As each day goes by, a shift is happening in healthcare. It’s a shift that’s easy to see and many, including myself, have noted before. The shift is hospitals acquiring ambulatory practices. It’s happening at such a rapid pace and before we know it, a small percentage of doctors are actually working for themselves. This change is going to have a dramatic impact on EHR.
One of the biggest elements of this change is who is making the EHR decision. Previously, a large portion of ambulatory EHR decision making had been done by the doctors who owned the medical practice. As doctors have started working for hospitals, the decision making process has shifted to IT executives (To be fair, many IT executives are also doctors, but often not practicing).
This change in EHR decision making is having a dramatic impact on the health IT world and will continue to have an even greater one going forward.
I and others have noted that we believe that the movement of doctors working directly for hospitals is cyclical. As one person said today at AHIMA, “doctors are the most independent people I’ve ever met.” Independence and working for a big company don’t mix very well. So, I’m sure we’ll see many doctors go back to their independent practices. In fact, one guy I mentioned this to at AHIMA said, “It’s already happening, but it’s going to take a different form.”
He’s right about this. Doctors leaving their new found masters (hospitals), aren’t likely going to be able to go back to the traditional practices they did before being acquired. I’m not sure of all the ambulatory medicine models that we’ll see, but I think those entrepreneurial doctors who want to be on their own are likely going to have to be creative in their approaches to practicing medicine. Otherwise, they won’t survive in this rapidly evolving world of ACOs.