Persistent Innovation in the Face of Healthcare Reform

By: Howard Burde, Principal at Howard Burde Health Law, LLC | @BurdeLaw

Healthcare in the United States is characterized by persistent innovation.  Such persistence differentiates the American healthcare system from most others (save, perhaps, Israel’s and India’s). This year’s Venture+ Forum during HIMSS17 (as with each of the previous 10 years) reflects persistent innovation. In a year when the country is about to embark on yet another voyage into health system reform, let’s take a few minutes to consider the innovations that will drive the next reform, or which will thrive in spite of it.

Patient Care

For one, health information technology innovators are focusing on those aspects of the healthcare system which are less likely to be impacted by political discussions or changes to or repeal of the Affordable Care Act.  Seeking to avoid volatility, innovators are developing technologies and business models for self-funded employers and union funds.  They are building technologies that connect patients and reduce costs; focusing on those that support models improving access; and are taking a step back to integrate technologies that fueled the great expansion of health IT over the past decade.

For example, in the self-funded space (far larger than the individual market, by the way), innovative healthcare providers such as Activate Healthcare are establishing on-site and near-site primary care and wellness clinics for employer and unions.  Such clinics utilize technologies that integrate acute health, wellness and coaching, as well as providing patients with visibility into their benefits.  Concierge applications help patients track not just their symptoms and therapies, but their benefits, networks and incentives as well.   New applications like the New Life Challenge represent cutting-edge technologies that implement the latest research on healthy lifestyles into a larger patient centered plan.


Likewise, and in conjunction with this shift, is a renewed focus on access to care.  For example, the telehealth industry is expanding, as is the American Telemedicine Association. Additionally, the state boards of medicine are relenting slightly with the agreement to develop a state compact similar to the nursing compact that has been in place for decades. And finally, patient, caregiver and provider demand for telehealth technologies is outpacing supply. 

Consistent with telehealth expansion are transportation applications, remote monitoring and reporting technologies, enabling patients and caregivers to capture real-time data and integrate such information into reports to providers.  Transportation, or lack thereof, is a hidden barrier to healthcare access, especially for an aging Medicare population.  Apps that combine patient engagement with transportation and scheduling make healthcare possible for a range of patients who lack cars.


Health IT innovations that improve clinical functions, such as workflow and scheduling applications have value regardless of any changes at the federal level.  A technology to watch is new clinical decision support for diagnostic imaging technologies.  Machine learning has allowed the development of remarkably accurate computer analytics of diagnostic images.  Meant to augment, not replace, radiologists, these technologies are under study at many if not most of the major medical teaching institutions around the country.


Finally, we are seeing more innovative technologies that connect the data and analytics of applications that interoperate with electronic health records.  The rapid expansion of the use of EHRs and analytical applications has created its own kind of siloing of health information.  The new applications bridge heterogeneous data messages, allowing for an informed perspective by and for the provider and patient.


in health and IT meet.