The Need for Modularity in Healthcare Tech Solutions
In healthcare technology, relying on a single vendor for all digital solutions often results in subpar tools for clinicians. As the industry evolves, it’s clear that a modular approach is essential, allowing different systems to connect seamlessly and deliver the best solutions. While the EMR (Electronic Medical Record) has traditionally been a central piece, many organizations are shifting toward more open, cloud-based systems that integrate with diverse tools. This flexibility helps reduce the burden on caregivers, streamlines processes, and enables better use of advanced technologies, ultimately improving patient care and operational efficiency.
Listen to Narinder Singh and Eric Yablonka discuss the shift towards modularity in healthcare technology, highlighting the importance of integration, flexibility, and innovation to improve care delivery and reduce burdens on caregivers.
Video Transcript
Narinder Singh:
And usually it ends up looking something like this where it doesn’t quite hit. You’re putting inferior solutions in front of clinicians because to get them all from one place, it’s hard for any single vendor to be number one or number two it. So you’re giving your clinician somewhere a worse solution. And I think in most industries we’ve now recognized that rather than have to debate this suite versus kind of best of breed, we need modularity. We need things to be able to connect it, and that becomes the kind of cornerstone. However, healthcare is one of the examples where the EMR is kind of that one middle piece, and I think people are trying to apply the EMR concepts to non EMR problems. That second box is temping. Talk to me a little bit about when you were in the CIO chair, how you thought about this kind of one solution versus integration and what advice you would give to the next generation from that.
Eric Yablonka:
Sure. Well, when I first started in healthcare technology, which was in the mid eighties, there were very few offerings. There was a lab system and a billing system and maybe an order communication system and that was it. And of course today there isn’t anything that happens in a hospital that isn’t underpinned by some digital capabilities. So the world has really changed. And when we were in our best of breed environment, we even called it best of breed gone amuck in one of my organizations. It was in a time in a world where the integrations was less robust, even less standards than they are today. And quite frankly, people really look to aggregate products with a vendor to one manage costs and two to have that built in interoperability, if you will. And now where we are I think is we have, and the McKinsey digital transformation article really talked about headwinds and the number one headwind for transforming digitally is legacy systems and tech debt.
Number two is budget, and number three is change management. And I think those top three all really are some of the challenges we have in moving our architecture from perhaps in EMR and ERP as infrastructure and then the systems that integrate and interoperate with that, that provide the capabilities that the EMRs either can provide or do really poorly at that don’t advance the imperatives of the organization. So it is a bit of a new world. There’s more open capability. People are migrating to cloud less on-prem and using advanced tooling from companies like Google, Amazon, Microsoft to get that interoperability. So I’m quite optimistic that we might be able to break that, you call it lock-in, but break that sort of, you can’t really go beyond what you have to be able to evolve over time as EMR involves evolve over time so that all your applications can work seamlessly.
One and two is you take the burden off the caregiver, reduce burnout, improve the cost basis, have machines, do the machines work and be the integrator and have humans do the human work and don’t have humans to be the integrator of that data. That’s the future of healthcare and it’s not going to happen all within an MR context. And it doesn’t matter which EMR it is. I mean we can name names, but I think in general there’s a lot of innovation that’s coming from companies and organizations that want to partner with the EMR companies, particularly on the behest of the healthcare organization. That’s usually how they get a lot of attention from the EMR vendors. So I think there’s a lot of opportunity, but we have to go from that. We hated best of breed, now we have a single vendor. The single vendor is great, but perhaps they can’t do the kinds of advanced things we want to do. How do we do that without just creating sprawl in a mess in another way? And I think the CIOs today, the chief digital officers CIOs are much more advanced in that thinking and know how to handle that in a much better way than we did maybe 10, 15 years ago.
Narinder Singh:
Talking a little bit more about that, the EMR vendors, EHR vendors are certainly not standing still. Some CIOs do have the approach of I’m just going to wait to see what they deliver me. It’ll be good enough. I don’t want to deal with the sprawl piece, but some of the things we’ve talked about, the ai, the machine to machine have the data and streams of data that aren’t what the EHRs were designed for initially. So you’ve got a couple of counter forces there. EHRs are trying to do more, may or may not be the best technology for more CIOs would love to not add or they can avoid if you fast forward in 10 years. Are EHRs more or less important as a part of the overall portfolio of technology solutions for hospitals?
Eric Yablonka:
That’s a great question. Predicting what will happen in 10 years and health tech is a bit of a trick, but what I would say is it is hard to imagine EMR is going away. Perhaps we’ll have the next generation of ’em, they’ll be all cloud-based and perhaps they’ll have advanced capabilities. But remember earlier in the discussion we talked about the haves and the have nots. We’ve talked about organizations that perhaps still generate a healthy bottom line to reinvest in technologies. And so there’ll be a lot of organizations that’ll just have to stand pat because they don’t have a choice and there’ll be others that will be able to innovate and to move to the next generation not only of EMRs but the systems around them that really turbo charts the healthcare organization,
Narinder Singh:
Healthcare, it tends to be three, four, 5% I think probably different between haves and haves nots probably on the lower third of industries that are spending on it and technology. Does that sit right with you? Does it sit right? Is there any hope of that changing? Do you think we can get to where we need to with that level of investment?
Eric Yablonka:
Well, that metric has to do with operating cost spend and generally the 3% was considered the golden number to hit or exceed. And in some organizations I was able to do that and some I couldn’t. It’s very, very hard to get stuff done on a very tight budget when I had just indicated earlier, there isn’t much happening in the healthcare organization that has not underpinned by it. With that said, CIOs, CDOs, our roles include our fiduciary responsibilities to spend wisely. And so I think people have always struggled with trying to get the most out of the resources that they have, but we may have to really look at that in a different way. One great example is the more we go to cloud, the more we’re increasing our opex, perhaps reducing our CapEx, but increasing our opex. Some CFOs might be okay with that. Some CFOs like the CapEx spend more because I can titrate it year to year depending on our financial performance of the organization. So I think one of the big challenges is going to be how do you handle that operating number as you go more to a month to month lease versus buy or a contract for a cloud service versus fill the data center. I think all of those things are important. We’ll have to stop my dog’s barking.
Narinder Singh:
Well, I’m sure. I’m sure your dog has an opinion too. It’s like everyone does on this. Well,
Eric Yablonka:
Somebody rang the bell, so sorry about that.
Narinder Singh:
That’s okay. If you think about folks that used to walk into your office, vendors come in and they’re pitching, Hey, put my technology in. I’m going to help you generate more revenue or put my technology in, I’m going to help you save cost. And of course there’s some variance between those two and they’re indirect and direct. Was that 50 50 or was everybody coming in to pitch revenue? How did you see that maybe as you were at Stanford at the tail end of your career? Were people pitching, I’m going to help you make more money, or are they ing, I’m going to help you reconcile that cost side of things?
Eric Yablonka:
Well, it really depended on the application and use case
Narinder Singh:
Out of 10 people that walked into your office that week, how many of them were pitching, Hey, we’re going to help you make more money, versus we’re going to help you save money and become more efficient.
Eric Yablonka:
Well, I think we heard it all. Save money, increase productivity, reduce cycle times, increase reimbursement, improve turnaround times. We’ve heard it all. It is a common pitch. It really gets down to when you contract, what are people willing to commit to as it relates to either saving money or improving productivity? And rarely would a business partner back up the claim in the sales cycle with a contract that perhaps shared some accountability for that. On the other hand, we did have a couple of business partners, particularly younger companies or companies that were eager to get a foothold who might work with you in a more flexible basis and then you could try things to validate the use case and or the outcomes. And those vendors were always interesting to talk to because they had opportunities that perhaps they could offer that a huge company wouldn’t think of.