diagnosis and guide treatment procedures.

Prevent
This final rung is an end-state vision for technology providers to reach where they design the ability for us humans to successfully prevent illnesses from occurring and champion the eradication of root causes of a disease. One interesting innovation that I have seen recently is a handheld device that can be used to detect melanoma. Another example of this is in the area of personalized medicine, where groundbreaking researchers have applied complex mathematical models to create personalized, more intricate sets of care guidelines against major diseases.

Today, a significant majority of IT activity occurs in the first and second layers. While we have made great strides here, we have way to go before we match this level of achievement in the top two layers of healthcare value.  Which is what led me to jump off my “I am a health care technologist” pedestal and land resoundingly on the floor with my personal value calibrator permanently reset. We must bring value to all of the rungs of the ladder.

Perhaps there will be a day when IT and innovation in technology enable progress to the extent where cancer is a chronic rather than a fatal disease. On that day, I will feel something beyond pride in being a health care technology professional. I will feel honor. I, and all of my colleagues, will continue to reach for the top of that ladder. Not just for the companies we work for, but for our families, our friends, and all the patients fighting for their lives and the care teams fighting alongside them.