The inevitable disruption in healthcare, per Baptist Health South Florida's Tony Ambrozie

A conversation about digital health, disparities and COVID-19.

Tony Ambrozie serves as the senior vice president and chief digital officer of Coral Gables-based Baptist Health South Florida. 

Mr. Ambrozie will serve on the panel "What Healthcare Needs Most From Digital Tech in the Next Decade" at Becker's 7th Annual Health IT + Revenue Cycle Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place Oct. 4-7 in Chicago. 

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Question: What are you most excited about right now?

Tony Ambrozie: The general acknowledgment and acceptance of the criticality of digital, data and automation — all powered by technology — in healthcare is a momentous change compared to just a couple of years ago. The transformation of the consumer and patient experience is so critical to consumers in the age of digital experiences by Apple and Amazon. Data and automation can do miracles for the provider systems in terms of both efficiencies as well as the quality of care. 

Healthcare has poorly been lagging behind other sectors of the economy in these areas, and consumers, patients and providers see it in negative ways every day. Movement and progress in this space are fascinating to those driving the transformation. In addition, two other developments in the space of medical records systems are welcome, and frankly, we'll pass due. 

First, the increased awareness by technology vendors and hospital systems of the toll our medical records systems are taking on providers who have to spend more time and effort navigating screens and clicks at the expense of face-to-face with patients. That face-to-face is so important to both patients and providers. We know from elsewhere how to solve this. We now have the awareness; we just need to execute it. 

Second, while a bit more distant and challenging to solve, in terms of patient data, we need to move from a provider and hospital-centric view to a patient view and provide records portability and transparency wherever patients go. Visiting a new provider who doesn't have access to the patient medical data because that data happens to be housed in a different system is not merely inconvenient and wasteful but is dangerous. And remember, patients own their data, and the care activities that generated that data in the first place were paid for already.

Q: What challenges do you anticipate over the next two years?

TA: We have a lot of challenges in healthcare today. We are exceedingly expensive for the breadth of services offered. The U.S. is more expensive per capita than the nearest developed nation, while for quality of care over the entire population, we are in the 30s among all nations. Worse in some areas, especially in the disparity of care quality among racial and disadvantaged groups. This status quo cannot continue forever. 

The causes of this sad situation are multiple and complex; so will the solutions. Suffice it to say that I believe better technology will be part of the solution.  

In addition to these long-term systemic and structural problems, we have some tactical issues driven by the pandemic — namely provider burnout, a massive backlog of unaddressed COVID-unrelated conditions, as well as inflation. Everybody is struggling with all these same problems. 

The danger that I see is that, while legitimately trying to address these rather tactical challenges, we lose focus and momentum on the initiatives, such as digital and data transformations, that will help us address the long-term systemic and structural challenges. We must focus on those for the sake of our patients and their care, as well as the health of our institutions. 

Q: Where are the best opportunities for disruption in healthcare today?

TA: While it sounds scary to some, disruption in healthcare is inevitable simply because of the many shortcomings across the many levels and the tremendous opportunities offered by reimagining processes and business models, all powered by digital and data. 

We constantly see new entrants into the space, with [venture capital] pouring billions and tech companies probing and pushing. The size and inefficiencies of the U.S. healthcare industry are simply too irresistible. One of the biggest challenges all these entrants face is not as much the complexities of the three-parties model (patients, providers, payers) that exists elsewhere but the inability to scale. Everybody wants to disrupt with the same doctors and nurses, now burned out and some leaving the field. Additionally, the population is getting older and needs more care, and our ability to train providers is very limited, takes time and is not scalable. 

Some shift is already happening from hospitals to ambulatory centers. The true disruption will come when more of the care and especially monitoring moves at home or with the patient instead of in the consulting room. Clearly, high-acuity care is not changing, but lower-acuity monitoring, diagnosis (think at-home COVID tests), and even treatment (some hospitals tried this during the pandemic with at-risk patients). This opens up immense opportunities for more and better (i.e., more immediate) care. The technology must improve and processes and payer models must adapt, all of which will take some time, but I think this is the future. 

Q: How is your role as CIO evolving? How are IT teams changing?

TA: An interesting and not well-noticed phenomenon has been occurring in the last two decades, even outside the tech companies. Because there is so much increasingly sophisticated technology powering all businesses that are becoming critical to not only the competitiveness of business but their very survival, IT is transforming from a cost center to record transactions, as in the first four decades of IT in the enterprise, to a profit center driving the business. This is especially the case with digital and data. 

As such, fundamentally, the CIOs and CTOs are increasingly becoming business leaders who know technology well and come up with solutions to business problems through technology. 

For example, while I own all technology systems — which you would expect from a traditional CIO — I operate mostly from the chief digital officer perspective driving digital transformation. So it's about customers and the business, not the technology, although that's the indispensable ingredient that makes it all possible. 

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