Healthcare Reform and Information Technology: The Future is Now

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During his keynote lecture at the 2012 Glaucoma 360 meeting, George Cioffi, MD, was asked to predict what would shape the future of glaucoma. At that time, one of the topics he focused on was healthcare reform, with an emphasis on information technology. During that 2012 presentation, Dr Cioffi showed the audience a picture of Judy Faulkner, CEO and founder of the healthcare software company Epic Systems. At the time, Epic was serving just 250,000 doctors and was in about 25% of hospitals.

Dr Cioffi asked, “Is this the most powerful person in medicine?”

Nearly 10 years later, at the 2021 Glaucoma 360 New Horizons Forum this past weekend, Dr Cioffi revisited the topic to answer that question.

“[Epic] is ubiquitous. It’s in every single one of the major research institutions. It’s in 22 out of 23 primary care hospitals, it’s in all the top Children’s Hospitals,” he said. “But it’s not only there, it’s in outpatient medicine as well…Almost all the people who have adopted EMRs have adopted Epic. The market share presence that this has is unbelievable.”

But how is this shaping medicine, ophthalmology, or even glaucoma care? Dr Cioffi said it could put us on the path to a comprehensive health record.

“It’s going to connect everything,” he said. “It’s not just going to be an EMR, it’s not just going to sit in a doctor’s office but it’s going into behavioral health, it’s going to connect to your home infusion center, and maybe your apple watch or retail clinics and home health agencies.”

The Importance of Big Data

It’s not just Epic collecting information, Dr Cioffi points out. The importance of Big Data has exploded for all stakeholders.

Dr Cioffi said that until recently insurance companies have only had access to claims-based data but now are fighting to gain access to EHRs to direct patients to high-performing providers. The government similarly seems to be utilizing Big Data, as evident by recent CMS proposed policy changes that would have decreased funding to ophthalmologists.

“Why are they doing this?” asked Dr Cioffi. “They understand through Big Data now that we are costly.”

Dr Cioffi applauded that AAO for starting the IRIS Registry—one of the largest specialty databases—around the time of the EMR explosion which has helped ophthalmologists “steer the ship instead of being steered.”

“I think there is a confluence of data under one house. But data can be used for good or evil. And for those of you who thought healthcare reform stopped in 2012 or 2016 as administrations changed, I’d say it actually accelerated. And part of it is driven by the data acquisition centralization. Lines are really ubiquitous now. Data sharing between providers, payers, patients, and many others is increasing at a break-neck speed and payers are looking to shift risk and steer care.”

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