investments doing very well. The second one is people who do [health information] exchange activities and interoperability stuff. The third will be secondary use of data; people beginning to look at EHR data to do post-market surveys or to support clinical research or do comparative effectiveness (which measures how well treatments for an ailment work alongside others). I think the fourth is uneven but, given the chronic disease problem, different ways to engage patients, whether in the workplace or through personal health records.
X: Glen Tullman, CEO of the medical software powerhouse Allscripts, recently said: “We are at the beginning of what we believe will be the single fastest transformation of any industry in U.S. history.” That sounds a bit audacious. Do you agree with that?
JG: I don’t know about a transformation of “any” industry in U.S. history. One thing is that the pace of transformation in many industries has picked up over the past couple of decades. Telecommunications has gone through amazing change. Retail has gone through amazing change. Financial services have gone through amazing changes, etcetera. So, I don’t know how to compare the economic and historical accuracy of that statement, but I do think we’re going to go through a hell of a lot of change in healthcare IT in a relatively short period of time. The pressures [to reduce costs in health care] are reaching breaking points. The funds are flowing in to do a variety of things. Increasingly, if you’re a doc or a hospital, it’s hard to avoid doing this electronic health records stuff, because it’s strategically and operationally perilous to not do it.
X: Watertown, MA-based Athenahealth (NASDAQ:[[ticker:ATHN]]) says it’s done surveys with doctors on Sermo.com that show most physicians surveyed think they’re going to lose money from EHR adoption. Do you think doctors will balk at buying electronic health records, despite the incentives available to them?
JG: No, I think they’ll buy. It kind of depends on how many hospitals and doctors’ offices you thought should be able to qualify for the incentives in 2011 and 2012. [Editor’s note: Doctors who qualify under EHR use standards called “Meaningful Use” can begin receiving Medicare and Medicaid incentives in 2011.] I think there was a lot of belief that a majority of them should, but that was never congressional intent. The intent was that a minority, maybe a significant minority, would qualify. Part of it is that expectations are out of line. There are organizations that will qualify, even though the bar is high. I also think it was a smart move on the part of the Office of the National Coordinator to set the bar for qualifying high, and then saying: “I know it’s high. But you tell me where to back off and why. So I’m seeking your guidance and counsel.” It’s better to start high and back off than start low—and nobody’s going to force you to go higher, they’ll just force you lower no matter where you start. So I think it was a smart move despite all the [mess] that was created here. I think the other is that providers are sort of under this belief that the federal government ought to cover
