by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
Pop quiz: Among early-stage companies that are successful, what percentage are successful with the initial business model with which they started (Plan A) vs. a secondary business model (Plan B)?
Harvard Business School Professor Clay Christensen studied this issue. He found that among successful companies, only 7% succeeded with their initial business model, while 93% evolved into a different business model.
So let’s take this finding and reexamine our human nature. In light of these statistics, what makes more sense:
- Defending Plan A to your dying breath?
- Assuming Plan A is probably flawed, and anticipating the need for Plan B without getting defensive?
We question many of the assumptions underlying HITECH Plan A. We also want to talk about the need and content for Plan B in a constructive way.
In this essay we’ll discuss:
1) The Need for HITECH Plan B
2) Questioning Assumptions — Issues to Reconsider in Plan B
a) Rewarding Incremental Progress
b) Addressing Root Causes for Non-adoption of EHR Technology
c) Questioning Health Information Exchanges (HIEs) as Building Blocks for the Nationwide Health Information Network (NHIN)
d) Catalyzing Movement Toward Modular EHR Technology
e) Focusing Incentives on High Leverage Physicians
f) Recalibrating Expectations for EHR Technology Adoption
g) Getting Bang-for-the-Buck in Achieving Meaningful Use Objectives
h) Comprehensively Revamping Privacy/Security Laws vs. Tweaking HIPAA
i) Maximizing Sync Between HITECH and PPACA
j) Leveraging Potential for Patient-Driven Disruptive Innovation
k) Promoting EHR Adoption Beyond Hospitals and Physicians, e.g., long-term care, home health, behavioral health, etc.
l) Dumping Certification
3) Summing Up
Table of contents for Is HITECH Working?
- Is HITECH Working? 7 Observations Mom Could Understand
- Is HITECH Working? #1: Hospitals are grumbling but are playing in the game; success is not guaranteed.
- Is HITECH Working? #2: Key physicians will sit on the sidelines (at least for now).
- Is HITECH Working? #3: ONC got it right on the 3 major policy interpretations: Meaningful Use, Certification, Standards
- Is HITECH Working? #4: While most attention has been focused on demand side incentives (will doctors and hospitals buy EHRs?), the supply (vendor) side of HIT is already transforming.
- Is HITECH Working? #5: “Gimme my damn data!” The stage is being set to enable patient-driven disruptive innovation.
- Is HITECH Working? #6: HITECH and Health Reform Objectives are Synergistic
- Is HITECH Working? #7: Where’s Plan B? Congress and ONC need to address major flaws in HITECH.