BOB vs. ERP Concept For Patient Experience

I had a quick dialogue with Andrew Webber (President and CEO of the National Business Coalition on Health) earlier today at the WHCC (see #whcc10 twitter feed).  I wanted to talk with him about how we create a unified consumer experience in today’s healthcare environment. 

Today, a consumer gets messages from their employer, their physician, their pharmacy, their PBM, their managed care company, their hospital, their disease management company, healthcare sites such as WebMD, and probably several other places.  Very little of that is coordinated, and it’s certainly not always consistent in messaging and direction.

Mr. Webber explained that the employers need a “supply chain management” solution to share data across vendors and develop a consistent message.  We talked about how the Accountable Care Organization (ACO) concept will try to get us back to some type of solution where there is a primary “owner” of the relationship and that this would be with the trusted key in the solution – the MD. 

We talked about the fact that the employers have created this system which pushed the BOB (best-of-breed) over a consolidated, centralized solution.  And, we discussed the fact that employers continue to love these “boutique solutions” that develop niche plays (think Health 2.0 companies) which address an acute need.  They create great case studies but are often difficult to scale.

It made me think of some old IT models I worked on where clients had to decided whether to pick an ERP system like SAP or go with the best-of-breed and manage the infrastructure to connect them.  I think the current employer based system even went a step past this.  In the IT world, the company had to manage a connected infrastructure (think enterprise data warehouse and service oriented architecture).  BUT, in healthcare (or benefits), that infrastructure doesn’t exist.  Each entity owns their piece of it completely with limited interaction and connectivity.

This was the first time where I could see the point of a “employee centric model” versus an “employer centric model”.  I’m not sure I believe it could effectively be done, but it reminded me of a company that was trying to create a web-application that was a type of next generation PHR (personal health record) where the member could consolidate communications, designate preferences, and would adapt general (vanilla) communications to the consumer based on behavior, preferences, demographics, etc.

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