Stead agreed, saying that a regulated approach can work but it must redefine interoperable information as information that can be reinterpreted as knowledge evolves, separate data from applications so different kinds of computer systems can access it, and limit the use of standard data that has one and only one meaning.
In order to see reductions in cost and improvement in quality, Stead said that the industry has to change the nature of practice itself like coordinating care across the continuum and practicing evidence-based medicine. For the technology to work it has to be "architected so it can support change and adapt to change," said Stead.
When it comes to leveraging health information exchanges, Goetz said that the solutions need to be simple, thoughtful, and meet clinical goals. "We try and build information sources that can then drive value," he said. "We won’t get value without simplification."
And even though Goetz said the goals of the HITECH Act will be difficult to meet, he thinks the healthcare community will find a way to make it work.
Detmer is equally optimistic about the opportunity the stimulus package provides, but he is still not convinced that the rate of change will move more quickly than it is currently moving. "It is a tremendous opportunity," he said. "But workforce and training issues are quite real."
Simply having a good technology isn’t enough to remove the barriers of cost, change, disruption, and risk, said Brailer. "Healthcare entrepreneurs must actually understand how the healthcare delivery system works so they can actually make a change in it.”
The technology is only worth it if you are going to get a 40% to 60% improvement in value, said Stead. The stimulus package offers the healthcare industry a real opportunity to innovate. But to capitalize on that, Stead said, "we have to be willing to stop playing defense around a model that is not sustainable."