Value-based care, healthcare consumerism, the Triple Aim, socioeconomic and other external influences on patients – these are some of the forces driving healthcare provider organizations to reassess their legacy enterprise architecture and consider moving to a multi-cloud environment, one that proponents contend is more flexible and can thus better manage all these forces.
John Reeves, healthcare solutions evangelist at Boomi, a Dell Technologies company, discusses cloud computing and IT transformation in a HIMSS20 Digital educational session entitled Lightning Session with John Reeves.
An architecture changeover
There is a changeover in healthcare from the legacy service-oriented architecture (SOA) and enterprise service bus (ESB), Reeves said.
“We really are being faced with a conundrum in that the business of healthcare is changing quite rapidly,” he noted. “There’s a real push for an API-driven landscape. There’s a real push for syntactic and semantic interoperability. There is a real yearning for an adoption of standards for the portability of the patient record, and so that the lines of business can move more fluidly into adjacencies as the actual whole continuum of care changes to a more consumer-oriented approach.
“That really requires a different way of thinking when it comes to sharing information and when you evaluate your own organization’s journey to becoming more in line with the future state of cloud thinking and digital adoption.”
Many healthcare organizations have operational silos and systems of record for which much is unknown regarding the quality and efficacy of how that data can be used to promote new service lines or to provide new services, Reeves added.
Opportunities for new strategies
“And it’s becoming more and more a consumer-driven landscape, as well,” he said. “We’re seeing opportunity to recast existing applications that are important to the lines of business at any given healthcare-delivery network. We’re seeing opportunities to rapidly adopt new strategies. But what we’re also seeing is organizations burdened by the technical debt and the administrative overhead of the care and feeding of those important core systems that really drive their local workflows.”
Then there are the efforts to reach the Triple Aim of healthcare via health IT, Reeves said.
“We’re all trying to make the patient experience more enjoyable; we’re trying to make the clinician’s experience more enjoyable; and we’re having to now ask more of our architectures,” he said. “We’re having to ask more of clinicians and consumers to be mindful that this is the situation – that there is a transition the healthcare organization is going through from transactional-based medicine to value-based care to outcomes-based care, that it is a strategic one – and it is very important that we get it right the first time.”
Healthcare also is seeing a move, he added, to a position of awareness and wellness. Organizations have to be implementing architectures that allow for education and fluidity, so that transitions become more the norm. More is happening outside of the primary care physician visit – and outside of the four walls of the hospital there is more going on today that makes people want more, he said.
More agile, flexible architecture
“When you think about consumer behavior, the influx of genetic information and socioeconomic or environmental factors, you rapidly see that a multi-cloud scenario or an architecture that has to be more agile or flexible is necessary, because we are no longer bound by the constraints of the operational data model that we’ve been so wedded to when it comes to the EHR workflow,” he stated.
Another driving force is the reduced rates of reimbursement that all healthcare provider organizations are encountering today, Reeves said.
“So this business of having a more economically sound model when it comes to delivering health IT and IT transformation initiatives has to be encompassing cost avoidance; you have to have predictability and consistency in your IT architecture,” he said. “So the more that you can do to be a partner with the lines of business, to be more in line with the key performance indicators of your organization – that includes fiduciary responsibility with IT infrastructure – the better off an organization is going to be.”