The most pleasurable thing in the world for me is to see something and then to translate how I see it.
– Ellsworth Kelly, American painter, sculptor, and printmaker
When I’m not blogging on weekends and weeknights, trying to work on my novel on vacation time, and being a mom, wife, chauffeur, cook, housekeeper, and errand runner, I write about healthcare information technology (IT). It is, as they say, my day job. I’ve been writing about this industry since 2003, when my good friend Jack from grad school co-founded his business-to-business publishing company and asked me to leverage my experience working for a major health insurance carrier to write about the IT that insurers deploy. I free-lanced for his company, interviewing and writing articles about an industry that was initially new to me, for the next seven years.In 2010, I joined the company, now a media company, full-time. The previous year I had worked on a big project for a major client of ours, writing numerous case studies and a lengthy executive summary. It was a baptism by fire, as I’d never done a project of this magnitude before and it was crossing from the familiar territory of editorial to the uncharted waters of marketing. We took on more projects of this nature, and I became the sole custom content writer for these special projects. I had moved over, as purists scornfully or jokingly say, to the “dark side.”
As journalists, your interviewees, PR people, marketers, and the like do not see what you’ve written until it’s published. The separation of church and state is protected and preserved. What I write, however, is edited, reviewed, and approved by as many as several departments. They are our customer, after all. On a high note, a well-known industry visionary from a major global company merely added one sentence to my white paper and told his marketing director that I was his new favorite writer. On a low note, I’ve had a client redline what I’ve written to the point of non-recognition – in other words, if I had a byline, it would have to be deleted because it was no longer mine. Sometimes, you just never know, which makes each project somewhat of a blank slate. It’s my way of living on the edge, professionally speaking.
Why healthcare IT is important to you and me
Pressure and uncertainty aside, I enjoy what I do. Healthcare IT is an important industry that touches everyone because we are all patients – most if not all of us have been in a hospital and gone to the doctor’s office. Two major pieces of legislation to come out of the Obama administration that impacts all of us is the American Recovery and Reinvestment Act (ARRA) of 2009 and the Patient Protection and Affordable Care Act, also known as Obamacare or the Affordable Care Act (ACA), of 2010. Within ARRA is the HITECH Act, which essentially contains a number of incentive programs for the adoption of healthcare IT, especially electronic health records (EHRs) and health information exchange. ACA includes provisions that are more easily achieved through the adoption of healthcare IT, which is by design.
I have seen the shift in both my primary care physician’s office and my kids’ pediatrician’s office from paper records to electronic records. Our pediatricians carry around their tablets and enjoy pulling up apps with their stylus pens. Gone are the shelves upon shelves of paper records in file folders. It is disruptive technology, for sure. EHRs were originally developed as a documentation tool so physicians could properly bill for the services they rendered in the traditional fee-for-service, or fee for volume, reimbursement world. Today, we are asking EHRs to document care, aggregate relevant patient information, and deliver the right information to the right clinician at the right time in order to improve the quality of care, clinical outcomes, and patient safety in a more streamlined, cost-effective manner. (We are also trying to shift to a pay-for-quality reimbursement model.) There are naysayers who want to eliminate EHRs and all healthcare IT because they are expensive, disrupt clinician workflow, create more work, and don’t do what they claim they will do. Privacy watchdogs warn of greater risk of data breaches. The technology has to continue to be re-engineered and vendors have to develop robust, reliable, and user-friendly technology (not just sell a bunch of software licenses that lock healthcare providers into long contracts with bad technology that clinicians don’t want to adopt). And policy has to continue to be refined so as to protect patient information.
We are getting there. It’s a painful growing process. Legislation was put into place to speed the inevitable. The healthcare industry is woefully behind, if you look at how the banking and financial services and retail industries have embraced technology. Consumers will demand it in healthcare. They are already demanding to communicate with their healthcare providers across various channels of their choice and wanting to interact in a way that is more convenient for them. According to the Pew Internet Project, 45 percent of American adults have smartphones. According to an industry survey, 53 percent of clinicians use smartphones and 47 percent use tablets in their healthcare work environment. Medical schools are incorporating healthcare IT into their curriculum. So, really, it’s only a matter of time before we achieve the same state of IT adoption that we enjoy in other industries. And it’s only a matter of time before you can be in another part of the country far from home, end up unconscious in the emergency room, and the physician who is treating you can pull up your EHR, see what medications you’re taking, what allergies you have, and what other health conditions you have, and therefore know what medications he or she can or cannot give you based on that critical information. That’s why I take pride in what I write. This is important stuff. Admittedly, some topics are more engaging than others. Vendor neutral archive, anyone? But my job is to make the topic engaging. My job is to entice healthcare executives, managers, and clinicians to read what I write. Whether writing fiction or nonfiction, a short story or chapter in a novel, or a blog or case study or white paper, I have one goal: To find the narrative and tell the story in a clear, concise, and engaging way.
Cocktail party topics
In my research, I learn so many things. For example, RAND Health reported that approximately 133 million Americans had a least one chronic illness in 2005, which is astounding to me. According to the Center for Disease Control and Prevention, every year, chronic disease, which includes cancer, diabetes, heart disease, and stroke, causes 70 percent of deaths in the U.S. and comprises approximately 75 percent of medical care spend. Our healthcare costs comprised 17.9 percent of our Gross Domestic Product (GDP) in 2012, and it’s expected to climb to 18.4 percent of GDP in 2017. And yet, up to 80 percent of chronic diseases can be prevented – mostly with lifestyle changes. The solution is both simple yet exceedingly difficult.Here are more interesting data. Did you know that persons aged 65 years or older numbered 39.6 million in 2009, which is 12.9 percent of the U.S. population or one in every eight Americans? By 2030, the number will grow to approximately 72.1 million older persons, or 19 percent of the population. The proportion of the global population over the age of 60 is projected to double from approximately 11 percent to 22 percent – from 605 million to 2 billion – between 2000 and 2050, according to the World Health Organization. Imagine the implications on our societies and economies to have countries with inverted pyramid populations?
In the U.S. we haven’t yet figured out how we are going to build a sustainable healthcare delivery system that will allow us to “age in place,” or grow old at home and not in an institutional setting. We have to look to other models in other countries. In Hong Kong, for example, instead of dispersing more funds to care for dependent citizens, the government is adding incentives to the same allocation of money if the patients’ functionality – which is the operative word – improves. We need to identify and support necessary enabling technologies to ensure a person’s maximum functionality so he or she can live productively within the community. Evidence exists that enabling an older person to stay at home saves money. Global aging, therefore, should be approached as both an opportunity for business and for improving the quality of life, rather than just a challenge or a burden, advocates argue. Now that’s exciting stuff to me, especially as I grow older.Writing about these challenges and paradigm shifts and potential technological solutions and visionary policies is an intellectual exercise for my brain. I’m learning so much; you could even call me a SME (subject matter expert), which is what I call my interviewees, in a number of topics. I have also had the opportunity to hone my presentation skills in webinars and before groups of healthcare professionals. Would I rather be writing novels and blogging? No doubt. But I’ve become a more thoughtful and careful writer and I have a better eye as an editor of my own writing through my industry writing through the years. I just need to clone me thrice to get everything done – something healthcare IT unfortunately can’t do. For that, we would have to turn to science fiction….