The answer may lie in the cloud.


Workflow management is this ungainly looking, many-tentacled beast that must be tamed in order for a physician's practice or health system to run efficiently and profitably. As the healthcare landscape becomes more maze-like, physicians are burdened with the difficulty of navigating the protocol twists and compliance turns and, as a result, are buried in paperwork and front-office administration when they could be spending more time seeing and treating patients — the very thing that attracted them to healthcare in the first place.  

So how can we bridge this gulf that exists between the front and back office of a physician's practice? It can be bridged through this novel thing called the Internet — or more specifically, the cloud.

Healthcare is one of the only industries I can think of that has yet to move onto the Internet in a meaningful way. Here's this channel that has innovated retail, banking, you name it — but, arguably, is still nascent in the most critical business of all. We have literally overlooked the very thing that can tip the workflow scale in the right direction and take the onus of administration off the shoulder of providers. 

By putting practice management services into the cloud, we can keep in pace with changing reimbursement protocols and track against meaningful-use thresholds and other reimbursement programs so that doctors can get paid sooner from insurers and collect their bonus checks. There's this knowledge hanging in the cloud, and the ability to extrapolate that knowledge on a daily basis, that software has failed to capture. Legacy software simply can't match this level of flexibility, and physicians have to waste time manually installing software platforms that in essence become obsolete the day they're loaded in. In the cloud, everything's iterative and everything's changing based on issues doctors are confronting in the business of medicine.

But what about the topic du jour, electronic health records? They pose challenges to workflow too. The fact of the matter is that a large number of doctors are sort of lukewarm on the idea of EHRs because, in their eyes, these expensive, bulky software programs are asking them to abandon their pen-and-paper charts and get trained on something with unproven value. The government is urging doctors to jump on this bandwagon, to the tune of $30 billion worth of incentives, but with no definitive proof that their workflow will improve. It's pie in the sky in many ways, so for EHR adoption to be successful, they absolutely cannot slow the physician down or add any more layers of labor or frustration to the administration of healthcare. There is enough junk clogging up the arteries of healthcare already. 

I happen to think that EHRs that live in the cloud are the answer. The cloud will become the thing that enables the creation of an efficient market for healthcare information and will lead a great migration from four-legged, lumbering legacy software products to two-legged, upright cloud-based solutions to advance workflow management in a significant way.

Jonathan Bush is chairman and CEO of athenahealth.
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