For the past few years, one could hardly turn on the television or open a newspaper without hearing about healthcare reform or the American Recovery and Reinvestment Act (ARRA). Outsell's David Bousfield has taken a deeper look at how content companies can use one to improve the other in his report "Growth Trends in the Market for Clinical Decision Support Tools."
The report, published in June, says, "Specifically, the Health Information Technology for Economic and Clinical Health Act (HITECH), which is incorporated into the ARRA, provides a total of $19 billion in federal investments for HIT adoption and implementation." With that kind of money floating around, it is more important than ever for companies to understand how they can best fit into this market.
Bousfield focuses on American healthcare, he says, because of its size and willingness to experiment. "It seemed more likely that we would see examples of success," he says. A few companies quickly surfaced as the current leaders in the clinical support tool space: Hearst, Elsevier, Thomson Reuters, and Wolters Kluwer among them.
"The players claim to have large numbers of customers, but when you look at the evidence there's still a lot of marketplace," Bousfield says. In other words, there are plenty of products on the market, but they are not living up to their potential just yet. For one, a lack of interoperability between many of the HIT tools makes it impossible for multiple, complicated systems to work together. As the marketplace matures, this problem is only exacerbated. One conclusion of the report says publishers will need to constantly evolve and demonstrate measurable improvements in patient outcomes. It is no longer sufficient to have the best content. "The leaders today may not be the leaders tomorrow," he says.
Clinical decision support (CDS), education, and management analytics were singled out as areas of opportunities. "Many publishers produced excellent print tomes in the past. ... Where are they now? They've disappeared," Bousfield says. "Now they need to present this info at a granular level. They need to deliver very specific information at just the right time." According to the report, publishers need to realize that their content is no longer useful unless it is broken down into bite-sized nuggets that can be integrated into the support software. Furthermore, these tools need to be able to manage the pieces of information in a way that enables updates and upgrades to be seamlessly applied to an entire healthcare organization, at the push of a button.
Another finding says the presentation of the information and of alerts and warnings need to be done in a way that does not impede or distract the decision making of the healthcare professional. Users are often overwhelmed by "alert fatigue." For instance, a doctor may make a decision to alter a recommended dosage based on a patient's age or other factors, and many systems cannot understand this, causing repeated-often annoying-alerts. This could lead to disaster for a patient (as anyone who habitually ignores computer pop-ups knows). "The system," Bousfield says, "isn't that bright yet."
Several of the companies mentioned in the report, many of which are not necessarily thought of as healthcare companies, have made smart acquisitions to position themselves in this growing market, notes Bousfield. For instance, Wolters Kluwer acquired ProVation Medical in 2006, which offers tools such as ProVation MD, which replaces dictation and transcription and allows physicians to document procedures at the point of care. ProVation software produces coding-ready and image-enhanced documentation that the company says results in greater efficiency, increased profitability, and clinician satisfaction. As a result, ProVation has now become the hub of Wolters Kluwer Health.
Even with tools such as this on the market-and there are hundreds of competitors of all sizes-Bousfield sees room for improvement, and even a narrowing of the market. The report says it best: "A feature of any new market of significant size is the ‘gold rush' phenomenon ... but over time, unless the foundations for the market diversify, vendors will disappear if they cannot retain some competitive advantage."