Dr. Delos "Toby" Cosgrove who stepped down as CEO of the Cleveland Clnic in May, 2017, has been appointed as an executive advisor to the Google Cloud team (see: Toby Cosgrove joins Google Cloud). This may be mainly a ceremonial appointment or Google may be seeking to gain expertise from him regarding the relevance of the cloud for the future of healthcare. Below is an excerpt from the article:
[Gregory] Moore,...[Vice President of Healthcare], noted that Cosgrove would take on the challenges of the Triple Aim, a framework aimed at improving the patient care experience, improving population health and reducing the per capita cost of healthcare. To those efforts, Moore adds a fourth objective: the Quadruple Aim of improving the work experience of clinicians and staff. According to the Annals of Internal Medicine, for every hour a physician spends with a patient, they spend two hours on related administrative tasks.....Moore added. Cosgrove, 78, stepped down as the Cleveland Clinic’s CEO in May 2017, after having led the renowned health system for 13 years.....As president and CEO at Cleveland Clinic, he initiated and drove major initiatives, such as creating best practices in healthcare, ramping up focus on patient outcomes and improving patient experience. As Moore sees it, moving to the cloud is one of the best ways to achieve critical healthcare goals. For example, Google Cloud’s work with the Colorado Center for Personalized Medicine (CCPM) and Health Data Compass helps clinicians and researchers to quickly identify patterns in patient data, helping to lower costs and improve outcomes.
This is the first time that I have personally seen a reference to the Triple/Quadruple aims in healthcare. This concept exists in the medical literature (see: From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider). Here are the four aims:
- Improve the patient care experience
- Improve population health
- Reduce the per capita cost of healthcare
- Improve the work experience of clinicians and staff
It has occurred to me, partly based on this Cosgrove appointment, that the long-term goal of Google is to develop a cloud-based EHR. Such a goal would seem to be particularly relevant given the reference to the four aims above and the constant litany of articles discussing physician burnout linked to EHRs (see: EHRs get most blame for epidemic of physician burnout). Moreover, providing a cloud-based EHR solution for hospitals also gives Google potential access to an enormous amount of clinical data. This then enables the company to develop algorithms to improve the patient care experience, to improve population health, and reduce the cost of healthcare.
Starting from scratch in the development of a web and cloud-based EHR will also enable Google to correct many of the inefficiencies and design errors of our current ERHs which often require multiple keystrokes to accomplish simple tasks. I suspect that easy access to clinical data and the subsequent development of algorithms may be so profitable in the long run that Google may be willing to provide a web-based EHR inexpensively, thu providing a means to lure hospital clients away from their current EHR vendors. Essential for such a switch will be the availability of efficient tools to convert current a hospital's current EHR database to the Google cloud (see: Switching EHRs? Get the Data Conversion Correct). Obviously, current EHR vendors like Epic and Cerner would fight such a switch tooth-and-nail and perhaps even lower their prices.