If there were a graveyard of failed health IT projects, it would be littered with the tombstones of efforts that first launched with fanfare at big tech companies like IBM, Google, Microsoft and Amazon.
It begs the question: Is healthcare too hard for big tech companies?
That’s the view of Kyle Silvestro, an industry veteran who over the years has watched numerous technology companies spend billions of dollars building healthcare projects only to shut them down a few years later with little to no results. Silvestro is president, CEO, and chairman of SyTrue, a healthcare-focused artificial intelligence/natural language processing company.
Big technology companies continue to find their place in healthcare, and while some have made inroads in recent years, particularly with cloud services (last week’s HIMSS22 show floor was dominated by big booths from Amazon Web Services (AWS), IBM and Microsoft), their progress has come after much trial and error.
This is often because consumer technology vendors don’t understand the nuances and complexities of healthcare, and the unique challenges that come with having mountains of inconsistent, siloed, dirty healthcare data that can’t be easily interpreted or shared across organizations.
Healthcare IT News spoke with Silvestro to explore Big Tech in healthcare and why he believes the constant entry and exit of non-healthcare-specific vendors is stifling innovation and slowing healthcare transformation.
Q. How would you explain the history of Big Tech in healthcare?
A. Big tech companies have a poor track record in healthcare. Industry giants like Google, IBM and Amazon have repeatedly made inroads in healthcare, each hoping that their size, infrastructure and influence can bring order, if only through willpower, to our nation’s dysfunctional, inefficient and outdated healthcare system.
But the actual impact of these efforts has been very different: most of the big tech companies’ efforts in healthcare have failed, stifling real innovation in the sector and undermining market confidence in technologies that are successfully addressing real market needs.
Like the promises, these failures have been massive and well-documented: Search giant Google Health tried a personal health records service, but it was plagued by interoperability issues and low user adoption and shut down after just three years.
IBM’s artificial intelligence and data analytics platform, Watson, excelled at answering questions on the TV show “Jeopardy,” but it only had a nominal impact in healthcare and was ultimately sold off unprofitably.
Similarly, Haven Health, a joint venture between Amazon, JPMorgan Chase, and Berkshire Hathaway that aimed to disrupt health care and health insurance, was dissolved after three years when it became clear it would not achieve its lofty ideals.
It’s easy to see why healthcare is attractive to Big Tech: it’s a $4.1 trillion market plagued by disorganization and waste. Big Tech has been successful in addressing these issues in broader consumer and business markets, and many are convinced they can apply similar principles to improve these inefficiencies in healthcare.
But these large companies quickly realize that healthcare is a very different industry, with complex, deep-rooted problems that can’t be solved with a one-size-fits-all approach. Truly improving healthcare requires specialized knowledge and applications that fundamentally transform processes.
Q. You’ve said that most of the systems from major technology companies are not customized for healthcare, take months or years to customize, and are not scalable to meet the needs of healthcare organizations. Can you give us some examples and results?
A. Google Health is a great example of how oversights in healthcare customization can impact usability and the bottom line. While Google Health’s user interface was praised both inside and outside the healthcare industry, the process of getting data into Google Health was complicated.
Patients often lacked access to reliable health information, few could afford the time required to update their health record details, and the complexity of the information was too difficult for patients to manage on their own.
The root of the problem here was the data itself. Big tech companies consistently underestimate the “dirty data” problem that healthcare has. Healthcare data is, for the most part, not clean and consistent. It’s full of industry-specific terminology and formats like ICD-10, SNOMED, RxNorm, MedDRA, and more, that don’t neatly align or integrate with anything else.
Additionally, patient data is stored in a variety of sources, including a wide variety of laboratory systems, imaging systems, and electronic health records.
To make matters even more challenging, up to 80% of the data healthcare organizations need to improve decision-making is unstructured in nature and trapped in clinical narratives in EHRs or stored as PDFs and image files that are difficult for machine learning algorithms to decipher.
Google Health’s failure to truly address the challenge of dirty data in healthcare created integration problems that its sleek user interface couldn’t overcome.
Q. What do you think about Oracle’s planned acquisition of Cerner? Do you think a big tech company can pull off a leading EHR?
A. Given the lackluster track record of big technology companies in healthcare, Oracle has a lot to prove in this space. Oracle cannot fall into the trap of not putting enough focus on healthcare just because it is only one part of what it does.
Oracle has one advantage that many other large technology companies that have failed in the healthcare space don’t have: it got its start by acquiring a company that was born and bred to serve the needs of the healthcare community.
Oracle isn’t starting from scratch trying to apply its strategy and philosophy to a new and uncharted field: It has a well-known organization in Cerner that is familiar with the challenges of healthcare and has already addressed many of the issues that have historically caused many other large technology companies to abandon efforts in the space.
Rather than dismantling and rebuilding what Cerner has already done, Oracle should focus on accelerating the modernization of Cerner’s established EHR by leveraging its platform, database, and low-code development tools.
If Oracle can use its resources to improve and streamline caregivers’ EHR experience, through things like voice-enabled interfaces and secure cloud applications, it has a chance to succeed where other big tech companies have failed.
Q. What must Big Tech do to succeed where it has failed in healthcare?
A. Succeeding in healthcare requires total immersion in the field, requiring not only specialized knowledge but also a huge investment of time, resources and money to address common problems such as dirty data, privacy considerations around patient information and interoperability challenges between all parties in the care continuum.
When healthcare is just one part of Big Tech’s overall business, it becomes unnecessary. The challenges and costs easily outweigh the potential benefits and rewards. So it becomes easy and tempting to abandon healthcare efforts in order to bolster short-term financial performance and satisfy shareholders.
To succeed, big tech companies need to commit to healthcare, as many smaller, healthcare-focused companies have done. At the very least, they need to invest in and build on the knowledge and solutions already established in the space. But most big tech companies seem unwilling or unwilling to make this move.
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Email the author: bsiwicki@himss.org
Healthcare IT News is a publication of HIMSS Media.
